The government’s decision to re-open schools last week after a prolonged closure has been greeted with mixed reactions by parents, who, while welcoming the decision to resume physical classes, have also raised concerns over possible health risks children could face once they go back to school.
As most students have spent inactive lives within the confines of their homes during the prolonged holidays, many parents are worried over injuries they could get from taking part in outdoor field activities, including the inter school rugby and cricket matches currently taking place. They want to know what kind of sports are safe for their children to play. Others worry that their children will once more be expected to carry heavy school bags.
They seek professional advice on how school bags should be packed and carried given the risks of slouching and spinal deformities. Still others are anxious over adverse mental and physical health impacts on their children who will now spend three days doing online studying under the new phased off study program plus two days of learning at school till the fuel shortages ease.
To allay their fears, The Sunday Observer sought the advice of Head of Rehabilitation Services, MJF Charitable Foundation, Dr. Gopi Kitnasamy. He offers parents and students simple Do’s and Don’ts that could prevent / reduce the above mentioned risks , emphasising the fact that active participation by parents alongside their children in such activities, will help them stay fit, and less vulnerable to developing early noncommunicable diseases ( NCDS).
Excerpts
Q: The Covid pandemic lockdowns followed by the current transport issues has compelled children to spend more time indoors watching T.V. or playing computer games. This lack of adequate outdoor activity exacerbated by unhealthy food has already left its mark in the rise of obesity in children leading to early diabetes, hypertension and cardiac problems. So tell us, how important are outdoor activities for children?
A. Outdoor activities form an important part of their life and have 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: 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, organised activities like running, gymnastics, swimming and tennis are good choices. And children above 10, are typically 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 is your advice about the risk of injuries from these sports?
A. We need to take into consideration the risk of injury in returning to sport after long lockdowns, the extended periods of online activities and reduced physical activity. Students should adopt a phased and gradual approach to get back to their sports and always follow the advice of their coaches. Jumping, maximal accelerations and decelerations, rapid changes of direction, and expressions of maximal speed as the players try to outmaneuver each other may account for the rise in injury rates during sports.
Q: How can their adverse impacts be reduced or avoided?
A. 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. Proper physical conditioning can go a long way toward keeping players off the injured list and on top of their game.
The other important strategies to prevent sports injuries are being in proper physical condition (strength & 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. Coaches should assess the physical activities students were able to do during the lockdown as a starting point for the reintroduction of formalized training.
Q: Sitting at their desks while writing in the classroom or during online activities can also lead to wrong posture habits that could cause health issues. What is your advice on posture and its importance?
A. Good Posture is very important to avoid spinal and other related problems in the future. Encourage children to stand like a soldier, with head up, shoulders back and tummy in. Sitting in good posture in the classrooms and during online activities are always important. Classroom furniture are ‘One size fit all’ types and not adjustable which is not always ideal, but children can sit well by bringing their chair close to the table, sitting back in the seat with their back upright. They should avoid hunching over textbooks and be given the opportunity to move about during long lessons.
Q: Heavy backpacks have also been cited as a cause for many health-related problems to children. What effect will this extra strain on their back cause on the growing bodies of these children?
A. When undue strain falls on the back, it can lead to poor chest expansion, decreased lung capacity and poor stamina. The backpack should never weigh more than 10% of the child’s body weight. The heavy load causes them to lean forward to battle the pain in their shoulders. This in turn leads to postural and other problems.
Q: Such as?
A. The wrong or heavy backpacks can lead to several problems. It can cause bad posture, tired muscles, spinal problems, Scoliosis (“S”curvature of spine) and, if unchecked, severe ailments like a compressed spinal nerve. The weight of larger backpacks can affect a growing child’s posture and spinal health. Other joints besides the child’s spine can be affected because a heavy weight can throw the neck, shoulders, and pelvis off balance.
Q: What about the way children carry their bags, some slinging it on one shoulder only?
A. Holding the bag in one hand by its straps or carrying the bag over one shoulder can affect their posture permanently. An incorrectly packed backpack or an incorrectly fitted backpack can also harm the child’s health.
Q: So what’s your advice to the parents on selecting proper school bags, packing and carrying techniques?
A. My advice is that they should always be aware of their child’s spinal health when purchasing a school bag. Purchase backpacks with wide, padded shoulder straps and a pelvic strap. This will help distribute the weight to the hips and take weight off the back. Encourage children to wear their backpacks over both shoulders. Pack the heaviest items so they are closest to the child’s back. If the heaviest items are packed further away, this throws out the child’s centre of gravity and causes unnecessary back strain. Make sure that items can’t move around during transit, as this could upset your child’s centre of gravity, use the backpack’s compartments.
Q: Obesity in children is an emerging problem in Sri Lanka as it leads to early diabetes and other non-communicable diseases. Is this due to lack of exercise? Diet?
A. Childhood obesity is a complex health issue. Lack of physical exercise in children is the main culprit in the startling rise of childhood obesity, heart disease, diabetes, and all other types of preventable medical conditions. Other behaviours that influence excess weight gain include eating high-calorie, low-nutrient foods and beverages, sedentary activities such as watching television or other screen devices and sleep routines.
Q: Can obesity adversely impact on children who wish to excel in the sports field? How?
A. Obesity can cause limitations of the cardiopulmonary and the metabolic systems, resulting in exertional dyspnea (shortness of breath or difficulty in breathing), contributing to the limitations in the functional capacity. In addition, the sedentary lifestyle often adopted by these children contributes to impaired exercise tolerance and poor 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 needs 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 very good choices.
Q: Advice to parents to help prevent development of early health issues in school children?
A. Get children active after school, at weekends and during holidays. Remember, an active parent equals an active child. So while encouraging your children to go outside and play, participating alongside them in such activities will motivate and encourage them further. Like a weekly family walk, or cycling which is becoming a popular trend due to transport problems. Teach your child to ride a bike and cycle together.
Go for a swim together. Don’t just use the park or beach for a picnic, do something active too like kicking the ball around or running a race. Enter your family in events like a fun-run or bike ride. Take the stairs, rather than the lift or escalator, and ask your children for a little help with carrying the shopping bags. During the wet weather, find ways of being active indoors as a family.