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Questions: Please E-Mail your questions to the National Youth Sports Safety Foundation.

nyssf@aol.com

Question:
I just came back from my daughter's state tournament field hockey game against Sandwich. They lost a tough battle 2-1, but my concern is that the Sandwich team fielded two boys on their team who dominated the ball for the Sandwich team. They took every free hit, shot every goal and passed the ball between them - while the rest of the Sandwich players (girls) barely touched the ball.

My daughter had the daunting job of marking the top boy player and was doing an awesome job until he high sticked a drive while she was marking him and landed his stick on her hand. He was penalized, but I just spent the evening in the emergency room. While her hand is severely bruised- there are no breaks. After the injury he scored to win the game.

I am very concerned about the current trend of boys playing field hockey on girls teams. This is a physical sport with players being matched up against one another. Boys are just stronger physically and the chance of injury occurring is great. My daughter is a very tough, excellent player who can keep up with the best of them but this trend I fear is a safety issue. A 120 pound girl is simply no match for a 175 pound guy. What does the NYSSF think?
Many of the cape teams and teams elsewhere in the state are adding boys so that they can WIN. They use Title IX as an excuse. They claim it is so the boys have a chance to PLAY- I say bologna- they can start a boy's 6v6 league (if they can't get enough bodies for 11 v 11) and get the competition the boys seek against their own gender. No one would expect lacrosse to be coed, no one would expect soccer to be coed, no one would expect rugby to be coed. They are similar sports to field hockey, yet also not conducive to mixed play.

Teams like my daughter's team who are purely talented girls simply do not have a chance. Some teams now have 4 boys on their roster. Why can't these schools start boys teams? In 10 years with this current trend, most teams will no longer start many girls-the sport will be dominated by the boys. This year's Boston Globe All Scholastic player of the year will most likely be a boy. Parents across the Commonwealth are irate and the Massachusetts Interscholastic Athletic Association says they have their hands tied because of Title IX.

Your opinion is greatly appreciated, from both a personal and professional view.

Answers:
1) Sports for children should be fun. This trend certainly is taking the fun out of field hockey for many young women. The potential for head injury (with an actual potentially fatal injury in a Mass HS last year) underlines the need for helmets and face guards in field hockey. Paul Vinger, MD, Protective Eyewear Certification Council, Tufts University School of Medicine, Lexington Eye Associates
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2) Things shouldn't be the way they are. Coed teams are great in principle, but they don't always work out. When girls play on boys' teams, they understand the chances that they are taking.
Boys can be better developed, bigger, and more muscular. However, what chances does a boy take when he plays on a girls team? Certainly, he probably won't encounter any physical abuse. If one or two boys on a girls team tend to dominate play, then that's wrong. It's unsportsmanlike. How many boys should be allowed to play, three, four, six, ten? Obviously some restraints have to be used. If boys are allowed to play on girls teams, then I don't know what the solution is. Safety is an important factor, and you might say that allowing boys to play on some girls teams is plain unsafe! Alan Ashare, M.D., Chairman, USA Hockey Safety and Protective Equipment Committee
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3) During my 47 years of involvement in youth sports at the interscholastic and youth league levels we have often debated the need for additional rules, regulations and policies to govern athletic competition. My criteria for each proposed addition or revision have been the following:
l. Does the proposed change promote the safety of the participants?
2. Does the proposed change promote fairness in competition?
3. Is the proposed change enforceable within the structure of the sport in its present form (namely, is the change enforceable financially and administratively)?

I am not familiar with the court's interpretation of Title IX in Massachusetts, nor do I know the results of appeals by MIAA (Massachusetts Interscholastic Athletic Association) regarding the issue of boys or girls playing in non-traditional sports. However, it is clear that the situation described in the e-mail from the parent of the injured field hockey player disqualifies boys from playing in girls interscholastic field hockey games when the three criteria listed above are applied. Any time changes if rules, regulations and policies fundamentally change the way a sport is played, there will be repercussions. These
changes should be anticipated by those who propose the changes. The consequences of these changes are also the responsibility of those who govern the sport.

You asked for my personal and professional opinions. I have given my personal opinion, but I hesitate to call it a professional opinion because I am unaware of the details surrounding the situation. The issue you have raised is not unique to Massachusetts. Perhaps the National Federation of State High School Athletic Associations has solutions that have been tried and proven effective by states under their auspices. I hope this is helpful. Vern Seefeldt, Ph.D., Professor and Director Emeritus, Institute for The Study of Youth Sports, Michigan State University
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4) The writer is correct that a game of physical contact is different than a game of pure skill (i.e., archery) which does not rely on physical contact as a tool to win. Male and female adolescents are very different in ability and aggressiveness. In a contact or collision sport some adolescent boys may have a distinct advantage. I'd use the precedent that in Pop Warner football, there is a weight limit to try and prevent unfair physical advantage of heavier kids. Daniel S. Rooks, Sc.D., Tanger Be Well Center, Beth Israel Hospital

Question:
My 12 year old son had his first football practice yesterday. This is his first year playing football. He complained that his helmet was so tight that he had to sit out from a headache a couple of times. Is there a danger in a helmet fitting too tight?

Answer:
If one has to choose between a too tight fit and a too loose fit, the tighter fit is the better choice. It is not uncommon for a youngster wearing a helmet for the first time to complain it is too tight and hurts. Football helmets in particular need to fit very snugly. Football helmets
have a chin strap which helps to stabilize the helmet on the head and even helps attenuate energy on faceguard impacts. Chin straps are not the best at keeping helmets on the head. Neck straps like used on motor sports helmets are better for keeping the helmet on, but in football the helmet could be moved in such a way that the neck strap might apply dangerous
pressures to the larynx and other delicate throat structures, making the chin strap the better choice but to keep a football helmet on and in place the fit needs to be snug (snugger than most helmets) and the chin strap tight. With all of that said, the helmet should not be painful to wear. It is possible to get the helmet so tight that some blood supply to the scalp
can be compromised leading to numbness and pain. Tight, even uncomfortably tight, and even a report of headache and red marks on the fore head are not necessarily signs a helmet is too tight, but the fit should be evaluated and adjusted according to the manufacturers instructions. Most manufacturers say snug and firm to the point the fore head skin moves with the helmet, but not so tight as to be painful. Also keep in mind that most helmet padding
systems are thermo sensitive and will get softer and break in over time, some will even get loose enough after a week of wear they need readjustment. In short keep it snug, but not painful. David P. Halstead, Technical Director, Southern Impact Research Center, LLC.

Question:
I am an athletic training program director trying to get ready for the upcoming school year. For one of my courses I would like to teach about the development (physiological) of youth and what the guidelines are for youth participation in sport/conditioning/weight training. Unfortunately, all of my text are failing to give me the information that I need. Are their any recommended guidelines in these areas and what is the reasoning behind them?

Answer:
The topic of youth strength training continues grow in popularity and interest. Over the past decade all major health and fitness organizations have published position statement papers on this topic. You might be interested in a paper entitled "Youth resistance training: position statement paper and literature review" which was published in Strength and Conditioning in 1996. (It is also available from the National Strength and Conditioning Association 719-632-6722). More recently, the American Academy of Pediatrics published an updated version of their position paper in the June 2001 issue of Pediatrics. Lastly, a book I co-authored entitled Strength and Power for Young Athletes (Human Kinetics) highlights safe and effective strength-building exercises for kids ages 7-15. Avery Faigenbaum, Ed.D., University of Massachusetts, Boston

Question:
Would you have any advice for the father of a 13 y/o boy playing football about the use of knee braces prior to any injury. I'm a radiologist and see lots of MRI's on young adults with torn ACL's and menisci. I think I read something a few years back about Ohio State football players using preventative knee braces. Kids are starting to get big enough to hurt each other at my son's age. Thank you

NYSSF Response:
The use of prophylactic knee braces in football remains controversial. Some colleges brace large interior linemen. No one at this time can say if bracing child athletes could prevent ligament injuries, particularily of the ACL, since these are usually "noncontact" injuries, from twisting or cutting. These forces are very difficult to control with braces. Lyle J. Micheli, MD, Director, Division of Sports Medicine, Children's Hospital, Boston

Question:
My 6 year old is starting football this year. He has gone the first two days of a week of conditioning. I don't think some of the exercises are appropriate for his age group. He seems to be doing the same conditioning as my twelve year old son. My concern is that he is not strong enough yet to do the conditioning right and he will end up hurting himself. Will you please send me some ideas on the exercises a six year old should be doing to prepare for football? Thank you for your time, K

NYSSF Response:
A 6 year old is physically and mentally less mature than a 12 year old. As such, conditioning programs need to be modified for specific age groups and abilities. Too often, coaches make the mistake of using the same program for all young athletes. This can result in injury (and drop-out from sport due to feelings of enbarrassment and failure). Further, coaches who work with young children should focus on the development of fundamental fitness abilities (ie, running, jumping and catching) as opposed to the development of sport specific skills. Above all, programs for 6 year old kids should be fun with lots of movement. Although the question of whether or not a 6 year old should be playing competitive football is debatable, it seems that this program is too advanced for the young child. My suggestion is to find another sport or activity characterized by qualified coaches who make the experience fun for all kids--regardless of fitness and ability level. Avery Faigenbaum, UMASS-Boston

Question:
A friend of mine has a son who is a 13 year old hockey player. Tecnically he should be playing at the Pee-Wee 'AAA' level as a second year Pee-Wee. However, since he has been 'fast tracked' along the way has already played two years Pee-Wee and is set to play Bantam 'AAA". In fact he has been rated as one of the best players in his age group across Canada.

Recently he was selected to play Midget 'AAA' due to his maturity, talent and ability. This would be a jump of two playing levels or classifications. However, there is debate from the Minor Hockey Association as to whether it is in his best interest to play at this level due to the perceived risk of injury above and beyond the normal risks of the game.

Please note that the players at the Midget level are generally 15 and 16 year olds, although there are some 14 year olds playing. It is worth mentioning that the size of the player in question is not an issue nor is his ability to handle the level of play. He has played against boys of the Midget age classification for a number of years during the post-season
'Spring-time' hockey.

My question is whether there have been any reports published in North America which support the view that, in terms of physiology (tissue, tendons etc.), there are no obvious additional risks of injury (ie above the normal risks associated with the game) for a 13 year old playing Midget hockey than those for a 14-16 year old playing Midget hockey. In other words, is there any difference in the physiological make-up of a 13 year old and a 14-16
year old which put him more prone or at a greater risk to injury.

Thank you for your consideration in this matter. T.

NYSSF Response:
1) The key from my perspective to moving kids up is their individual level of maturity, both physiological and psychological. Chronilogical age is not the best measure of at what level a child should be playing, or is capable of playing. If the child is much smaller there could be significant risk. Dr. Tom Crawford, eteamz, Vice President, Education/Motivation/Strategic Relations

2) The question posed is difficult to answer from a scientific standpoint. When I was on the Committee to study appropriate date of birth determinations for eligibility in youth ice hockey, we could find no evidence that the smaller, younger players, when playing with older, larger players, were more likely to become injured. However, in-house testing we did at the Youth Sports Institute indicated that the peak height velocity of male hockey players in Michigan (1986) occurred at age fourteen years, eight months, but their ability to benefit from this growth occurred eight months later. In other words, the fact that a boy was larger than his peers did not immediately transfer into motor prowess or the ability to skate faster or shoot the puck faster.

My concern is as much with the emotional and psychological problems that such a change
in playing environments could bring. Even if the thirteen-year old boy is physically as skillful and biologically as mature as his fifteen-sixteen year old teammates and opponents, is he as mature socially? With all of the concerns about drugs, alcohol, tobacco and age-inappropriate sex at these impressionable ages, is the three-four age range too large for the player's best long-term development.

My consent to the "fast tracked" arrangement would only be granted if I was assured that the conditions that equalize competition among young players had been met.e.g. physical size, biological maturity, skill level, and social maturity. Finally, I would want the situation supervised by a coach who understood the ramifications of mismatching in any one of the
four categories. Vern Seefeldt, Ph.D., Professor and Director Emeritus, Institute for The Study of Youth Sports, Michigan State University

3) This is a very important question. Are younger players at risk from injury from
older players? One thing is to consider the size of the player, but I don't believe that I've seen a study showing that, when a size differential occurs in youth athletes, it is the smaller player that gets hurt more often than the larger player. In fact, anecdotes and a paper on youth football (about 6 or 8 years ago) suggest that the reverse is true, the larger player gets hurt more often than the smaller player. This player is in Canada, where the age groupings are slightly different: In the USA, this player (age 13) would be a first year Bantam; Moving him up to the Midgets in the USA would be a jump of only one playing level.

I know of no study that suggests that the physiological make-up of a 13 year old would make him more liable to sustain injuries when playing with players who are 15 or 16 years old (Midget age). At the high school level, we have 14 year olds playing with 18, 19, and 20 years olds, and I don't know of any additional incidence of injuries at this level. I think that a
greater problem would be the emotional strain of a 13 year old playing with 16 year olds. But he seems to have conquered that problem. Alan B. Ashare, M.D., Chairman, USA Hockey Safety and Protective Equipment Committee

Question:
My 7 year old is training for his jr. black belt in karate. I am concerned about the number of push -ups he is required to do along with the running time that is required. He is to do 60 push-ups within 2 minutes and run 1 mile within 10 minutes. Are these appropriate for a 7 year old? Should he be doing this many push ups with his legs extended or should he have his knees bent? The required position is legs extended. The only other physical fitness component is 80 sit ups in 2 minutes but those do not bother me as much since there is no joint stress involved. Any thoughts would be appreciated. Thanks, MB

NYSSF Response:
First of all, with appropriate instruction and supervision karate can be a wonderful experience for children and can enhance muscle strength, aerobic fitness and certainly flexibility. My
concern regards the fitness testing that this child is subjected to. When properly performed and administered, fitness testing can help teachers and coaches track children1s progress, identify weaknesses, develop an individualized fitness plan and evaluate the effectiveness of the conditioning program. While pushup, sit-up and 1 mile run tests are routinely administered, the standards this child is expected to meet far exceed established norms. For example, according to the Prudential Fitness Gram, 7 year old boys should be able to perform 10 pushups to be in the "upper end of the healthy zone". To require a 7 year old to perform 60 push-ups in 2 minutes seems unreasonable and potentially injurious. Further, if children are encouraged to perform push-ups rapidly it is likely that their exercise technique will be flawed (and potentially result in an injury). Similarly, to ask this child to perform 80 situps in 2 minutes is also unreasonable and potentially injurious. According to national standards, 7 year olds should be able to perform 24 curl -ups. Note that the traditional sit-up test is no longer performed because during the last half of the situp test the child is primarily using his hip flexors (and this may stress the lower back). Lastly, the completion of the 1 mile walk/run in 10 minutes is also unreasonable. Interestingly, the Prudential Fitness Gram does not even recommend 1 mile time standards for children under the age of 10. In short, this "karate fitness testing" program should be modified and the instructors/testers should take time to re-think and re-design their assessment protocol. In my view, this type of test battery will likely turn most kids "off" of karate training and/or result in an injury. Avery D. Faigenbaum, EdD, CSCS

Question:
Could you let me know if your organization has a position statement against "checking from behind" in organized sport which many result in head or spinal injury. Thank you. JT

NYSSF Response:
The three amateur organizations controlling ice hockey in the United States (USA Hockey, NCAA, Federation of High Schools) have been united in their policy on "checking from behind." They have approached the problem in two ways: punitive actions, and educational programs.

Checking from behind carries a stiff penalty, either a minor plus a misconduct penalty, or a major plus a game misconduct penalty. Checking from behind can also be treated as an Attempt to Injure or Deliberate Injury of an Opponent penalty. These punitive actions have had some effect.

USA Hockey has instructed coaches and players on the dangers of checking from behind since 1988. In 1996, USA Hockey instituted the Heads Up Hockey Program to educate players about the dangers of checking from behind. The videotape, Heads Up Hockey Challenge, is shown to every player at the beginning of every season. There are two themes: DON'T check from behind and (when going into the boards) HEADS UP, DON'T
DUCK. The ideas behind these programs (and the videotape) can be seen on the
Massachusetts Hockey website (www.masshockey.com). Alan B. Ashare, M.D.

Question:
I have two grandchildren ages 6 and 10. We are considering the purchase of a trampoline for them. We have always thought they were too dangerous but the new safety enclosure sides appear to have minimized the injury potential. Please comment on the advisability of purchasing this trampoline. Thanking you in advance, Karen

NYSSF Response:
1) I am not familiar with this model of trampoline. I assume that the enclosures will prevent a child from falling off of the trampoline, or at least, keep the child on the trampoline when he/she jumps up. If the only problem with trampolines is that children were falling off
of them, then putting enclosures around the trampoline might "make them safer." However, other problems with trampolines are that children can land on their necks on the trampoline, and cause serious damage. My feelings are that they should shy away from this purchase, unless the grandparents are willing to provide a full time qualified person to monitor their grandchildren's activities while on the trampoline. The addition of enclosures does not solve all of the potential serious problems with this piece of equipment. Alan B. Ashare, M.D., staff physician, St. Elizabeth's Medical Center of Boston, Chairman, USA Hockey Safety and Protective Equipment Committee

2) I don't know what percentage of injuries actually come from the participant leaving the device. It seems that the enclosures would minimize that. I wonder if they have been designed so that it is impossible to clear the sides. I would hope that was thought out but if not the enclosure could add to the hazard. My gut is that many, perhaps a large percentage, and some serious injuries can occur without leaving the device and as such trampolines might still be considered too dangerous compared to the potential benefit. I know at UT the tramps have a sophisticated harness system to reduce injury risk, if a jumper (usually a cheering squad member) is out of position a spotter can actually stop their fall prior to impact to
the tramp or elsewhere. That seems like the best approach, but it likely is not feasible for a backyard type. David P. Halstead

Question:
I am writing because I would like some information about vanadyl sulfate. It's a sport supplement and also has been used in medical applications for diabetes. I am only 20
years old and am taking kineiolosy at university, so I don't know whole lot about this compound. I am very interested in sports medicine, but I don't really know who to talk to about it. Anyway, please help me with the vanadyl information, I want to take it to spike insulin levels while taking creatine and working out. I heard that it is safe if taken at about 45mg per day, I think it was mg anyway. Thank you for your help, if you have any info about the compound or about sports med stuff I would appreciate it.

NYSSF Response:
There is very little research on this for humans. It is a mineral that functions to help insulin transport glucose into muscle. It is not an essential mineral - there is no RDA for it. The small amount of research done has not shown it to be effective in enhancing performance. Most weight lifters have moved away from using this because they find it does not
work. So, it is most likely a waste of money. Priscilla Clarkson, Ph.D.

Question:
My 5 year old is dying to play paintball with his cousins when he goes there for a visit in 3 weeks. I don't know anything about the game, except that it can be extremely dangerous. The last time his cousins played, they weren't wearing protective headgear and one of them sustained a serious eye injury. Could you please send me some information as to the positives and negatives of this game. Thanks, TP

NYSSF Response:
Paintball to the unprotected player is extremely dangerous. However, with eye protection that is certified to ASTM F1776, the game is quite safe, if played on a supervised playing field that follows the guidelines of ASTM F1777. I would allow a child to play paintball on a field that is insured and gives documentation that they follow ASTM F1776 guidelines for paintball
field operation. With a protector that conforms to ASTM F1776 for paintball and proper equipment and supervision, the risk of injury would be quite small--probably far safer than riding a bicycle. Paul Vinger, M.D.

Question:
First year, middle school, girls volleyball coach has had an 0-8 season. He starts having the girls jump in a blocking drill 210 consecutively without rest. The girls complain of aching legs and see it as punitive. (Especially since this was started the day before a game.) I am more
concerned that more damage will be done by overuse (jumpers knee) or increase the risk of ACL injury. Am I justified in my concern or just being over protective? Thank you in advance for your input. MR

NYSSF Response:
1) Girls' volleyball certainly requires jumping ability, and several vertical jumps may be executed in playing a point. However, this number would not exceed 10, and would not be performed consecutively. First, the total number of practical jumps should be reasonable (e.g. 30 jumps), and they should not be performed without rest for more than a few consecutive jumps (e.g. 3 jumps). Second, as in any conditioning program, the girls should start with a small number of jumps and gradually progress to more total jumps. Repetitive jumping places great stress on the ankle, knee, hip and low back joint structures, as well as on the muscles of the lower leg (shins and calves), due to both propulsive forces and landing forces. Such repetitive stress is particularly risky for growing preadolescent girls and should not be encouraged. A sensible strength training program combined with low quantity - high quality jumping drills would be much better advised for safety purposes, and undoubtedly more productive from a sports performance perspective.Wayne Westcott, Ph.D.

2) I read your comment and I am greatly concerned about the conditioning program these young volleyball players are required to perform. Not only does this training regimen seem inappropriate for young athletes, in my view it is likely to cause an injury. While jumping drills can be gradually incorporated into an athletes training program, I find it unacceptable to perform 210 consecutive jumps the day before a game. Your concerns are justified and your interest in the well-being of these young athletes is noteworthy. The conditioning drills for these young athletes need to be modified immediately. It may be beneficial for the volleyball coach to work with an athletic trainer and a certified strength and conditioning specialist in order to design a program that is consistent with the needs and abilities of first year volleyball players. Sensible conditioning programs for young athletes can be found in our new book called Strength and Power for Young Athletes. Avery D. Faigenbaum, Ed.D., CSCS

3) It is difficult to evaluate a training program using a description of one point in time and not knowing about the rest of the season. However, based on the information you provided, the Email contains some disturbing facts. First, the number of repetitions is extremely high for a first day for the age group. This is assuming that the coach did not have them jump in place or something else requiring exertion of similar intensity. Second, regardless of the level of conditioning of the players, the report of sore knees and discouraging attitudes suggest that this is a significant increase in the physical "conditioning" they have been experiencing and a clear training error. Third, the "drill" was introduced to these young players the day before a game. I would not be surprised to hear that many of the players experienced excessive soreness the day of the game, which resulted in lower than typical performance. While a jumping drill may be appropriate for volleyball training, the repetitions (number of jumps) and timing (mid-season, before a game) of this drill are inappropriate for middle school girl volleyball players and are putting the players at unnecessary risk for injury and premature discouragement with the sport of volleyball. Daniel S. Rooks, Sc.D.

Question:
I am a sports teacher in Botswana, Africa and I am very involved in the development of
swimming in Botswana. I work with children between the ages of 6 and 13, from the beginner swimmer to the primary school competitive swimmer, but our resources and information here are very limited. What I need your advice on is whether swimming butterfly is recommended for
children under 10 years. At present, we start teaching fly drills to children as young as 7 and they compete in 25m events from 8 years. Is this going to develop shoulder or back problems at this or a later stage? We also start developing the breaststroke, will this cause knee problems?
Any advice in this are would be greatly appreciated. VI

NYSSF Response:
As regards to these swim strokes, I believe they can be safely taught to younger
children, but the volume of training must be limited. Total distance in
these strokes should be limited to about 1000 yards per day. L J. Micheli, MD

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