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commerce magazine and by the record north jersey's trusted source and northjersey.com [music playing] [music playing] welcome to caucus new jersey i'm steve adubato kids are playing more sports than ever before too much training and a lack of rest can obviously lead to serious problems joining us in the studio today to discuss ways we can avoid these for our kids we have aline lewis who's a former competitive athlete who underwent spinal fusion surgery at age 42 can i say that? yes you did? but you were an athlete for many years before that and after and after [laughter] doctor christopher mendler is the director of sports medicine at holy name medical center he's been with us before he's back by popular demand phil hossler is a certified athletic trainer at east brunswick high school has been doing it for forty

years and diana stairace starace... excuse me is the injury prevention coordinator at rwj university hospital i want to thank you all for joining us there's gonna be websites up throughout this program where you can get information about how to protect your kids our kids from sports injuries doctor help us on this when i think sports injuries we have two young boys who are as we do this program nine and eleven i always worry about head injuries right? right is that the primary one we're talking about concussions head injuries? is that the primary injury of today a primary injury in yeah is that the... general that we're worried about when certainly talk about sports injuries is that the primary one? it's the hot topic right now and for good reason it's really not the only injury that's out there that we need to be thinking about and talking about what else are we talking about? but overuse injuries in young kids can range from chroniback issues you can have acute injuries obviously a big one to discuss is acl injuries and other ways you can prevent them? acl? anterior cruciate ligament inside the knee important ligament if that one's not working you're sidelined for a while so depending on you know the

sport depending on the age depending on the athlete there are a lot of different important topics certainly concussion being a big one these days across the board so here's the thing you play competitive sports you are a swimmer a diver and gymnastics right? yep from ages what to what? i was a gymnast from the beginning until probably age 13 and then i got too tall to be a gymnast so i really went into diving and swimming okay so when you were competing was there anyone around you saying listen moderation is the key let's hold back a little bit get an injury you rest those kind of things? i think my parents were more a control factor i think the coachers were really intense back then define intense pushing you know don't worry about it don't worry about it ice it later ice it later kinda thing but i think my parents kept them checked in

kept the coaches checked in? yeah it's interesting cause this is not about blaming this is not about pointing the finger throwing anyone under the bus but there are coaches involved there are trainers involved kids are involved in this whole thing it's a complex situation but you wing up having spinal fusion yes right do you believe there's a direct correlation between the way you were involved in sports and athletics at a younger age and having that surgery? i do i think partially it may have been genetics but partially it was overuse i think all the repetitive high impact in extension had something to do with either how my spine developed how it grew how you know it arthritis between the joints as i got older but what's overuse? here's the thing i get confused with this what is overuse? and how do we know it? well the nationwide

statistically there are more overuse injuries being reported to the emergency rooms now than before but the average age is dropping for those be specific we are getting for whatever reason like you said parents colleagues scholarships hopes of fame and glory there's just too many choices in today's world i have kids at school who practice two hours in a sport and then go to club and practice two hours again that same night what's wrong with that? it's like the best analogy i can give you is take your brand new smartphone when it's fully charged it does a lot of good for you but you've got to shut it down and recharge it one or two every other night same is true for the body it has to recharge to be totally effective and if it's not

you get a less than optimal performance because muscles aren't there joints aren't there and the young people growth plates haven't closed yet they don't appreciate hours and hours and hours of pounding on yet to be fused growth plates and what's happening to these kids? well they end up with a lot of stress fractures a lot of fatigue lethargy i'm tired of sports let me do something else mom doctor one second hold on wait a minute you went from clinical physiological issues stress factors to psychological and emotional issues real quick because you can measure the doctor myself and the trainer... when they blend together they're not independent in that case what do you mean the blend together? you're talking about stress factors and all of a sudden a kids saying i play too much too many hours now i don't want to play anymore are we talking about both? the intertwining will mess with each other and when you get to the question you know what is overuse injury what are we talking about here? it's even that's a careful balance between the training process i mean training everytime we go

out there and do our exercise thing it's stressful for the body and as phil pointed out what we need to do to balance that amount of stress we do for the activity with the amount of rest and recovery we do if you don't do enough stress you don't train the body to get any srtonger and faster and you don't get any of that benefit and that's actually a good benefit but if you don't allow sufficient recovery then you're still actually not going to get the benefit from that stress you did and what happens is it's a balancing act if you put on too much stress with insufficient recovery you're gonna overuse the system and every individual has a different sort of weak link in the chain and it doesn't have to be just one link that's gonna have a fatigue issue it may be a muscle tendon unit it may be a bone unit it may be just their entire body's just wiped and fatigued and they start getting into maybe they're stale maybe they feel a little burnt out or they get truly like an overtraining syndrome where they're really just kinda fried if you will on a psychological side of it and they interplay with each other i have an athlete years and years ago at a different school that i work at now state champion in wrestling

his senior year of high school did not wrestle at all in college he'd been doing it since he was five he's only eighteen he's been wrestling competitively for thirteen years already he was burned tired of it who do you put that on? i know it's case by case i said i wasn't gonna blame i take it back but hold on one second diane here's my thing a kid say a kid says i want to go only because our son nick is into notre dame okay i like rutgers cause the price is better so he talks about notre dame so he sees notre dame football right cause they have a huge media contract right so you can't miss them on the weekend so he says to himself i want to go to notre dame and say he wants to play football and in his mind the only way to do that is to be involved in football and okay so say he's doing that mm hmm and he gets a little injury but he knows that if he has a little injury and then

he rests which is what he's supposed to do and someone else goes in and takes his place he now goes to the back of the line in his mind little kid ten eleven years old mm hmm he thinks he has less of a chance to go where? to notre dame okay so what's the job of the parent? what's the job of the coach cause they'll also see coaches pushing the kid saying i'm not saying any particular situation but i've seen coaches and also there's a show i told you on esquire you know who you are friday night tikes you know who you are i've seen these coaches tell them are you kidding? you're not hurt get back out there right now who's responsible here? think it's a combination i think that's why we get out and do so much education we really try and push that we being... at robert wood johnson we have a sports injury program and we get out to whether it be faculty and staff at a school or whether it be a group of pop warner coaches or parents and their athletes to talk to them about what happens when you push

too much what happens you know how do you end up with an overuse injury why is warming up and stretching so important why is hydration so important all of those things to keep that athlete healthy and we love being able to talk to parents because they're the ones really in control or they should be anyway but that sounds very that's the best practice and by the way go on the website you got the holy name website you got the safekids.org go on those websites right now but here's the thing go back to what i said i've seen the coaches and i don't just mean on that tv show i mentioned but in real life you've seen them you see a coach pushing your kid you see a coach pushing your kid and telling your kid you're never gonna get to the next level whether it's notre dame or anything else it doesn't really matter what we're talking about you want to get to the next level you want to be a star you want to be a leader you step up you rub it off you get back out there again show me you're tough what is the job ofhe parent in that situation? i truly believe that it's the parent... by the way am i making this up does that happen? no no no but i do believe that first of all you have to understand the mindset of parent cause some of the parents are right with the

coaches they're pushing their kid just as much as the coach is pushing but if it you're a responsible parent and you want your child to grow up to be healthy and strong and have good emotional stability and good social skills all of those things are part of sports sportsmanship all of that then you've got to be the parent who steps in and explains to your child that getting to notre dame is not that important right now what's important is that you have fun that you learn good sportsmanship you learn teamwork you learn how to you know be part of that group and do the best that you can do but you also have a coach who's pushing you know right and we have an entire societ that's pushing the entire society that's pushing? i mean we have sort of a mindset within our society but it's not about blaming coaches or anyone else but you do see this no no no parents have responsibility the coaches have responsibility the athletes have responsibility obviously the younger they are the tougher it is but our general mindset is you know we got the olympics going on gold medals yeah silver bronze you know it's about you know if you're not number one does it matter anymore and really it's about getting out there participating having

fun being healthy keeping that balance sounds good it's like mom and apple pie but really the parents are bombarded just as much as the kids are from messages from different places you got speed and agility schools we got all these other programs and if your kid's not in it your kid's gonna fall behind and even a well intentioned parent can get kinda swept along and then also and you end up with this point where you know i had a conversation several years ago a young lady not to pick on a particular sport she happened to be a gymnast and she had a back issue that's kinda common in gymnastics that can really kinda slow them down if not take them out of the sport and we had been working on it and we weren't getting good progress i finally said you know what? you can't be having fun anymore you're telling me this always hurts we've got to just shut it down the kid or the parent? the kid i'm having the converstaion with the kid how old is the kid? the kid was thirteen okay i said you can't possible be having fun at this point in time and she looks at me deadpan serious look on her face and sayd doc, this hasn't been fun since i was nine years old this is what i do this is my job i spend 24 hours a week in that gym doing this

this is what i do what did you do? and the mom who is like i'm not one of those moms kinda was like okay where did we go wrong here and i said oh i was you're shutting... we're shutting this down right now obviously you can't continue to train you can't compete right now we got to see what we can do for the back and it takes time but here's a kid who was national levels four years? from to thirteen it happens she made is clear she wasn't having fun when you i saw a visceral reaction when i heard that i guess to answer that you know when we were younger i trained as a competitive gymnast but it was in season and then off season played i swam i did all kinds of other stuff and then i think now children are allowed to specialize in a sport at age nine if they want to ay spring baseball rec baseball yes they can do that but then they play with a travel team at the same time they can continue during the summer they play winter league baseball they're constantly playing you have three kids the same sport... yeah... ages? fourteen twelve and eight how do you manage that situation? they choose something

each season how do you manage the overuse the not pressuring them too much knowing what you know from your experience i let them guide me come on you gotta give more than that if they just... i don't want to go to practice i don't want to do this then fine woah woah you really? absolutely cause if our son nick says he doesn't want to go to practice my response is no problem you can't play nick if you don't go to practice i don't care whether he's a star of the team but i say he has a responsibility right if they've made a committment to a team at the beginning of the season absolutely they will finish out that season i won't let them quit got it but when the season is over if they say i don't want to do that anymore what about being the best? i'd rather have them have fun what happens when you see other parents and you do yeah absolutely who are demanding the best from their kids and you know they're putting really unhealthy pressure on those kids do you ever say anything to those parents?

no knowing what you know you never say anything? no is it your place? it's not a position for a fellow parent yeah no i don't think it's my place who's place is it? i can get away with that in many cases because i have an objective situation where the kid's in my office because they're injured and i mean the mindset of what we generally try to do in you know like a sports medicine practice is we're trying to get you back out there but we're trying to get you back out there healthy and so many times that means we need to modify what you're doing for a period of times sometimes it doesn't mean we need to shut you down but in that sense it's a little bit easier to be kind of that objective outside voice i mean i'm also a parent i have children involved in sports i see that from that level too where i just go as the parent i'm not the doc or the team doc and as a fellow parent t's kind of tough i mean even if i were to say well you know i'm a sports physician and i kind of know these things the parent you know if they are looking for kind of that moment that teaching moment and they're kinda like gee you know

what do i do and they're kinda asking you're a friend and they're confiding in you it's one thing but to just step and get in another parent's face like back off your kid that's kinda tough not just saying not to do it let's talk about what's out there right now let's talk about what programs what initiatives what resources are out there right now to be helpful to a parent watching right now and you know a lot of you a lot of us are struggling with this right now what's out there right now? back to your original point steve coaches motivate okay if getting in shape was not uncomfortable all of america would be in shape good point okay so there has to be some yelling to motivating some... there has to be yelling? can you do more can you do more but answering your own question you need to like chris and i were saying earlier psychologically and phisiologically when you and i see them and they're broken kids you mean? yeah sprain pulled hamstrings stress fractures then

they spend too much excessive if they come in and the kid is lethargic and missed three days in a row, has an excuse if they're mentally not there then maybe they should not be there if the parents are pushing them then maybe it's time for the parents to realize the kid is sending your son or daughter is sending messages i really really don't want to play this sport twelve months a year and who's the and do your safety sports safety clinics step in and help those parents tell those kids maybe it's time is that what you do? we try to educate them about what the consequences may be if you continue to play a sport twelve months around say they don't get it? i bring in believe it or not i bring in the orthopedic surgeon with me and he talks too and he'll talk to these parents about what he's seeing and seeing the overuse injuries that he's seeing in fourteen year olds what is it? scared straight for parents? kind of kind of because they need to realize that

as great as your kid is at whatever sport that is the likelihood of them being famous is this big woah woah woah you tell that to parents? i do yeah for what purpose? so that they can understand that you can push and you can push and you can push but where is that going? and what is that doing for your child? and don't you want your child to be happy? and healthy and content with their life as opposed to getting pushed to maybe reach you get to here but you're not gonna get to here what about confronting the coaches? who's job is it? and what programs are out there to confront and deal with coaches who in fact are part of the problem? new jersey is in a very unique position for that as an athletic trainer i have not won or lost a game in my career all i do is care for the health of my kids my athletes i can say sorry you can't practice today

you're talking to the kid though yup and we're actually and where's the coach? the coach and new jersey's the leading state in the nation for high school athletic trainers 92 percent 92 percent of our high schools have athletic trainersnd athletic trainers are that as chris said that calm voice that separates the craziness from the correct answer that's what we do coach no and my coaches go okay phil and that's it oh come on phil that's it respectfully you're playing the kid the team is playing for the state championship no they're playing for the group four group four right state championship playing over at the big stadium right i call it the meadowlands what's it called now? that's what i call it too [laughter] yeah yeah that's old school but they're playing over at the what... you know the big stadium what is it met life? met life right brendan byrne so they're playing over there okay so they're playing over there right right they're playing for the state championship right and the star running back's got a thousand yards that he's run so far and they're playing the

state championship and the kid's got the hamstring problem a deep hamstring pull can he run? they can't... no he's got a deep hamstring pull so he can't run but you can take the kid up you can give the kid a shot oh no [laughter] no [laughter] oh no [laughter] no? that's not happening no no i'm saying the coach says to you you can give the kid a shot you can deaden it you tape it up hat kid will give us 50 60 yards you say? no way no way in god's green earth coach forget it i actually have a question that's not... steve it's not happening this doesn't happen? it's not that... maybe i can't say it never happens somewhere those are less common than perhaps they once were yeah but what's changing? i think education is part of it i think it's a different sort of culture you know for a doc to stick a needle in a high school kid at a game they better be very comfortable with the potential downstream of that but take it back yeah kid gets dinged open a kickoff kid gets dinged right dinged meaning

dinged ridiculous name for getting hit in the head right kid gets hit in the head kid goes down little woozy coming off kid's also a star player on offense you look at the kid and you're not sure what's going on he's not knocked out kid says i want to get back in and you're not sure no see now you're saying no again as if i'm making things up that don't happen in today's world you are steve and five years ago very ry realistic story... in today's world that one especially the head injury one has definitely since you said the kid got a woozy once the kid gets up woozy you're gonna get a lot less pushback now from parents coaches not never i mean i was at a game as the sideline physician at a school that was recovering for another practitioner right so i've been at the school twice before so theoretically they got some face recognition but they don't really know me yes and last game of the season quarterback senior you know big game? yeah it wasn't the states or anything got it but kid comes off you know he got sacked he's dinged he comes off we sit down we

talk and i know he's not right so i borrow his helmet coach comes over he goes is he playing i said? you borrowed his helmet? meaning you took it away? yeah i took his helmet away i know what you mean and you know the coaches weren't pleased with me but they kind of bit their tongue and walked away i got heckled by the parents the stands the fire department on the truck so it still does happen a fire department? i know good to know they're all behind the kid's health jump back in jump back in it happens people get carried away i think after things settle down there is the one person who really didn't give me any pushback was the kid? the kid? right and i kept the kid out and ultimately he did okay and ultimately the other folks kinda quieted down fortunately for me they won the game so i still was able to get out of there with my car [laughter] [laughter] the kid wanted to go back in it didn't matter you did it? no it didn't but he didn't push either i mean in that sense it was okay if the kid had pushed doesn't matter? it's not the no if the kid doens't look ready kid's choice? he shouldn't go back out and jump back in that was my question when you see children with their parents or children with

their coaches who are you more likely to have to talk down? you have to talk the kid down or the parents and the coaches and in that situation it was the parents and the rest of the crowd the kid was kind of the easy part of the conversation i think at other times the athlete will be just as on that page getting back in there are kids lying sometimes? oh do kids lie and just no [laughter] are kids lying because t's called a the sin of omission say it again? it's the sin of omission talk about that they don't say a word about it right they don't want to get pulled out especially if in the situation you're talking about last game of the season blah blah blah blah blah kid's got a scholarship on the line go ahead cause even if they don't it doesn't matter they're part of that team they want to help the team the team is winning they don't want to be pulled out what's our job when that situation comes up? what's the job of the parents? the coaches? the trainers? the medical professionals? what's everyone's job? to do what's best for that child for that kid's health even if that kid is saying i can't believe you stopped me from being there and with my teammates yeah and they'll get over it they'll get over it they might not get over a second impact syndrome you know that's say that again woah second impact...? give me that again?

they may not... [laughter] second impact syndrome is a condition it's rare but it basically can be lethal if you get hit a second time while you're still symptomatic from the first hit and we're talking concussion injury okay you're still symptomatic from one concussion you get hit again doesn't have to be a big injury in a very small number of cases basically the blood vessels within your brain all swell up and if you imagine like a kid who gets his hand sandwiched between two helmets and it blows up real quick right you stick it above the device it gets better it's a very quick visodialation the blood vessels get big you shrink it back down with some ice? yeah if it was in the head it's got a little bit of a space issue with this hard ing called a skull it can't stretch out it pushes down out the bottom and that's called herniation listen got a minute left i know we do not... did not answer a lot of questions i know you raised a lot of questions and that's why we have the information up throughout this program as to where you can go for more information final thoughts go i think it's important to act intuitively with your kids even if they say they're not hurt really watch them

moderation? pay attention i think moderation is absolutely the key yeah don't be afraid to rest rest practices and games with three parts what you do before what you do during, and what you do after hmm eat right sleep right and rest right before tomorrow a few seconds go i think education is key of raising awareness for not just athletes but for parents and coaches and really getting out to the community and let them know what the consequences can be doctor? i agree with moderation i agree with education the other is simple communication sometimes it we'll keep talking off the air go ahead gets away from the parents... the preceding program has been a production of the caucus educational corporation celebrating 25 years of broadcast excellence and thirteen for wnet njtv and whyy funding for this edition of caucus new jersey has been provided by the healthcare foundation of new jersey health republic insurance of new jersey md advantage insurance company of new jersey njit

new jersey institute of technology new jersey's credit unions new jersey natural gas and by njbest transportation provided by air brook limousine caucus new jersey has been produced in partnership with tristar studios this program has been made possible in part by holy name medical center my name is doctor john rundback i'm actually the medical director of the interventional institute here at holy name medical center peripheral artery disease actually is extrmemely common it's one of the forms of hardening of the arteries as interventional radiologists we perform minimally invasive image guided procedures generally the procedures we do are alternatives to what would otherwise be major surgery almost 80 percent of those patients avoid amputation if they're referred to us for these sort of procedures holy name medical center in teacneck new jersey 1 877 holy name healing begins hereer

captioning sponsored by macneil/lehrer productions >> wooduff: as unaccompanied children continue to surge across the border, president obama asks congress for nearly $4 billion dollars in emergency money. good evening, i'm gwen ifill. and i'm judy woodruff. also ahead this tuesday, a sharp escalation in the deadly violence gripping the middle east. israeli forces launched more than one-hundred airstrikes on the gaza strip to counter rocket attacks by hamas. >> ifill: plus, chicago's struggle to curb gun violence after another deadly weekend. >> wooduff: and, in indonesia, a heated race for president, showcases a new breed of politician, who's risen from the ranks of the working class.