The latest decision by Health and Education officials to place outdoor school activities high on their agenda has been welcomed by most health authorities concerned by the rising number of early non communicable diseases ( NCD) due largely to lack of exercise, starting from early childhood through adolescence to adulthood. Now that the new term and sports meets, cricket matches and related outdoor activities are about to commence in April , Chartered Physiotherapist, Dr Gopi Kitnasamy says there has been a disturbing rise in sports injuries in the past few years, which could be rectified with simple exercises instead of surgery. As he points out, “ Lots of children shy away from seeking treatment because they are afraid of surgery. The goal of a physiotherapist is to heal without surgery. Surgery is only recommended as a last resort. However, if treated early most injuries can be cured permanently without even scars”, he told the Sunday Observer in a recent interview.
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Q. The Health Ministry and Education Ministry recently decided to give priority attention to school outdoor sports with the idea of promoting fitter students for the future. Is this a good thing?
A. Yes it is. Outdoor activities form an important part of their life and has long term benefits on their health. Adequate outdoor activity increases health and physical development by improving sensory development, reducing obesity and stimulating blood cells. It helps kids stay fit and active which will benefit them in the long run. They can ward off health problems like obesity and heart ailments later in life. Participation in sports activities improves physical fitness, coordination, and self-discipline, and gives children valuable opportunities to learn teamwork.
Q. There have been recent incidents where children have fainted by too much exposure to the sun . Your comments?
A. While too much of the sun’s warm rays can be harmful to your skin, the right balance can have lots of benefits. The vitamin D thanks to the sun, plays a big role in bone health. Low vitamin D levels have been linked to rickets in children and bone-wasting diseases like osteoporosis and osteomalacia. Doing outdoor activities before noon when the sun is very hot these days, for 30 minutes to an hour would be fine.
Q. What outdoor sports should children play to get the maximum benefits?
A. I would say, always consider age-appropriate activities with children. Your child is likely to show natural preferences for certain sports or activities. Start there, keeping your child’s age, maturity and abilities in mind. For children of ages 6 – 9, organized activities like running, gymnastics, swimming and tennis are good choices. Children above 10, are ready to take on complex skill sports, such as football, basketball, hockey and volleyball. Keep in mind, however, that growth spurts caused by puberty can temporarily affect a child’s coordination and balance. Before allowing your child to participate in a contact sport, consider his or her age, maturity, and physical size. Whatever sports your child participates in, ensure that he or she has a foundation of proper technique and movement.
Q. What about the risk of injuries from these sports?
A. All sports have a risk of injury. In general, the more contact in a sport, the greater the risk of a traumatic injury. Most frequent sports injuries are sprains (injuries to ligaments) strains (injuries to muscles), and stress fractures (injury to bone) caused when an abnormal stress is placed on tendons, joints, bones and muscle. The developing bodies of the children are more vulnerable to injuries compared to that of adults. Fortunately, most sports injuries in children can be prevented. Some of the more effective ways to prevent these injuries include age-specific coaching, appropriate physical conditioning, and proper use of equipment. You can also prevent injuries by encouraging children to train for their sport, rather than rely on the sport to whip them into shape. The other important strategies to prevent sports injuries are being in proper physical condition (strength and flexibility), wearing appropriate protective gear, making warm-ups and cool-downs part of the child’s routine before and after sports participation, staying hydrated and stopping the activity when there is pain.
Q. Are there specific exercises for each sport?
A. Exercises for children should include the three important elements – endurance, strength and flexibility. Endurance develops when kids regularly get aerobic activity (sports) which if done regularly strengthens the heart and improves the body’s ability to deliver oxygen to all its cells. Improving strength doesn’t have to mean lifting weights, they can do push-ups, crunches, pull-ups, and squats to help tone and strengthen muscles. Stretching exercises help improve flexibility, allowing muscles and joints to bend and move easily through their full range of motion.
Q. Do they have to be done on a daily basis and how long will they take for students who have little time to spare?
A. These exercises will take 45 – 60 minutes and can be done on a daily basis but all three elements need to be given equal importance.
Q. What happens if an injured student neglects getting himself treated?
A. If management of sports injury is neglected or delayed it can lead to adverse outcome. When muscle is injured and not treated, it can lead to scar tissue formation and the muscle can loose its flexibility and neglected ligament and joint injury can bring about soft tissue (ligament) loosening and joint instability. This may lead to the repetitive injury and eventually more serious functional loss and will force you to get out of your sport.
Q. What kind of injuries need surgery?
A. Surgery is often considered a last resort, it is commonly used following a serious injury or as a result of persistent symptoms.
Common surgical procedures in sport include repair to damaged cartilage and ligaments in the knee (especially crucial ligament tears), AC shoulder injuries, dislocations and tendonitis. Surgery can usually be used to repair damaged soft tissue, align bones and re-position joints.
Q. What injuries can be treated with physiotherapy and what are the latest treatment options available?
A. Most sports injuries which can be treated with Physiotherapy are musculoskeletal and soft tissue related. Managing and preventing injury in children requires a different approach to adults. Children’s bones are still growing and the presence of the growth plate or apophysis creates a group of conditions unique to children.
Laser therapy is now a popular, safe and effective method of accelerating recovery and is particularly effective for acute soft tissue related sports injuries.
Q. Is swimming also liable to result in injury? How?
A. Swimming is a fantastic sport that combines all body strength, flexibility and endurance. Swimmers are unfortunately prone to overuse injuries affecting the shoulder, neck, lower back and knees. Training errors such as overtraining, overloading, or poor technique may also contribute to this condition.
Q. Can these injuries be treated with physiotherapy? Is there a special treatment you recommend for such injuries?
A. Treatment involves corrective exercises and elctrotherapy but more importantly, finding the root cause of the injury and modifying stroke technique to prevent the issue from reoccurring. Avoid overtraining in one particular style of swimming. Core strengthening, rotator cuff strengthening (very important – to prevent shoulder injuries) and land based exercises done pre, post and during your swimming season.
Q. Are there home remedies for sports injuries?
A. You can treat some of the minor sports injuries at home. Follow the acronym R.I.C.E. as a first aid. Rest the area, apply Ice, Compress it with an elastic wrap, and Elevate it.
Ice therapy, cold therapy also known as cryotherapy, is one of the most widely known and used treatment modalities for acute sports injuries. Apply only for 10 minutes but you can repeat it 3-4 hourly. The application of ice to an injury, in the acute phase can substantially decrease the extent of the damage by decreasing the amount of bleeding by closing down the blood vessels. Reducing pain, reducing muscle spasm, reducing the risk of cell death by decreasing the rate of metabolism
Q. Is leading an active life a pre-requisite to doing well in sports? Why?
A. Yes definitely, staying active and healthy, reduce the chance of future injuries from occurring, and improve overall performance. A well balanced diet, healthy eating habits, adequate fluid intake and good sleeping routines are also important to improve sports performance.
Q. What exercise do you recommend for obese children to get down their excess fat?
A. Obesity in children often is the result of a sedentary lifestyle. Exercising to reduce weight is very important but need to be carefully monitored.
Asking children to elevate their heart rates to a heightened aerobic exercise rate for 30 minutes or longer may be dangerous. Start with an exercise pace that resembles a brisk walk, rather than a jog. Warm up slowly for the first few minutes, let children take breaks as needed and make sure they drink water whenever they become thirsty. Obese children may develop joint or back pain if they perform repetitive, high-impact exercises like running, aerobic dancing, jumping or skipping. Low impact exercises like cycling and water jogging and aerobics are good choices.
Q. Your advice to parents?
A. Active parent equals active child. Parents must make a concerted effort to encourage their children to go outside and play and do these exercises along with them.