TrueSport: September 2020

How To Balance Safety and the Return to Sport

While the question of if your team is allowed to return to sport will likely be determined by municipal government and school board regulations, how you return to sport may be up to you as a coach and/or parent.

Dr. Leon Kelly, county coroner in El Paso County, Colorado, and one of the officials determining local policies around COVID-19, has some advice about how to safely return to sport. In addition to providing this guidance to the public, he’s applying best practices as an assistant coach for his young son’s baseball team, giving him firsthand insight into how play can be reinstated as safely as possible.

Understand the balancing act

Right now, public health officials like Kelly are facing a nearly impossible challenge of balancing normal standards of health and well-being for children, like structured exercise and socialization, with the concerns around the COVID-19 pandemic.

“Return to sport is a giant risk versus reward equation,” Kelly explains. "How much risk are you willing to tolerate to get the benefits? We know that sports are an absolutely critical component of health, socialization, self-esteem and learning to overcome failure and disappointment. We don’t want to lose that.”

When balancing the costs and benefits, return to play has largely become sport specific. Sports that are high-touch like wrestling, football, and basketball are unlikely to return this season in most school districts, but sports like baseball and tennis that are low contact might be allowed to resume practice, says Kelly.

Focus on low-touch elements

“Remember, a single case can quickly lead to a large-scale outbreak, especially as schools re-open and athletes are in contact with more people regularly,” Kelly notes. That means for many districts, practices may be allowed to resume, but competition that puts athletes in close contact with teams from other areas is out of the question.

If your sport is currently out of bounds for competition, consider how you could return to play in a way that is low-touch. Even football teams may be able to resume drills that would allow players to experience social benefits while minimizing contact.

Keep it small and structured

Local guidelines may control how many players you can bring together, but even if you are allowed to have larger gatherings, Kelly says that keeping numbers low and holding staggered practices may help mitigate risk.

There are also risk reduction strategies for competitions. “For our baseball team, for example, we have a couple of teams that we’ll play against all season, rather than playing against teams from all over the state,” he says. “We also set strict rules about how many parents can be in the dugout, what we would do instead of post-game high fives, and mask requirements.”

For both return to practice and return to competition, consider holding a virtual Q&A session for parents and team members about any new procedures and protocols before gatherings resume.

Ensure proper sanitization procedures

It’s best practice to discontinue communal offerings and implement sanitization procedures. For example, Kelly suggests swapping that communal Gatorade container with a big vat of hand sanitizer in the dugout. “On our baseball team, everyone comes with their own equipment, like bats and unfortunately, we’re not able to have the post-game snack together anymore,” he adds.

In general, ensure that shared equipment is regularly sanitized and that disinfecting wipes are always on hand. Write out a list of the equipment you’ll use at practice and how you’ll keep it clean, clarify any personal hygiene requirements like hand-washing pre-practice and set strict consequences for ignoring the rules.

Consider temperature checks and team masks

Checking athletes’ temperatures at practices is smart risk management, even if many children who contract COVID-19 are asymptomatic. The simple act of temperature-taking helps remind athletes of the seriousness of the situation -- and may save a life.

While wearing masks can be hard for younger athletes to understand, you’re more likely to get buy-in from all your players if you make them a fun part of the team uniform. “On our team, we had masks made with our team logo,” says Kelly. “Now, everyone is excited about wearing them! The rule is that they have to wear them in the dugout, but the masks can come off when they’re out in the field.”

Create a team code

“In our school district, kids and families are signing a pledge that says we’re doing certain things to mitigate our risks,” says Kelly. “We’re promising that we’re wearing masks when we’re out, we’re not engaging in high-risk activities, we’re staying home if we feel sick … basically, that we're going to do the right thing so that we can be positive contributors to our school's community.”

Consider a pledge like this for your team that both athletes and parents sign before returning to play.

*Change your philosophy *

“The culture of sport has always been that you tough it out, you rub some dirt on it, you keep moving,” says Kelly. "And that's often a fairly good philosophy. But in this case, the right thing to do is say, 'Hey, I don't feel good, I'm going to stay home.’ Or, 'I've been in contact with someone who tested positive for COVID-19 and I feel fine, but I'm still going to sit this one out.’”

In this case, the stronger decision isn’t playing through it, it’s staying home. This time offers an opportunity to help kids grow and learn how to be good teammates and leaders. "We just need to be realistic about what we're going to get out of this year and maximize those benefits for the kids,” Kelly concludes.

Takeaway

It’s a difficult time to decide if and how athletes should return to play. Keep these practices in mind as you decide when and how your athletes can safely engage in sports.

What Parents Need to Know About Sports Physicals

When your athlete comes home from school with a paper requiring a doctor’s sign-off before they can start the season, getting them in for the sports physical can feel like a chore. But really, the pre-participation sports physical is an opportunity for your child’s primary care physician to catch any underlying problems, check in with your athlete and make an honest assessment about their readiness for play. Here’s what Dr. Michele LaBotz, TrueSport Expert and sports medicine physician, wants you to know about why and how you can best tackle the sports physical.

It’s an important check-in

From injury recovery to body weight concerns, and irregular heartbeats to concussion recovery assessment, your child’s pre-participation examination isn't just another item to check off the to-do list with as little effort as possible. It’s a legitimate visit to a medical professional to determine if your child is healthy enough to play and it should be treated seriously.

Since these examinations often end with a simple ‘cleared for play’ stamp of approval, LaBotz says that it’s a task often viewed as an imposition, not a helpful intervention. “If you have a kid who's been really healthy and everything is fine, the physical may feel like a waste of time,” she says. “But I've done enough of these where we’ve found something surprising, like previously unrecognized vision problems or high blood pressure that, if left untreated, could become a lot more serious.”

It may be one of the few doctor visits your child has

“For healthy kids, the pre-participation examination may be the only time that they’re seeing a doctor all year and many doctors can combine them with a routine well child visit” says LaBotz. Insurance coverage can vary, but well child visits are often covered, while dedicated sports physicals often are not, so combining them typically works well.

Sports physicals should ideally be performed at least six weeks before the start of the sports season to allow for enough time to address any issues that may arise. It can help to keep this timing in mind when scheduling your child’s routine check-ups with their primary care provider.

Fill out the history together

The medical and family history are a very important part of the sports physical, and one of reasons why sports physicals are best performed in the primary care provider’s office. In addition, the sports physical forms typically have a section for parents and athletes to complete. Don’t just sign off on this or let your child fill it out alone. Sit down with your athlete and go through the past year in sport together.

“You’d be surprised how many parents hadn’t heard that their child had sprained an ankle or had a bad fall during practice,” says LaBotz. And on the opposite side, your child might have already forgotten about a pulled muscle or a mild concussion that you remember in vivid detail. You may also have more information regarding family health history that your child doesn’t think about, like a history of significant heart or lung disease.

They offer kids a chance to talk

It’s not just physical support that children might need: doctors are also tasked with assessing whether a child is dealing with any mental or emotional issues. For a young athlete, body image issues and disordered eating could be problems that would otherwise go undiagnosed. And because doctors are bound to confidentiality requirements, this might be the only chance your child has to comfortably discuss things like drug or alcohol use, performance-enhancing drugs and supplements, or birth control with a professional. These visits may help provide your child access to other resources, since a doctor can refer them to a therapist, registered dietitian or other appropriate expert.

Your child will likely be cleared for some play

“No doctor wants to keep children out of sport,” LaBotz says. They understand that children should have at least one hour of moderate to vigorous physical activity daily for general health. “But if the doctor does find a reason that your child shouldn’t play a certain sport, we can often provide clearance for an alternate sport. A common example these days are athletes who may have ongoing issues from a previous concussion. We would not be able to clear them for a contact sport like football or soccer, but there are many other options.”

Sports physicals aren’t created equal

It may be tempting to opt for a cheaper or more convenient urgent care or pharmacy-based clinic for your child’s sports physical. But that fast-food approach to medicine is doing your child a disservice. “Your child’s primary care doctor will be able to compare year-over-year data during a physical in a way that an urgent care doctor isn’t able to do,” explains LaBotz. “One of these fast visits where the doctor doesn’t know your child can easily result in them missing important signs or changes that could signal a more serious problem.”

Takeaway

While it’s tempting to prioritize speed and convenience when it comes to the sports physical, there are plenty of reasons why it’s important to take the process seriously and get your athlete to their primary care physician for this important examination.

Stress Better: How Parents Can Help Athletes Grow from Stress

Stress automatically calls to mind negative moments in life: A difficult upcoming test, a fight with a friend or parent, global collective stress like the coronavirus pandemic or even self-created stress about what others might be thinking. And yes, too much stress and too few resources to combat it can be a bad thing … but allowing kids to entirely avoid it actually does them a disservice.

Board-certified family physician and TrueSport Expert Deborah Gilboa, MD, specializes in youth development -- including stress management. Her main message to parents is that children need to experience stress in order to be prepared for later life and become effective leaders. "Our job as parents is not to protect them until they're adults. It's to ready them for adulthood. And the ability to deal with stress is one of our best tools,” says Gilboa.

Here, Gilboa explains how parents and coaches can teach young athletes how to process and handle stress, rather than bulldozing it away.

Understand your response to a child's stress

“From the time kids are very small, we have to be hyper-vigilant to keep them safe: There's no more helpless creature than the human newborn,” says Gilboa. “It’s natural to try and control absolutely everything that you can, but that won’t help your child grow and lead. Parents are hardwired to pay attention to every sneeze and cough, but then by the time our kids are adults, they suddenly need to be able to do everything for themselves.”

For nervous parents, Gilboa notes that despite the scary 24-hour news cycle, in many ways, it’s never been safer to be a child in the U.S.

Consider the source of the stress

“Very few parents get kids into sport to win championships or trophies, we’re just trying to teach them life lessons and as such, we shouldn’t deprive them of chances to deal with adversity and stress,” says Gilboa. This experience is especially beneficial in the semi-controlled environment of sport.

“Those experiences of getting benched or having to run extra laps or being second string, they’re all valuable life experiences even if they cause stress. Kids have to learn to put the group ahead of themselves sometimes. They have to learn to do stuff that they don't feel like doing. They have to learn to show up when they’d rather stay home.”

Lead with empathy

Often, a child’s stress can be lessened simply by having an adult acknowledge it and believe that it exists. While it’s tempting to laugh off certain stressors for a child, you have to understand that to them, a minor stress may feel like the end of the world.

“You can’t tell young people how they should feel -- it’s ineffective and disrespectful,” Gilboa says. “As parents, we sometimes think that if our kids are stressed, we have somehow failed them already, so we try to rationalize that if a child is stressed, they’re not ‘really’ stressed. So first, we need to recognize that our kids do have stress, despite what we may think about it.”

Help them understand their feelings

Often, a child will feel stressed but not be able to articulate that emotion. As adults, Gilboa notes that we can help children work through their complicated emotions and should make sure that they feel safe sharing how they’re feeling. This includes if someone is hurting them, if they’re being bullied, or if they feel uncomfortable. Ensure that your child feels he can share any emotion with you without judgement or immediate action on your part.

Use low-consequence opportunities for teaching

While you may consider an argument between your child and a teammate to be a dramatic annoyance, they might consider it a major stress. These smaller issues are great learning opportunities with low risk for your child.

Rather than trying to solve the problem for the athlete by phoning the coach or the teammate’s parent, use this as a chance for your athlete to learn about stress management. That may mean discussing how to confront the teammate, talking through some stress-relieving techniques like deep breathing or even having your child speak directly to their coach.

Stress can get out of hand

“As with sport, overtraining with stress is certainly possible,” Gilboa admits. “It’s important to make sure you’re not pushing your child too far.”

“If a child experiences too much stress from too many directions without the right support and training, they could become damaged—just like someone who runs once a week would be injured if they suddenly tried to run a marathon. It’s our job to help support our children to make sure they have what they need to deal with stress without over-taxing themselves.”

Promote a healthy lifestyle

It’s worth noting that some stress can be brought on or made worse by how your child is taking care of themselves. Stress is exacerbated by a host of physical influences, including hormones and sleep. Even overindulging in junk food or drinking too much caffeine can interfere with healthy reactions to stress. The simple solution is generally healthy living: Make sure that your athlete is getting plenty of sleep, hydrating and fueling properly, and exercising enough.

Takeaway

While it’s natural to want to eliminate stress for your young athlete, they need to learn to manage stress to prepare for adult life and sport provides a perfect testing ground to hone stress-management skills.

6 Ways Coaches Can Facilitate Peer Pressure for Good

Peer pressure is often viewed automatically as a negative: It’s shown in TV shows, movies and books as what the ‘bad kids’ do in order to convince ‘good kids’ to break the rules. But in the right contexts, peer pressure can be a leadership tool that’s used for positive outcomes.

Board-certified family physician and TrueSport Expert Deborah Gilboa, MD, specializes in youth development and knows that young athletes flourish when allowed to take on leadership roles, but she also points out that coaches still have a pivotal part to play in developing effective and positive leaders.

Below, Gilboa explains how to use your team’s social dynamics to improve and strengthen relationships and teamwork.

Peer Pressure is Inherently Neutral

“Peer pressure isn’t inherently positive or negative,” says Gilboa. “It’s leadership: Kindergarten teachers use peer pressure all the time. They say, 'I like how Tommy is sitting on his square and waiting patiently with his hands in his lap and then all of the other kids go sit quietly with their hands in their lap, thinking 'Notice me next!’”

This is the same reason that parents prefer their children hang out with friends with good habits. "Every time we put our kids into a study group, onto a team or into an extracurricular activity, it's because we recognize the power of social bonding to influence kids' behavior,” she adds.

Create Leadership Opportunities

Harnessing that positive peer pressure as a coach means focusing on the current team dynamics and using ‘social mapping.’ Social mapping -- figuring out which athletes have the most social credibility and power -- can help a coach decide who to put in charge of warm-up drills, who to ask to do demonstrations, or who can lead the team during a game.

Look for athletes who have that social power and who exemplify the behavior and attitude you want to see from everyone on the team. Encourage those athletes to lead.

Differentiate Between Leaders and Bullies

It can be challenging to keep social pressure trending positively, especially with a team that’s constantly acting out. Be aware of the warning signs of bullying, since peer pressure can turn negative. In fact, Gilboa notes that most peer pressure situations can be positive or negative simply depending on context, so you do have to pay close attention to the social cues and the intent behind leadership behaviors.

Use Your Own Social Cache

Whether you believe it or not, you’re the most powerful person at a team practice as the coach. "I tell mentors all the time that as a coach, as a counselor, as an adult, you actually have the most power. You're the coolest kid in the room.The kids want your attention. They want your approval. They want your admiration,” Gilboa says.

That means you have the ability to use peer pressure the same way a kindergarten teacher would -- just focus on the positives. “Point out to the group when an athlete is doing something right,” says Gilboa. “But when you’re correcting someone or pointing out a mistake, try to do so to the individual rather than the whole group.”

*Teach Respect Over Popularity *

Social cache and popularity aren’t always one and the same and that applies to your status as a coach. "We can't focus on popularity. If we focus on popularity, then kids' respect for us will actually decrease,” Gilboa explains.

Instead, focus on gaining their respect and your popularity will slowly over time go up, says Gilboa. “If you think about middle school teachers, the ones who were popular were really only popular with certain kids. The ones who are well-respected, even if they were tough, are generally respected by everyone.”

Purpose, Attitude, and Behavior

Utilizing positive peer pressure comes down to three tenants: purpose, attitude and behavior. "Teach athletes that you can always control your purpose, your attitude, and your behavior,” Gilboa says. As a team, try to lay out a framework for your season’s goals with these three things in mind.

Gilboa adds, “Leadership is about figuring out what tactics you are going to use to get a whole group to do what you want and if you control those three tenants, you're much more likely to get the outcome that you want in most situations."

Takeaway

While it has negative connotations, peer pressure is a leadership tool that can be used to achieve positive outcomes for teams and players.