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and by nj biz. all business, all new jersey welcome to caucus new jersey. i'm steve adubato. you know youth athletes are getting hurt at an alarming rate. detecting these injuries can be really difficult but there are signs that parents and coaches can really look for. joining us in the studio, to discuss the ways we can help prevent youth related sports injuries we have, liz romic, who is a physical therapist at madison spine and physical therapy. doctor patrick roth, who is the chairman of the department of neurosurgery at hackensack university medical center phil ross is a master kettlebell instructor and finally paul simpson is fifteen years old freshman football player at ridgewood high school who is diagnosed with a stress fracture

earlier this year. i want to thank all of you for joining us. talking about youth related sports injuries. um.. doctor, do we have... and by the way lots of information throughout this show websites, use them. right so we're here from public broadcasting. we have two kids, nine eleven two boys involved in youth sports. see injuries everyday. sometimes you say eh it's part of it no big deal. do we have an epidemic of youth sports injuries? i don't know if it's an epidemic but um do we have a serious problem? there's a problem what is it? i think what-- there's lots of problems. one is that in sports, starting at the professional level, working it's way down the intent is too much to win, to hurt and i think we've lost sight of the beauty of sports and player development. what do you mean hurt? give me an example to hurt. well i think, uh, you know in football players um, hurl themselves at other players head first and injure their necks and lower

backs, doing that. um, to hurt. people over train in sports and get uh fatigued or stress fractures. whole range of things. i was watching nd again i don't like doing this but i'll do it anyway. i was watching a show called uh is it friday night tikes? is that the show that show, you know what i'm talking about? uh no no friday night, no it's tikes guys. yes it's the dance show. it's the show that is a reality show. uh i think it's on the esquire channel. started watching it because i was fascinated by young kids playing football and the coaches and i will tell you, check it out. because you get multiple coaches telling kids, these kids are nine, ten, eleven, go for the head. take 'em out. i don't want to see him get up. playing for the championship. trying to play to get to the championship and these coaches knew that they they knew they were on camera. and i don't want to make this an indictment

of these particular coaches, but i wonder to what extent that is the exception or the rule in terms of the coaches out there, and what they are teaching those and not just in football but from football such a violent sport in so many ways, are we in fact teaching kids to in fact, play to hurt? is that your experience? um for my experience, no, not at all. all coaches taught us the right technique and all they tell us before the game, make sure you have fun. and make sure you just-- they never say aim for the head. 've never heard that in my life. never heard that? but the over training sue, it's interesting, you had a stress fracture in your... um, in my... his lower back. cause you treated him? yes. right? when did you think you had a problem? well, it wasn't during football season the pain was pretty bearable. i mean i thought it was just like maybe i pulled a muscle or something. i didn't feel like i needed to tell anybody about it. i thought i could-- i didn't want to stop playing. i wanted to keep playing. say that again i didn't want to stop playing. i liked playing the sport. so there it is, keep going. um, so i didn't tell anybody

about it then during the off season, i started uh doing private baseball training and that's when it started getting bad. you switched over to baseball? yeah and baseball you have to turn the hip a lot of the hip you got to turn the hip and realize you can't turn the hip the way you needed to hey there must be something going on he has surgery then? no he didn't have surgery. did you have physical therapy, what happened? i had physical therapy, um. i even with a stress fracture? how do that's interesting. you're known by many in the field as very conservative. i don't mean politcally. um, you do not opt for surgery vrey often, do you? depends on the circumstances. a holistic approach? i try, you know, in a child or a kid growing up i obviously try to avoid surgery. and um my interest actually with this particular entity is to strengthen the core around the injury and there create an internal brace that prevents stressing what is already a stressed area. can we talk about the core? yeah, let's talk about that.

what is the core and why is the core our core so connected to prevention of injuries and then jump in. go ahead. well, if you look at the core, by definition it's your whole trunk. it's not just your abs it's your hips, your back, this whole torso body, is your core. we should make it clear that you've spent years doing, was it, competitive body building? ll, i was actually, a little bit of a past here i um, spent since uh from 1979 til the year 2010 i was competitive on a national level in uh combat sports. combat sports. and you also did a lot of physical training. a great deal. okay. okay, powerlifting, as well? i did powerlifting, i did do body building okay the whole thing both of them. okay. and so the core means core is our center of our body. and what does that-- what does that have to do with helping us prevent, particularly, with young people, who are involed in sports what the heck does that have to do

and jump in, i'll come back i think that's an excellent question. preventing injuries really is a spectrum of interventions. and probably the first one is identifying when there is a problem to begin with. so, we see a lot of remember he said-- exactly. he said he didn't want to tell anyone didn't want to tell anyone, because wanted to stay in the game. go ahead exactly. so, we see a lot of student athletes in our clinic, in all six clinics that we have in bergen county. and that pretty much is the story of everyone. no one wants to admit that something is wrong, cause they don't want to not play. so identifying when there's problem is the first step in preventing an injury. then the second is identifying what may be causing that problem in the first place and as a physical therapist we often see that there are five functional problems. functional. functional problems-- people example. motor coordination. um, ability to do their job or their sport correctly. and i think that's something that you work with. specializing-- technique technique. why-- there's where your core comes in. but why is technique or, or, or poor technique so closely correlated to a higher rate of sports injuries?

well, if you do not have the proper technique, how are you going to perform under duress? if your alignment is good your alignment. your alignment, the alignment, we're talking about core before, why it's so important. try to walk without using your core. everything comes from the center, out. the core, the core, the core just in it's name is the center. okay, so the core is the key. question. and this first of all we need to make clear you're a freshman playing and you got called up to varisty along with some other freshmen. uh, i never got called up as a freshman. i just want to be clear when played it was much later. um... here's the question. your training, how much of it was focused on here as opposed to whatever lifting, whatever, i don't know the routine you did, but how much was focused on your core? there's actually a good amount focused on the core. we did a lot of ab work as well like back work.

ab work. why the ab work? you loved it didn't you? i'm joking. and did you realize at the time how important that was to have helping you prevent or minimize injury? i didn't really at the time, we had a certain rotation, we had like, uh, lat pull downs like a lot of crunches, just like stuff to strengthen pretty much, they pretty much went for every part of your body to strengthen. did you mess with those kettlebells? i did not, we do not have kettlebells in the-- do not. could you lend me a hand over here cause i heard you have a shoulder injury. i uh, had a bicep tendon tear. could you appreciate that? i've heard of them yeah right with the dumbells you would know. these kettlebells, get a shot of this bob cause i'll be sweating in about 2 seconds this is so much heavier than you think. doctor you are an advocate of kettlebells are you not? i am. make the case as i'm holding this and about to put it down very quickly. boom. go ahead. interestingly enough, i uh, i also the stress fracture that paul has, i have myself. and i played football all highschool

and, lived with back pain in my teens. uh actually throughout my careeer. when i was a kid, i happened to have a, something in my basement called a roman chair, which is a back strengthening tool i know a roman chair and with the innocence of a kid i wandered downstairs to my basement when i was in pain and started to use it and discovered in myself that it would make my back feel better hold on is the roman chair the straight up chair it's kind of a reverse sit up machine yeah and you pull, don't you pull up? no you lie face down. your belly supported you see people with their hands behind the head, doing like backwards sit ups. and that helped you? it helped me. i didn't know why. i just did it. you know experimentation. of an innocent naive kid. and uh, kind of filed that in my memory banks. didn't discover that i had spindalaysis which is the stress fracture uh, of a lower back until- same thing that he same thing that paul has. wow. and uh, then i met someone in my town who happened to be a big

kettlebell advocate and started telling me about it and something made me connect the roman chair as a kid to the kettlebells as an adult and i started to learn about them actually i got phil into them and took it to a different level. and he started training me and teaching me about kettlebells, the proper form. but why are they different? let me ask you a question. why they different then simply having dumbbells and barbells and working with weights. you know everything, i'm sitting there going to the gym. there it is everything's right there. everything is balanced nicely. i'm like i don't have to balance this. because it's not this. everything's right there, right? that's, that's, that's the main thing-- that's the problem, i like that part. and that's what's so appealing about standard training cause you feel you get a good pump. this, that the other thing. the thing that you have to think about, is you said it exactly. everything's balanced. it's balanced for you. the thing with the kettlebell is it's got a center of gravity. what we call the cog.

what if i hold like this? okay. well-- please tell me this is a thirty/thirty five pound. it's twenty two pounds. haha oh man that's not a good sign. okay and, and, what does one do with this? well, you do a myriad of movements. me, personally, i practice somewhere around one hundred and seventy movements or you know, but there's a core of six or seven movements here but why is this different than working with a dumbbell? so, the reason this is different go ahead is that when you play a sport your body and all of your muscles have to act coordinated in certain directions three dimensional. so a kettlebell will work in all of the plains and will train your body to sustain forces which can cause fatigue and fatigue causes injury because you don't know where that self-- m taking, bob get a shot of this so if im trying to move this around okay body has to compensate for the movement there's a center of gravity of the bell changes. the center of gravity of the bell changes and the body has to compensate for that. and it compensates for that by recruiting all your different stabilizers. and that's why

when you had that universal, that unilateral distribution of weight, how often do you have that in sports you know what you're saying? you're saying in sports, and i am really sweating now um, what you're saying is, that when you're working on the universal, are you working on bars that, that have the exact amount of weight on each end, that is not comparable to what a young person or anyone would face in a sports related situation. because things are coming at you at all different directions. now, i... you want to start working with this thing? do you think it would help you? from what i've heard, yes i think it would. steve i'll also tell you this cause i had a very similar experience as doctor roth did. when i was sixteen i was playing football i got speared, broke three bones in my back and because i was-- speared means someone with a helmet yes. led with a helmet into your back yes, into my back, yep. we were uh scriminging bayonne. uh, and i you don't have to say who the team is now we lost our audience in bayonne but go ahead.

so, i mean it was belleville, i don't know and just like paul, i wanted to make an impression, so i stayed in the game and i-- of course. i'm gonna be a tough guy so i compressed three vertebrate. and then i went home when i couldn't even walk. there it is. yep. i was advised that i wasn't, not going to do sports the rest of my life. that's not right (?) at sixteen. at sixteen? yeah. so, listen you tell your experience you tell your's, you didn't want to say anything. i've had more ridiculous injuries and i don't want to even talk about. the lamenecktomy, the shoulder bicep tendon, tear a million different things here's the thing. what advice do we have for parents right now, who i told our eleven year old the other day, he was complaining he was running down to first base in travel baseball game and i saw him holding his hip. now i don't remember him hurting his hip. but he was running down to first base holding his hip and i said, nick what's up e goes, ah i think i hurt my hip i said, when? he goes, i don't know. but it's hurting me. i said nick, listen just stretch it out a little bit

but i'm sure you'll be fine. i don't know if it was the right advice or not but i thought to myself what should i have just done right then and i want him to tough it out. but i don't want to have him increase the odds of something bad happening. give advice to parents right now, who have to take charge of their kid cause the coach is not in charge, that parent is, correct? parent, parent is definitely in charge and um, there's never like all of parenting there's never a right or wrong answer you know and each decision has to be individualized. and um... you have to take into context many things how important is the... for many parents the, they, i guess they invision their children as future professional athletes obviously it's what's wrong with that? that's just an unrealistic goal. say if the kids says he or she wants it nothing wrong with dreaming. but uh if you look statistically it's not a realistic goal yeah the kid says he or she wants it. the kid says give me an opportunity. let me get out there. i know that i pulled this or that and i

know that this is bothering me but i can tough this out. i'm tougher than these other kids. you say as a parent... well i think the first thing you need to do in this scenario is that the child should be evaluated by someone diagnosed physician to rule out any very terrible injury. okay, so you don't have the terrible injury but you have some injury that requires a certain amount, okay, realistic, grey area requires a certain amount of healing and rest based on a best practice. exactly from protocol but a championship game is coming up. and the kid says wait a minute this is the state championship game and you want me to sit out this game? this is the game that can help us win the championship i could get a college scholarship and you're elling me i can't play? you say? well it depends on the extent of the injury if someone has a severe injury then you have to balance the whether you want someone it's a judgement call you air out the... it's a judgement call. i know everything's case by case but in the end are we saying that we should be teaching parents, promoting the parents air on the side of sitting the kid out?

okay, steve i'll tell you something, i-my uh my son, is one of the top shotputters in the country. he's going to dartmouth next year. if you must say so yourself go ahead i'm very proud of him, tremendous. congratulations by the way. um, last year, there was a state championship. it was uh, predicted to uh you know-- track and field track and field. indoor shot. and um, he had slipped in the circle, prior to in the meet qualifying, it was the meet champions and he had slipped in the cirlce and hurt himself. and you know it, this is a great showcase for him but, you know what, i yanked him. you pulled him? i pulled him. and the-- what was his reaction? rst you know, i do it, i'm like, yeah? i go let me see. and he you know he couldn't perform and a. he's gonna under peform and b. he was gonna make the injury worse and then it would affect him how he's gonna do in the sport so is it just how bad the injury is

t the time. i don't know what is cause i know, you're spinning around. hamstring, could have been a groin. could have been anything. i don't know what it was. but here's the thing it may not be real serious at first but if you compete and play when it's like that, doctor it could get worse. isn't that part of the issue, here? it's an issue, but i mean i think one thing to understand is that let's just take back pain for an example. back pain cause that's what paul had. the vast majority of back pain even the kids get, is not an injury. it's just part of life. people get back pain. so you have to sort out what is an injury d what is just part of life. and so you don't jump into an mri, for example. if someone has back pain, perhaps the first way that should be treated is through instructional therapy. and we talked about before-- one of the things i wanted to elaborate on something we talked about before, the kettlebell, one of the most important things that a kettlebell does, we talked about the center of gravity changing and the unpredictability of sports, that's all true. but

the fundamental thing that i think that patience, and kettlebells for back pain, this is an important point, is understanding the difference between back bending and hip hinging. say it again. back bending and hip... so you know, so you probably no one ever thinks about that. when you bend down, you bend down and pick up something off the floor, your back is-- your body going through three simulataneous things. one is you're bending your legs should we show this? we could show it. hey bob does this screw you up? terry. you want to do it? i'll do it. go ahead. phil's fantastic with the form. anyway, so just show them what it's like to first back bend. here's what most people do. they go to pick something up i have people walk in my studio ll the time. let's say i want to pick this cup. most people do it like that. what's wrong with that? about a thousand things. first of all, i'm taking my, the spine needs to be lined up like this. right. here it's very supported. it's called a neutral spine. you want to maintain that neutral spine no matter what. o if i bend my back, anyway, i'm

now taking myself out of the neutral spine position. are you increasing the chance that you could injury yourself? absolutely. and the other thing is that i'm creating that muscle memory in my back. and romoting like a ligament laxity. well, give me better way to pick up that cup. everyone check this out so, wait a minute. you bent... i hip hinge... and this is what kettlebells does. the number one thing with the kettlebells swing is the hip hinge. and look, one econd. i call it the karate chop to the hip. but let me show you is. look at the position i'm in. this is an athletic position. yes. whether you're playing tennis yes whether you're wrestling, football, second base right i'm ready to roll, okay? what am i ready to do here? fall on my face? hurt myself? but someone says

"i'm just picking up a cup!" what are you talking about? well, i'll tell you this. steve, when i was deadlifting over four hundred, five hundred pounds, okay? yeah, i know, i was doing that last week. go ahead, i'm sorry. and i turned and i picked up a box... a box, an empty box yes grabbed it like this. and i threw my back out. hold on, you got the four hundred and fifty pound deadlifting picking it up like nothing! then you pick up the box. boom! back went out for three days. jump in cause i see you have something. go ahead. you were deadlifting four fifty yesterday! go ahead. i think the thing to remember though is that, it's very important that whoever you work with or however you work out that you have someone who understands function. and understands efficient motion. so we're talking about how to prevent, how to prevent, exactly it's for kids! children don't have any idea but where would a kid get the access to that information? so, they need to work with qualified professionals. so as physical therapists, professionals, you know, we know how a body is supposed to work efficiently to avoid fatigued stress. and fatigued stress is how you get injured.

so the kettlebell in itself but the coaches are the ones who have the most access to them. is it the coaches-- they may or may not be qualified to identify whether a child can move properly are we then saying, for parents yes our primary audience. doesn't mean we don't want to talk to kids and coaches. we do. and physicians, medical community-- that a parent needs to try to, cause this is the advice a parent needs to try to help their child get the best access to information about yes, movement, movement! and function. do they move and do they function normally to be able to do their sport? this is what i see in my clinic all the time. i see dancers. i see gymnasts. i see fencers. and all of them have when they get injured. if it wasn't a traumatic injury from playing football. right. you know, if it wasn't a traumatic injury, just an over use injury the problem is they don't move efficiently. they have improper core stabilization, good foot control. they're not in proper balance. but they're doing the same thing one of the coaches told the kids the other day if you want to be the best second baseman, the best pitcher, the best whatever do whatever it is, a hundred times

two hundred times a day. which makes perfect sense on paper. the problem is if you're throwing a ball against the wall a hundred times a day but you were doing it the wrong technique, doctor, what's the problem with that in terms of injuries? well it's exactly what paul's injury is. paul has a fatigued fracture of his spine. so it wasn't an injury, necessarily from a single event or single thing that happened but, just over time doing something repetitively repetitive? and that combined with you know the growing child's body mechanics and the anatomical configuration of the spine led to what did? fatigue in a stress fracture. paul, let me ask you something. how old are you right now? i am fifteen fifteen. tough question. i know. you love football? yes. want to play football? yes. what changes do you think you will make? if any? to try to, try to prevent future injuries? i definitely need to work on my technique more, i mean, for

an offensive lineman, the path's block, first of all, whenever felt pain, in my lower back, it was always because i was taking a hit going like this and i always had my feet separated five foot seven, a hundred and eighty five pounds as we speak today yes you have to work on what? cause some of those defensive linemen with be twenty, thirty forty, fifty, maybe we played some big kids this year yes, we have. big kids. okay? i've ended up against a six foot five kid, very large kids. so technique for you, what does that have to do with if, for you in your mind, protecting yourself against injury? mean, i also still have to work on muscle development and other things just so i can actually like play against . but i mean if i don't have the right technique i feel like i'm putting myself at a lower like a higher risk of hurting myself here's another thing you have to do, isn't there? you know what it is. next time you feel something what are you going to do? tell somebody i mean forget about telling me but seriously, don't say it because you're on public television. you know what you need to do, right?

and your other colleagues you play with your teammates that's part of the issue too, right? yeah mean, a small part, if you like few seconds left, go ahead. if you're injuried and it's not as bad of an injury as you thought, and you report it and you seem kind of weakish oh boy, you end on that note. you know i appreciate your candor because as long as young people have the attitude that reporting an injury makes them look weaker, that means we have more programming to do. that means we have more of public awareness and education to do but i want to thank all of you for being with us. stay healthy young man. yes sir. good job. the proceeding program has been a production of the caucus educational corporation celebrating over twenty five years of broadcast excellence. and thirteen for wnet. nj tv. and whyy funding for this edition of caucus new jersey has been provided by berkeley college new jersey credit unions united water md advantage insurance

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. captioning sponsored by macneil/lehrer productions >> woodruff: a second american journalist appears to have been executed by islamic state militants, who threatened more to come if the u.s. doesn't back off. good evening, i'm judy woodruff. gwen ifill is away. also ahead this tuesday, are health care workers losing the battle to stop the spread of ebola in west africa? we talk to the head of the u.s. centers for disease control who says the outbreak is "spiraling out of control." then, the cyber-theft of celebrities' private photos prompts questions over just how secure personal information is online. plus, a woman's mission to give china's abandoned and often neglected orphans a sense of