September 8, 2025 • 42 mins
In this episode, we welcome Dr. Bianca Edison, a pediatric sports medicine and orthopedic physician, to discuss the critical issues surrounding youth sports. Dr. Edison shares her journey into sports medicine and emphasizes the importance of balancing athletic activities for young athletes. The discussion covers overtraining, the significance of rest and recovery, the impact of burnout, and practical advice for preventing common sports injuries in children. We also dive into the importance of sleep, quality nutrition, and healthy exercise habits. This episode offers valuable insights for parents, coaches, and young athletes aiming for long-term health and enjoyment in sports.
Dr. Bianca Edison is a pediatric sports medicine and orthopedic physician at Children’s Hospital Los Angeles and Clinical Associate Professor of Orthopedic Surgery at USC’s Keck School of Medicine. She received her MD from Baylor College of Medicine, completed pediatrics internship and residency at UCLA (where she served as Chief Resident), and pursued a sports medicine fellowship at CHLA. Bianca’s clinical work focuses on overuse injuries, injury prevention, dance medicine, and concussion—helping young athletes stay healthy and love movement for life.
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Episode Transcript
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Unknown (00:00):
Hello listeners. This is Dr Jessica Hochman. I'm
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(00:31):
Hi everyone, and welcome back toyour child's is normal. I'm your
host. Dr Jessica Hochman, todayI'm thrilled to introduce you to
my friend and incrediblephysician, Dr Bianca Edison. Dr
Edison is a pediatric sportsmedicine and orthopedic
specialist at Children'sHospital Los Angeles, and a
clinical associate professor oforthopedic surgery at USC Keck
School of Medicine. She earnedher MD at Baylor College of
(00:53):
Medicine. She completed herpediatrics residency at UCLA,
which is where I had theprivilege of training alongside
her, and then went on tocomplete a sports medicine
fellowship at Children'sHospital of Los Angeles. If your
child plays sports, whether it'ssoccer, baseball, dance,
gymnastics or anything inbetween, you won't want to miss
this episode. We talk aboutpreventing injuries, avoiding
burnout in youth sports, andmost importantly, how to help
(01:16):
your kids build a healthylifelong relationship with
exercise. I learned so much fromthis conversation with Dr
Edison, and I know you will too.
So without further ado, let'sdive in. Everybody meet Dr
Bianca Edison, good friend ofmine, amazing doctor. Thank you
so much for being here, and Icannot wait for everybody to
learn from you, gain from yourexpertise, and to know who you
(01:39):
are. So thank you again forcoming on your child as normal.
Thank you for having me. It's anhonor to be here with you today.
So Dr Edison, tell everybodywhat kind of a doctor are you
and how did you get interestedin youth sports medicine?
So I am a pediatric sportsmedicine and orthopedic
(02:01):
physician. How I got into thisfield, actually, it was by
happenstance. Towards the end ofmy training, I thought I was
going to go into generalpediatrics, honestly, however,
there was an elective in sportsmedicine, and I chose to do that
elective to just get moretraining. And after working in
(02:21):
that practice, it just opened myeyes. And I thought, What is
this magical place? You get towork with athletes all day long.
And so that was my parlay intoit. So I did further training
with a fellowship, and here Iam, and I love it. I get to work
with young athletes and peoplewho just want to be active or
(02:43):
get back to their respectivelove and sport and just helping
them and their families and thecommunity.
And out of curiosity, were youyourself an athlete when you
were a child?
I mean, I take a very broaddefinition of athlete the
growing up. Yes, sports was thevehicle for my parents to get
(03:03):
myself and my siblings out ofthe house and keep us
entertained, and so Iparticipated in several
different sports growing up, butprimarily danced for many years,
and also played tennis andtrack. Those were and the main
ones, but tried out a wholebunch of things. I tried out a
(03:24):
Taekwondo, I tried outvolleyball, I tried out
basketball, I tried outgymnastics, I swam, we skied as
a family, so lots of differentthings. I'm looking
forward to having a conversationwith you about overuse injuries
in kids. Because I thinkeverybody can agree that sports
are fantastic for kids. Theyprovide a great vehicle for
(03:46):
exercise. There's so much valuein learning how to participate
on a team, how to lose, how tofeel the joy of winning. But at
the same time, I know a lot ofparents talk about how youth
sports today are different thanthey used to be. There's a lot
more stress involved thatthere's a lot more time
commitment that's expected ofthese kids. And so I wanted to
(04:07):
ask you, what would overtraininglook like for a kid or a teen
that's in a sport?
Yes. So I'll start off bysaying, I love my field, but I
don't necessarily love where weexist right now in this youth
sports kind of ethos atmosphere,because there is a lot of over
(04:29):
training that is happening withour youth and our young
athletes. And so balance isreally the key. And so by
definition, from both ourprofessional sports medicine and
pediatric societies such as theAmerican Medical Society for
sports medicine and the AmericanAcademy or pediatrics over
(04:51):
training. Or over trainingsyndrome refers to all these
symptoms that result fromexcessive exercise over time.
Mind with insufficient recovery,basically, to facilitate the
body's adaptation to that kindof exertion. And so in other
words, a kid is doing way toomuch in their respective sport
(05:15):
without proper recovery, andwhen that particular athlete
does not take the necessary restthat they need. That's when they
fall into the realm ofovertraining, which creates a
lot of negative outcomes fortheir body as well as their
mental and emotional state. Andso if you have those training
(05:36):
loads, there more the recoverythat's allowed for a period of
time, then their performancedecreases, and that can result
in physical stress, detrimentalfatigue, injury, burnout, and so
things that parents can reallysee is if their child feels
(05:57):
really fatigued, to the pointthat it interferes with their
school, with their athletictraining, with their daily
tasks, if they just can't bounceback basically from their
intense workouts, or if theystart having more frequent
injuries, if they're in myoffice much more, or if they
start to show signs of burnout,all of those are signs of that
over training.
(06:18):
And as I think about it, withkids, you can have burnout, both
physically and mentally.
Oh, absolutely, we have about 60million youth that are
participating in organizedsports. However, a staggering
statistic from the AspenInstitute shows that upwards of
70% of children drop out oforganized sports by the time
(06:42):
they turn the age of 13, fewerthan four in 10 students play
sports in public high schools.
Only 23% of kids reach therecommended level of daily
physical activity that theyshould be achieving, and that's
decreased from 2011 which was at29% in your opinion.
(07:05):
Do you have any thoughts as towhy that is, why so many quit
sports by the time they'reteenagers? Do you think it's
cost? Do you think it'scommitment? Do you think it's
burnout?
So I led a group where we lookedat a research study and we
followed kids. It was alongitudinal study, so
basically, we started out withthem in middle school, and we
(07:26):
followed the same group all theway through high school.
Primarily we wanted to look atsleep, but we looked at sports
participation, burnout, anxiety,all of those things. What we
found was that burnout what'smore common in high school than
in eighth grade, bothacademically and sports related
burnout. What we found that onein four students had sports
(07:49):
related burnout. And so I thinkthere's a myriad of different
things that can reallycontribute towards this.
Unfortunately, youth sports havebecome a multi billion dollar
interest, and we're asking kidsto perform at levels really,
that sometimes it can be toomuch. A lot of times it gets to
(08:09):
be too much. Some are doing2025, hours a week of their
respective sports. And if that'sall you're doing during these
formative years, either it getsto be too much, or when
something happens that pulls youout, such as an injury, it can
cause a lot of heartache andemotional stress. And if you
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feel that, the focus is on theend result, be it either a
college scholarship, playingpro, getting endorsements, those
sort of things, then the childthemselves sometimes can feel
that they're not really beinghonored as their own individual
self. And so all of thesethings, and this pay to play
(08:55):
model in sports puts atremendous amount of pressure on
these young kids they're tryingto just grow and develop into
who they are as individuals andlearn themselves. And so when
the Aspen Institute did a verylarge survey nationally to look
at kids and ask them why theystopped playing, the number one
(09:16):
reason is that it's just not funanymore.
There are definitely kids that Imeet that just love the sport
they're participating in. Theycan't get enough of it. Let's
say it's baseball or basketballor dance, and they truly seem to
enjoy that sport. In thatsituation, are there any limits
that parents should be thinkingabout for their kids, or if
they're enjoying it and theirbody feels strong, can they do
(09:39):
that activity as much as theywant.
So the research shows that therestill should be some
limitations, and it could bebased on their age or their
stage of development, theircapabilities from both a
physical and a social emotionallevel and also. So looking at
(10:00):
what we know about what the bodycan withstand, so all of that
kind of grasp upon what we callthe American development model
of sports participation. Andthat came about in 2014 and it
was started by the US OlympicCommittee, along with the
national governing bodies forsports, and it's really based on
(10:25):
looking at each kidindividually, but also knowing
within the realm of theirdevelopment, based on their age,
what should be done for them,just to help them succeed and
really thrive in sports. Andreally love that for a long
term, because really our goalshould be that we should have a
(10:46):
society and a group of thisrising generation that really
loves to move, and should keepmoving to keep ourselves healthy
and strong. And so it says thatwithin that model, we recommend
between the ages of zero to 12years that children participate
in activities and sports thatpromote really discovery
(11:08):
learning and fun, and you'rehoning those skills of problem
solving and confidence boostingand conflict resolution. How do
you deal with something thatdoesn't go your way? And then
it's not until after age 10 thatwe recommend more challenging
skill development, and then notuntil that foundation is
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solidified after age 13, thatone trains at a much higher
level and actually competesthrough that we collectively
help support a more broader,more inclusive participation in
physical activity and sports, wehelp cultivate stronger athletes
and just maintain, again, moreactive and healthier society for
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those kids that have that strongfoundation really love what
they're doing, we want to makesure that they are also taking
proper rest, because the bodyneeds certain time to rest from
the high intense physicalactivity to allow the muscles to
repair and regenerate. So weavoid kind of burning out a
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particular area of the body andavoid injury. Our national
societies and organizationsrecommend that, for kids, you
take at least one day per weekof full rest. You know, we're in
California, we can afford toplay sports year round from a
weather perspective, but weshouldn't, and that you should
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take at least two to threemonths of rest away from that
particular sport where you dosomething else complimentary and
that to avoid again, that burndown some of those overuse
injuries.
I heard a general guideline,whatever age your kid is, think
about doing that many hours ofthat sport per week. So, for
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example, a four year oldshouldn't do more than four
hours of dance a week, and so onand so forth. Is that something
that you would agree would be aquick motto for parents to pay
attention to formost kids in most sports. Yes,
it's the rule of ages that comeabout from the American Academy
of Pediatrics and the Council ofmedicine and Sports Fitness that
you do generally use thatguideline, depending on the age
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that your child is, that shouldnot exceed the hours per week of
what that kid is doing for thatparticular sport, and that helps
protect them. I tell the parentsaccrue frequent flyer points in
my office so they keep havingfun on the field and they're not
broken and battered.
I had on the past Dr Skaggs,he's a wonderful orthopedic
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doctor, and he also mentioned astudy that he conducted where
teenagers that slept over eighthours were actually even better
at their sport, that they mademore of their free throws and
they had less injuries. Is sleepsomething that you also notice
plays a big role as well withchildren in terms of preventing
overuse injuries and injuries ingeneral.
So sleep is part of that restcomponent, and it's the one
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supplement that I recommend totake. It's free. You know,
everybody is so over scheduledand their Go, go, go all the
time, but it's really important.
And that study did show thatthose students who achieved the
recommended hours of sleep bythe National Sleep Foundation
actually had less rates ofinjury. They were two thirds
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more protected from injury. Andif you look at athletes such as
LeBron James and Michael Phelpsand Serena Williams, and you
know these greatest of alltimes, you will see that they
are athletes who actuallyprioritize their sleep. And
again, it's that time where thebody is allowed to regenerate
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and it allows the kids to getstronger, their performance
actually goes up. There's onesleep health specialist. Her
name is Dr. Are Sherry Ma. Shedoes a lot of work in this field
in terms of research, and workswith some of the pro athlete
teams, and she's conducted someresearch with some NCAA athletes
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as well as some pro athletes,and has shown that those who
actually prioritize the sleep,they get good quality sleep as
well that they perform better,and I really want to emphasize
quality sleep, because we alsodid a study where we looked at
the athletes when they wentthrough middle school and high
school, and we had them documenttheir sleep via sleep journal,
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but we also monitoredobjectively their sleep via
after graph watches. And so wenoticed that kids really
overestimate how much sleepthey're getting, sometimes
upwards of one to two hours,where they think they're getting
eight hours of sleep, and inreality, they're only getting
six because they're in bed,they're on their phone, so it's
(15:56):
not really sleep that they'regetting. So I also emphasize
that when I talk to familiesthat you want to implement the
nice, healthy sleep hygienehabits that will achieve not
just the number, but thequality.
To summarize what we'vediscussed so far in terms of
injury prevention, it soundslike in the younger years, you
(16:19):
want to go slow. You want tokeep it fun. You want to avoid
over training. You want toinclude a rest day. And then
once they're teenagers, you canthink about training with a
little more intensity,specializing and really
following what the child isinterested in. If they seem like
they're burning out follow thosecues, and if they seem like
they're interested, then that'sgreat. You can continue on that
(16:40):
pathexactly, keeping the catered at
the center, because that reallyhelps to guide everybody. It
should be a team effort, but ifwe keep the actual individual
athlete at the center, let themhave agency to guide how they
would like this and making surethat all the needed kind of
(17:02):
resources are there to help themthrive in a healthy way, then
we'llall win. I could not agree with
that statement anymore. I thinkfollowing the child is the
answer now for yourself. DrEdison, as a sports medicine
doctor, I'm curious, are therecertain injuries that you see
over and over again with kidsthat you would love parents to
(17:23):
hear about so that they canthink about prevention with
their children.
Yes, absolutely. So I'll giveyou another staggering
statistic, on average, one childunder the age of 18 once every
25 seconds, it's seen for asports related injury in the ER
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so that doesn't even include allthe stuff that we're seeing in
our clinics or in urgent care orjust on the field that you
haven't yet to come in to beseen. I'll say injuries are a
little bit different thanadults, because they're growing
and physically and developingemotionally, and they have open
growth plates, which can makethem more vulnerable. They have
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rapidly growing bones andmuscles that are attaching to
those bones which make them morevulnerable, paired with high
intense training, okay, allowsfor the right recipe for these
overuse injuries that we see,and we see them in the knee. We
see them in the ankle, the arm,the back, the shoulder, and so
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again, it's that unequal balancewhere they're doing too much,
they're having improper eithertechnique or improper recovery
time, for example, so a baseballpitcher who is 11, and they're
working on throwing, they'vebeen put in position of pitcher,
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the coach says, Yeah, I justreally want you to concentrate
on that. And they're throwingharder than they should, or with
improper technique. They're notallowing proper rest in between
their practices, they might notrealize all the muscles that
they need to engage in order tohave proper form when they're
(19:10):
throwing and then it results ina tear in a ligament that's in
the elbow, called the ulnarcollateral ligament. They're
coming in because they can'tfully extend their arm. They're
having a lot of pain there? Or,for example, someone who just
started their entering freshmanyear of high school and they
want to try out for the crosscountry team, the coach gets
(19:31):
encouraged and says, Hey, we'regoing to go from 20 miles a week
to 40 miles a week, just likethat, without kind of a ramp up.
And so then they're in my officewith a stress fracture, either
in their foot or in their lowerleg, or a gymnast who just
suddenly learned how to do aback walkover. And they just do
(19:52):
it over and over again inpractice, and they're practicing
25 hours a week. And so they endup in my office with a stress.
Back to in their lower back. Soall these things that can come
about that we see that comethrough those doors, but again,
the basis of all of those can bejust improper training,
deconditioning, sub optimalreadiness, sub awful fueling,
(20:15):
improper or poor sleep, impropertechnique. They don't have the
right equipment or something tosupport them and biomechanical
issues.
Do you find that for a lot ofchildren, they get signals of
pain from their body? I alwaysfeel like pain comes from the
body for good reason. I tellkids to listen to their body
when they're feeling pain, andthat that's the time to rest. Do
(20:37):
you agree with that? Because Ifeel like a lot of people try to
mask the pain with medicationsand whatnot, and that, right?
Truly, most of the time, that'sa signal from your body that
it's time to take it easy. Yes.
So we need to debunk all thedodge that pain is weakness
leaving the body. I've heardcoaches say that to athlete, and
it's scary, because that is notwhat we should be doing. We
(20:58):
should not be ignoring thosesignals. I tell my athletes and
families all the time, those arethe body communicating that
something is going on, somethingneeds to change quick, faster
than a hurry, or else we'regoing to end up in trouble. And
so if we ignore those signals,and that's when they end up with
a really bad injury, and we havea weird kind of relationship
(21:22):
with pain right now, I think, asa society, it's either that we
need to ignore it, because if weadmit to it, it's a sign of
weakness, or that we shouldnever, ever experience it. And
so we need to take something toget rid of it, rather than
really honoring those signalsthat the body gives us and doing
(21:42):
the right thing, and figuringout what's causing that pain in
the first place and dealing withthat?
I think that is so true, becauseI myself feel like when I'm
uncomfortable, I try to workthrough it. I want to feel like
I'm tough. I don't feel like,oh, I should mask all of this
pain, that it's there for areason. And then I definitely
agree with you, we have painmedication. Why should people
(22:03):
suffer? So there's also thatpiece of it that, especially if
it can aid in healing andfeeling better, there's gotta be
some sort of happy medium here.
Yes, I think we need to achievea more healthy relationship with
the concept of pain, and alsotry and redefine what pain is,
and when do we act on it?
There's also just differentnuances. It's not just pain. Do
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you have it or not? It's like,Do you have pain because
something is seriously goingwrong? Is that sharp sensation
in a joint or in a bone thattells you Something is
definitely wrong, or is itmuscle soreness, meaning that
you trained yourself reallywell. You worked some things
that you're not used to working.
(22:45):
And so if we can learn thosenuances more, then we'll all be
in a much better place as theyget older, and just as a society
as a whole,I agree. I think there's some
general principles I thinkabout, for example, can they
bear weight? Does the pain feelexcruciating and sharp, or does
it feel like muscle soreness?
And so some of that, I think,will come with experience and
(23:08):
time, and some of it, I think,for anyone listening who has
questions, that's when it'sgreat to see a doctor like Dr
Edison or your pediatrician.
Absolutely, yeah, the more wetalk about and communicate about
it, the better.
I also want to say that I'mreally glad you pointed out that
when it comes to supplements,the only supplement that you
endorse is sleep, becausethere's so much noise out there
right now about peptides andcreatine. So I love that you
(23:33):
said that the only supplementyou truly believe in is sleep.
Yeah, absolutely, one of thegreatest athletes, I think that
this planet has seen KobeBryant, I had the pleasure and
honor of talking with histrainer. He said that he took a
very natural approach towardshis training. He emphasized just
(23:56):
eating well, have a nice diet,prioritizing sleep and making
sure that he was training andmoving in the right way, which I
think is the way to go, if wedon't need to load ourselves the
latest and greatest from GNC andall of that, it's more so you
know, we need to go back to thebasics, if we keep a strong
(24:17):
foundation with that that willHelp Us overall
and help the kids. The basicsabsolutely thinking about
getting your sleep, getting awell rounded nutritious diet,
thinking about keeping yourstress low, not over training. I
couldn't agree more that thebasics are what really give us
that foundation to be the bestathlete that we can be. So in
(24:39):
terms of recovery, do you haveany advice? Yeah, from an injury
prevention standpoint, it'sreally trying to take an
individualized approach to thatyoung athlete's development and
training that can really helpdevelopment and puberty can come
at varying different times. Agesand ages for kids. So we can't
(25:02):
just go based on age. Then theyshould be able to do X, Y or Z.
We can't do that. And so knowingthat during those times of rapid
growth, there can be lots ofphysical differences between
kids, and can be very dramatic.
And so again, it's not thatwe're letting what someone else
does guide our own actions. Wecan't do this keep up with the
(25:26):
Joneses type approach with youthsports, in particular with your
own child, because that canreally set them up for failure
and for injury. Instead, we wantto look at individual growth
spurts, because those can affectcoordination, balance and the
ability to perform a particularskill. So given that when an
(25:48):
athlete is going through thoseperiods of rapid growth, it can
actually be beneficial to pullback a little and refocus on
those fundamentals and reestablishing a strong base, re
establishing good confidence,and then advance. Because as a
kid is rapidly growing, theircenter of gravity changes, and
(26:09):
so their movement profilechanges. Their muscles get
stretched super tight. Soeverything changes, and so
they're not moving the same waythat they did three weeks ago.
So they have to relearn all ofthat, recalibrate, basically.
And so if you're trying todemand them to stay at a super
(26:30):
high level performance and asuper high level of training as
they're trying to relearn that,then that's when things happen
and they end up with theinjuries. That's an
excellent point you make,because you're right. There's so
much change happening that, ofcourse, they're going to need to
reevaluate the movements they'redoing and the exercises they're
(26:52):
doing to prevent injury. Soquestion, there's some myths
that come up when it comes totraining that I would love to
clear up with you, or just askyou about. The first is
stretching. How much doesstretching really matter in
terms of injury prevention?
Yeah, stretching can be verybeneficial. So everything is
connected to everything else,from basically from your feet
(27:17):
all the way up to your centercore and your trunk. And so if
one of those kind of links areoff, then it throws everything
else out of whack. And so forinstance, let's take the
hamstring, which is in the backof your thigh. When you go
through a rapid growth spurt, ifyour femur, your thigh bone,
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grows super fast, it can pullthose muscles, particularly that
hamstring. If that's reallytight, then it's hard to engage
that muscle, and then it's hardto engage the muscle that's
really close by to that, calledthe glute muscle, which is your
powerhouse, the source of a lotof strength and stability. If
(27:58):
it's hard to engage that, thenother muscles are going to
overcompensate, particularly inthe front of your thigh, your
quad muscle, which is attachedto your kneecap and can pull
really tautly and cause a lot ofknee pain. That's what we call
patellofemoral syndrome. It'snot that if you don't stretch,
it's going to be detrimental,but what I say is, if you don't
(28:23):
stretch, then it's hard toengage everything together so
everything can be coordinated toprovide you with the proper
strength that you need. Thenyou're going to overuse certain
areas, and it's going to causepain, and then it can lead to
downstream negative effects. Sodo you have general guidelines
when you talk to parents interms of how and when kids
should be stretching. So what Isay is you should be doing a
(28:46):
good warm so your muscles arenice and warm and pliable. You
should be doing what we calldynamic stretching. Research has
shown that dynamic stretchingparticularly when you
incorporate that into an ACLprevention program, those like
the FIFA 11 plus and those sortof things for soccer and
whatnot, that it can reduce yourinjury risk for ACL tears, those
(29:10):
sort of things after practicewhen you're doing a nice cool
down stress, so things don't getso tight when you're about to
leave and go home. But you alsowant to prevent over stretching
too, because I'll see some of mydancers or performing arts
athletes who are using chairs orbolsters or someone else to push
them. So that can be dangerousas well, because you're putting
(29:33):
so much stress on the jointswhere it can cause a
lot of damage.
Yeah, and I think that goes backto also letting pain be your
guide with some nuance. If it'sa little bit of pain, okay, and
it feels good, but if it'shurting, I think that's obvious.
The body saying, do not do thisto me. No, yes. Now, what about
ice? Do you have any thoughts onice? When should ice be
(29:55):
implemented? And does itactually work to help with
healing the body after aninjury?
There's. Been a lot of researcharound ice and its utility, or
its futility, actually, and whatit's meant for in our sports
medicine realm, it's been shownto be useful for really acute,
immediate kind of uses, such asif you a fewly sprain your ankle
(30:19):
and you get a lot of swellingthat can help for comfort and to
help decrease that swelling, butlong term or chronically, that
ice really hasn't been shown todo
much, if anything. I feel likewith my kids, for example, it's
a great placebo. After mydaughter stubs her toe. If I
hand her some ice, it seems toat least calm her down. I'm
(30:41):
giving her something to refocuson. It's all very interesting,
because even if we don't havegreat data on how much something
may benefit somebody, I like togo by how you feel afterwards.
So if you put ice on yourswollen ankle and it makes you
feel better, detract from thepain, great in moderation, it
certainly can't hurt, right?
Okay, a couple more commonquestions that I hear from
(31:03):
parents. One is, do you have anythoughts on the use of Motrin or
Advil, any of the antiinflammatories? What would you
say in general when yourecommend those anti
inflammatories? Those should beused only if you really need
them.
And it goes back to thisinteresting relationship that we
have with pain and also tryingto avoid pain. So what I
(31:24):
absolutely recommend against iswhat we call pre medicating. So
some families will ask, What ifI just give them some motion
before the gain? That waythey'll be fine. But really,
that can mask a more seriousinjury or the patient might not
feel pain, that would clue themin that, hey, something's going
(31:48):
on, then they push themselves tothe brink where it's even more
serious injury. So definitelyrecommend only use it when it's
needed. It should not be usedchronically, because if you're
having pain so much where youfeel that you need ibuprofen or
Motrin on a regular basis ordaily basis, that's when you
really need to talk to yourpediatrician or family doctor or
(32:10):
sports medicine specialist tofigure out what's going on. Why
are you having this ongoingpain, or what do we need to do
about it? Because that shouldnot be happening.
So it sounds like for short termuse, okay, but to be careful not
to use it in a way that you'reband aiding pain, because if you
take some ibuprofen before youexercise to hide whatever pain
you're feeling, you may actuallymake your injury worse, because
(32:32):
the body is sending you thosepain signals for good reason.
That's absolutely true. And thena question that comes up a lot.
I'm just curious your thoughtson this. I know a lot of parents
that are gym goers themselves,and they want to include their
children. And a lot of parentswant to know if they can bring
their kids to weight lift withthem. Yeah, okay. And there's a
lot of myths that I've heardthat float around about
(32:54):
weightlifting and kids. Somepeople say, Oh, I heard it
stunts their growth. Some peopleare worried that they're going
to enter themselves. Do youthink that weight lifting is a
healthy form of exercise forkids? Do you have any guidelines
in terms of when kids shouldimplement weight lifting?
So the shortanswer is, yes, it can be
beneficial. The longer answeris, as far as strength training,
I want to try and expand thatnotion of that concept beyond
(33:17):
weights, and offer up the termresistance training, and the
question now is not what happensto our kids if they lift
weights. Instead, the pressingquestion should be, what happens
to our kids if they don't and soour professional organizations
to include, again, the AmericanAcademy of Pediatrics and its
(33:37):
Council on sports medicinefitness and American Medical
Society for sports medicinerecommend resistance training
for you because it can offertremendous benefits to include
better muscular and bone health,better fitness and those
strength gains occur withdifferent types of resistance
(33:58):
training, but you have to do itfor extended period of time, so
minimum duration of at leasteight weeks, frequency of about
two to three times per week.
That can be bands. It can be theequivalent of their body weight,
but there's no apparent negativegeneral effect on a child's
(34:20):
growth trajectory on theirgrowth plates, on their
cardiovascular system withresistance training, and it is
part of our recommendations fromthe CDC and the WHO that two to
three times a week we should beimplementing weight based or
Resistance based training thatneeds to be done with proper
(34:43):
technique, and that reallyshould be done with someone who
knows the proper form. If you'rea parent who has set training,
great, take them with you to thegym, but if you don't, then
involve someone who's a strengthand conditioning coach. Coach or
an athletic trainer to make surethat the kid is doing it the
(35:04):
right way. It makessense what you're saying that if
they have proper form, they'resupervised, and they enjoy doing
it great, but if it looks liketheir form is off, they're going
to injure themselves. That's athat's a good sign to not do it.
I always laugh, because wheneverI'm in the office with a 15
month old, they often do asquat, and their form is
perfect. Squat beautiful. It'sbeautiful. I always tell adults,
(35:26):
if you want to know how tosquat, well just look at your 15
month old. They're doing it justright. So there, I do think
there's also a lot of truth thatkids naturally want to move.
It's healthy for them to movetheir bodies. They can do it in
natural, proper form. And ifthey're doing that great, let's
continue to encourageit. Yeah. Now there are certain
things that we recommenddefinitely in terms of the
(35:47):
amount of weight. If you'regoing to implement weights
involved, the kids should startto fatigue after that 13th to
15th repetition, if they canonly lift that particular weight
twice and they're reallystruggling, that's way too much
weight. We don't recommend whatwe call power lifting, where
(36:08):
you're putting so much weighton, where you can just do one or
two and then it leads to a lotof injuries, where they end up
back with us. So for anybodyconsidering, for your kid,
starting a resistance trainingregimen, it's really important
to consult with your child'spediatrician or sports medicine
specialist to discuss thosenuances.
(36:29):
And I do think there's an extraadded layer of pressure for kids
these days because of the socialmedia influence. I meet a lot of
kids, they'll look at bodyimages online and online fitness
content, and they think thatthey should be emulating that.
So it's important for parents tobe aware of those normal
pressures out there.
Oh, absolutely. And just havinghand those conversations about
(36:51):
what is healthy and what'sstrong, not what's pretty, not
what's masculinized, all ofthose things, it's about, okay,
what do we need to do? So youstay healthy, so you stay
strong, so you stay loving whatyou're doing each day within
your respectivesport. And I'm just curious, out
of all your experience dealingwith athletes and parents, if
(37:12):
you could talk to parents whofeel that natural, normal
feeling that their kid isfalling behind. Because a lot of
parents can have that feeling astheir kids get older and the
competition gets fiercer and thesport becomes harder, what would
your advice be to parents?
Yeah, I would say trying torescind falling behind according
to what and really having thatquestion, is it that you think
(37:35):
they're falling behind based onwhat is a typical performance?
Do you think that they'refalling behind based on that
super elite club team, and whatyou're seeing, is it falling
behind based on what you see onsocial media? Is it falling
behind because you don't thinkthat they're going to score a
particular scholarship down theroad? What are we talking about
(37:57):
here? And then hearing thoseconcerns, we can address that
with the right and properinformation, but also trying to
re center that conversation,that there is a bell curve or a
scope of what is typical andeverybody is different, and that
(38:22):
we need to meet the child that'ssitting in front of us, based on
where they exist right now, andhear from them what their goals
are. So I try to ask kids thatcome in to see me, what's your
short term goal? What's yourgoal within the next kind of six
months? Where do you seeyourself in five years? If you
(38:42):
want to dream about it, what doany of those look like without
even asking the parent first?
Because then that helpseverybody in
the room hear about whichdirection we need to go in.
So what I'm gathering from ourconversation is we want to
encourage our kids to lovesports, and our job is to help
our kids have a healthy,balanced relationship with
movement, so that hopefullyexercise and moving their body
(39:07):
is something that they do fortheir life to be emotionally and
physically healthy.
Yeah, absolutely. And so we'restill having a healthy
relationship with movement forthe duration of their lifetime,
and really recentering ourpriorities with youth sports,
that in reality, the likelihoodof gaining a d1, full time
(39:33):
scholarship or an n, i l deal,as we look at What's happening
now, or gain crow the likelihoodof that is very small, however,
the likelihood of your childaccruing the amazing skills that
(39:54):
sports provide in terms of timemanagement, learning how to. Get
yourself up from a defeat or afailure, learning how to
interact with different people,coming together as a team for a
shared goal, learning how tointeract with different adults
(40:14):
on a regular basis, learning howto goal set, achieve those and
honor that journey. Thelikelihood of that by
participating with sports isvery high. So we need to focus
on that, because that sets themup for success as adults, as
successful individuals withinsociety, as people who will then
(40:36):
take over the responsibilitiesof this world. So we need to do
that and change everything thatwe're putting into and funnel it
into those priorities, becausethat will help all of us, not
just a very small percentage ofthe kids who play wonderful Dr
Edison, this has been such anenlightening, enjoyable
(40:58):
conversation. Can you tellpeople who are hearing your
advice and maybe want to taketheir child in to see you for a
consultation or to meet you as adoctor? Where can they find you?
Well, I am part of the fantasticsports medicine and Orthopedic
Group at Children's Hospital LosAngeles, and we have varying
(41:19):
locations with our satelliteclinics, I myself am
concentrated in the South Bay,but my partners are located in
Los Angeles, near downtown andArcadia in Valencia and Encino,
and any of us would be more thanhappy to help the families and
(41:39):
kids continue to be strong andhealthy, amazing.
So for us parents, I'm going toremember to listen to our kids,
to emphasize the fun, toencourage exercise, but looking
at the child following theirbody cues, following their
psychological cues, and the restshould fall into place.
Communication is keywhen giving them the space to
speak up, advocate forthemselves, or speak up when
(42:02):
something doesn't feel right, isso Golden.
Thank you so much. Dr Edison, itwas so fun to connect with you.
Thank you for being here. Thankyou so much for having me. Thank
you so much for listening toyour child as normal. I'm so
grateful you're here and part ofthis community. If you're
enjoying this podcast, it wouldmean the world if you shared an
episode with a friend,subscribed and left a five star
(42:23):
review, and don't forget tofollow me on Instagram at ask Dr
Jessica for more parenting tipsand updates. See you next
Monday. Thank you so much forlistening, and if you enjoyed
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who might find it helpful, andleave a five star review
wherever it is you listen topodcasts, it really helps other
parents find the show and jointhis community. See you next.
(42:46):
Monday. Bye.
Hello listeners. This is Dr Jessica Hochman. I'm
(00:02):
excited to share that I am nowbooking sponsorships for your
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If you have a product, serviceor a message that you think our
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get back to you.
(00:31):
Hi everyone, and welcome back toyour child's is normal. I'm your
host. Dr Jessica Hochman, todayI'm thrilled to introduce you to
my friend and incrediblephysician, Dr Bianca Edison. Dr
Edison is a pediatric sportsmedicine and orthopedic
specialist at Children'sHospital Los Angeles, and a
clinical associate professor oforthopedic surgery at USC Keck
School of Medicine. She earnedher MD at Baylor College of
(00:53):
Medicine. She completed herpediatrics residency at UCLA,
which is where I had theprivilege of training alongside
her, and then went on tocomplete a sports medicine
fellowship at Children'sHospital of Los Angeles. If your
child plays sports, whether it'ssoccer, baseball, dance,
gymnastics or anything inbetween, you won't want to miss
this episode. We talk aboutpreventing injuries, avoiding
burnout in youth sports, andmost importantly, how to help
(01:16):
your kids build a healthylifelong relationship with
exercise. I learned so much fromthis conversation with Dr
Edison, and I know you will too.
So without further ado, let'sdive in. Everybody meet Dr
Bianca Edison, good friend ofmine, amazing doctor. Thank you
so much for being here, and Icannot wait for everybody to
learn from you, gain from yourexpertise, and to know who you
(01:39):
are. So thank you again forcoming on your child as normal.
Thank you for having me. It's anhonor to be here with you today.
So Dr Edison, tell everybodywhat kind of a doctor are you
and how did you get interestedin youth sports medicine?
So I am a pediatric sportsmedicine and orthopedic
(02:01):
physician. How I got into thisfield, actually, it was by
happenstance. Towards the end ofmy training, I thought I was
going to go into generalpediatrics, honestly, however,
there was an elective in sportsmedicine, and I chose to do that
elective to just get moretraining. And after working in
(02:21):
that practice, it just opened myeyes. And I thought, What is
this magical place? You get towork with athletes all day long.
And so that was my parlay intoit. So I did further training
with a fellowship, and here Iam, and I love it. I get to work
with young athletes and peoplewho just want to be active or
(02:43):
get back to their respectivelove and sport and just helping
them and their families and thecommunity.
And out of curiosity, were youyourself an athlete when you
were a child?
I mean, I take a very broaddefinition of athlete the
growing up. Yes, sports was thevehicle for my parents to get
(03:03):
myself and my siblings out ofthe house and keep us
entertained, and so Iparticipated in several
different sports growing up, butprimarily danced for many years,
and also played tennis andtrack. Those were and the main
ones, but tried out a wholebunch of things. I tried out a
(03:24):
Taekwondo, I tried outvolleyball, I tried out
basketball, I tried outgymnastics, I swam, we skied as
a family, so lots of differentthings. I'm looking
forward to having a conversationwith you about overuse injuries
in kids. Because I thinkeverybody can agree that sports
are fantastic for kids. Theyprovide a great vehicle for
(03:46):
exercise. There's so much valuein learning how to participate
on a team, how to lose, how tofeel the joy of winning. But at
the same time, I know a lot ofparents talk about how youth
sports today are different thanthey used to be. There's a lot
more stress involved thatthere's a lot more time
commitment that's expected ofthese kids. And so I wanted to
(04:07):
ask you, what would overtraininglook like for a kid or a teen
that's in a sport?
Yes. So I'll start off bysaying, I love my field, but I
don't necessarily love where weexist right now in this youth
sports kind of ethos atmosphere,because there is a lot of over
(04:29):
training that is happening withour youth and our young
athletes. And so balance isreally the key. And so by
definition, from both ourprofessional sports medicine and
pediatric societies such as theAmerican Medical Society for
sports medicine and the AmericanAcademy or pediatrics over
(04:51):
training. Or over trainingsyndrome refers to all these
symptoms that result fromexcessive exercise over time.
Mind with insufficient recovery,basically, to facilitate the
body's adaptation to that kindof exertion. And so in other
words, a kid is doing way toomuch in their respective sport
(05:15):
without proper recovery, andwhen that particular athlete
does not take the necessary restthat they need. That's when they
fall into the realm ofovertraining, which creates a
lot of negative outcomes fortheir body as well as their
mental and emotional state. Andso if you have those training
(05:36):
loads, there more the recoverythat's allowed for a period of
time, then their performancedecreases, and that can result
in physical stress, detrimentalfatigue, injury, burnout, and so
things that parents can reallysee is if their child feels
(05:57):
really fatigued, to the pointthat it interferes with their
school, with their athletictraining, with their daily
tasks, if they just can't bounceback basically from their
intense workouts, or if theystart having more frequent
injuries, if they're in myoffice much more, or if they
start to show signs of burnout,all of those are signs of that
over training.
(06:18):
And as I think about it, withkids, you can have burnout, both
physically and mentally.
Oh, absolutely, we have about 60million youth that are
participating in organizedsports. However, a staggering
statistic from the AspenInstitute shows that upwards of
70% of children drop out oforganized sports by the time
(06:42):
they turn the age of 13, fewerthan four in 10 students play
sports in public high schools.
Only 23% of kids reach therecommended level of daily
physical activity that theyshould be achieving, and that's
decreased from 2011 which was at29% in your opinion.
(07:05):
Do you have any thoughts as towhy that is, why so many quit
sports by the time they'reteenagers? Do you think it's
cost? Do you think it'scommitment? Do you think it's
burnout?
So I led a group where we lookedat a research study and we
followed kids. It was alongitudinal study, so
basically, we started out withthem in middle school, and we
(07:26):
followed the same group all theway through high school.
Primarily we wanted to look atsleep, but we looked at sports
participation, burnout, anxiety,all of those things. What we
found was that burnout what'smore common in high school than
in eighth grade, bothacademically and sports related
burnout. What we found that onein four students had sports
(07:49):
related burnout. And so I thinkthere's a myriad of different
things that can reallycontribute towards this.
Unfortunately, youth sports havebecome a multi billion dollar
interest, and we're asking kidsto perform at levels really,
that sometimes it can be toomuch. A lot of times it gets to
(08:09):
be too much. Some are doing2025, hours a week of their
respective sports. And if that'sall you're doing during these
formative years, either it getsto be too much, or when
something happens that pulls youout, such as an injury, it can
cause a lot of heartache andemotional stress. And if you
(08:31):
feel that, the focus is on theend result, be it either a
college scholarship, playingpro, getting endorsements, those
sort of things, then the childthemselves sometimes can feel
that they're not really beinghonored as their own individual
self. And so all of thesethings, and this pay to play
(08:55):
model in sports puts atremendous amount of pressure on
these young kids they're tryingto just grow and develop into
who they are as individuals andlearn themselves. And so when
the Aspen Institute did a verylarge survey nationally to look
at kids and ask them why theystopped playing, the number one
(09:16):
reason is that it's just not funanymore.
There are definitely kids that Imeet that just love the sport
they're participating in. Theycan't get enough of it. Let's
say it's baseball or basketballor dance, and they truly seem to
enjoy that sport. In thatsituation, are there any limits
that parents should be thinkingabout for their kids, or if
they're enjoying it and theirbody feels strong, can they do
(09:39):
that activity as much as theywant.
So the research shows that therestill should be some
limitations, and it could bebased on their age or their
stage of development, theircapabilities from both a
physical and a social emotionallevel and also. So looking at
(10:00):
what we know about what the bodycan withstand, so all of that
kind of grasp upon what we callthe American development model
of sports participation. Andthat came about in 2014 and it
was started by the US OlympicCommittee, along with the
national governing bodies forsports, and it's really based on
(10:25):
looking at each kidindividually, but also knowing
within the realm of theirdevelopment, based on their age,
what should be done for them,just to help them succeed and
really thrive in sports. Andreally love that for a long
term, because really our goalshould be that we should have a
(10:46):
society and a group of thisrising generation that really
loves to move, and should keepmoving to keep ourselves healthy
and strong. And so it says thatwithin that model, we recommend
between the ages of zero to 12years that children participate
in activities and sports thatpromote really discovery
(11:08):
learning and fun, and you'rehoning those skills of problem
solving and confidence boostingand conflict resolution. How do
you deal with something thatdoesn't go your way? And then
it's not until after age 10 thatwe recommend more challenging
skill development, and then notuntil that foundation is
(11:29):
solidified after age 13, thatone trains at a much higher
level and actually competesthrough that we collectively
help support a more broader,more inclusive participation in
physical activity and sports, wehelp cultivate stronger athletes
and just maintain, again, moreactive and healthier society for
(11:51):
those kids that have that strongfoundation really love what
they're doing, we want to makesure that they are also taking
proper rest, because the bodyneeds certain time to rest from
the high intense physicalactivity to allow the muscles to
repair and regenerate. So weavoid kind of burning out a
(12:14):
particular area of the body andavoid injury. Our national
societies and organizationsrecommend that, for kids, you
take at least one day per weekof full rest. You know, we're in
California, we can afford toplay sports year round from a
weather perspective, but weshouldn't, and that you should
(12:34):
take at least two to threemonths of rest away from that
particular sport where you dosomething else complimentary and
that to avoid again, that burndown some of those overuse
injuries.
I heard a general guideline,whatever age your kid is, think
about doing that many hours ofthat sport per week. So, for
(12:55):
example, a four year oldshouldn't do more than four
hours of dance a week, and so onand so forth. Is that something
that you would agree would be aquick motto for parents to pay
attention to formost kids in most sports. Yes,
it's the rule of ages that comeabout from the American Academy
of Pediatrics and the Council ofmedicine and Sports Fitness that
you do generally use thatguideline, depending on the age
(13:16):
that your child is, that shouldnot exceed the hours per week of
what that kid is doing for thatparticular sport, and that helps
protect them. I tell the parentsaccrue frequent flyer points in
my office so they keep havingfun on the field and they're not
broken and battered.
I had on the past Dr Skaggs,he's a wonderful orthopedic
(13:38):
doctor, and he also mentioned astudy that he conducted where
teenagers that slept over eighthours were actually even better
at their sport, that they mademore of their free throws and
they had less injuries. Is sleepsomething that you also notice
plays a big role as well withchildren in terms of preventing
overuse injuries and injuries ingeneral.
So sleep is part of that restcomponent, and it's the one
(14:02):
supplement that I recommend totake. It's free. You know,
everybody is so over scheduledand their Go, go, go all the
time, but it's really important.
And that study did show thatthose students who achieved the
recommended hours of sleep bythe National Sleep Foundation
actually had less rates ofinjury. They were two thirds
(14:24):
more protected from injury. Andif you look at athletes such as
LeBron James and Michael Phelpsand Serena Williams, and you
know these greatest of alltimes, you will see that they
are athletes who actuallyprioritize their sleep. And
again, it's that time where thebody is allowed to regenerate
(14:46):
and it allows the kids to getstronger, their performance
actually goes up. There's onesleep health specialist. Her
name is Dr. Are Sherry Ma. Shedoes a lot of work in this field
in terms of research, and workswith some of the pro athlete
teams, and she's conducted someresearch with some NCAA athletes
(15:09):
as well as some pro athletes,and has shown that those who
actually prioritize the sleep,they get good quality sleep as
well that they perform better,and I really want to emphasize
quality sleep, because we alsodid a study where we looked at
the athletes when they wentthrough middle school and high
school, and we had them documenttheir sleep via sleep journal,
(15:34):
but we also monitoredobjectively their sleep via
after graph watches. And so wenoticed that kids really
overestimate how much sleepthey're getting, sometimes
upwards of one to two hours,where they think they're getting
eight hours of sleep, and inreality, they're only getting
six because they're in bed,they're on their phone, so it's
(15:56):
not really sleep that they'regetting. So I also emphasize
that when I talk to familiesthat you want to implement the
nice, healthy sleep hygienehabits that will achieve not
just the number, but thequality.
To summarize what we'vediscussed so far in terms of
injury prevention, it soundslike in the younger years, you
(16:19):
want to go slow. You want tokeep it fun. You want to avoid
over training. You want toinclude a rest day. And then
once they're teenagers, you canthink about training with a
little more intensity,specializing and really
following what the child isinterested in. If they seem like
they're burning out follow thosecues, and if they seem like
they're interested, then that'sgreat. You can continue on that
(16:40):
pathexactly, keeping the catered at
the center, because that reallyhelps to guide everybody. It
should be a team effort, but ifwe keep the actual individual
athlete at the center, let themhave agency to guide how they
would like this and making surethat all the needed kind of
(17:02):
resources are there to help themthrive in a healthy way, then
we'llall win. I could not agree with
that statement anymore. I thinkfollowing the child is the
answer now for yourself. DrEdison, as a sports medicine
doctor, I'm curious, are therecertain injuries that you see
over and over again with kidsthat you would love parents to
(17:23):
hear about so that they canthink about prevention with
their children.
Yes, absolutely. So I'll giveyou another staggering
statistic, on average, one childunder the age of 18 once every
25 seconds, it's seen for asports related injury in the ER
(17:43):
so that doesn't even include allthe stuff that we're seeing in
our clinics or in urgent care orjust on the field that you
haven't yet to come in to beseen. I'll say injuries are a
little bit different thanadults, because they're growing
and physically and developingemotionally, and they have open
growth plates, which can makethem more vulnerable. They have
(18:07):
rapidly growing bones andmuscles that are attaching to
those bones which make them morevulnerable, paired with high
intense training, okay, allowsfor the right recipe for these
overuse injuries that we see,and we see them in the knee. We
see them in the ankle, the arm,the back, the shoulder, and so
(18:29):
again, it's that unequal balancewhere they're doing too much,
they're having improper eithertechnique or improper recovery
time, for example, so a baseballpitcher who is 11, and they're
working on throwing, they'vebeen put in position of pitcher,
(18:50):
the coach says, Yeah, I justreally want you to concentrate
on that. And they're throwingharder than they should, or with
improper technique. They're notallowing proper rest in between
their practices, they might notrealize all the muscles that
they need to engage in order tohave proper form when they're
(19:10):
throwing and then it results ina tear in a ligament that's in
the elbow, called the ulnarcollateral ligament. They're
coming in because they can'tfully extend their arm. They're
having a lot of pain there? Or,for example, someone who just
started their entering freshmanyear of high school and they
want to try out for the crosscountry team, the coach gets
(19:31):
encouraged and says, Hey, we'regoing to go from 20 miles a week
to 40 miles a week, just likethat, without kind of a ramp up.
And so then they're in my officewith a stress fracture, either
in their foot or in their lowerleg, or a gymnast who just
suddenly learned how to do aback walkover. And they just do
(19:52):
it over and over again inpractice, and they're practicing
25 hours a week. And so they endup in my office with a stress.
Back to in their lower back. Soall these things that can come
about that we see that comethrough those doors, but again,
the basis of all of those can bejust improper training,
deconditioning, sub optimalreadiness, sub awful fueling,
(20:15):
improper or poor sleep, impropertechnique. They don't have the
right equipment or something tosupport them and biomechanical
issues.
Do you find that for a lot ofchildren, they get signals of
pain from their body? I alwaysfeel like pain comes from the
body for good reason. I tellkids to listen to their body
when they're feeling pain, andthat that's the time to rest. Do
(20:37):
you agree with that? Because Ifeel like a lot of people try to
mask the pain with medicationsand whatnot, and that, right?
Truly, most of the time, that'sa signal from your body that
it's time to take it easy. Yes.
So we need to debunk all thedodge that pain is weakness
leaving the body. I've heardcoaches say that to athlete, and
it's scary, because that is notwhat we should be doing. We
(20:58):
should not be ignoring thosesignals. I tell my athletes and
families all the time, those arethe body communicating that
something is going on, somethingneeds to change quick, faster
than a hurry, or else we'regoing to end up in trouble. And
so if we ignore those signals,and that's when they end up with
a really bad injury, and we havea weird kind of relationship
(21:22):
with pain right now, I think, asa society, it's either that we
need to ignore it, because if weadmit to it, it's a sign of
weakness, or that we shouldnever, ever experience it. And
so we need to take something toget rid of it, rather than
really honoring those signalsthat the body gives us and doing
(21:42):
the right thing, and figuringout what's causing that pain in
the first place and dealing withthat?
I think that is so true, becauseI myself feel like when I'm
uncomfortable, I try to workthrough it. I want to feel like
I'm tough. I don't feel like,oh, I should mask all of this
pain, that it's there for areason. And then I definitely
agree with you, we have painmedication. Why should people
(22:03):
suffer? So there's also thatpiece of it that, especially if
it can aid in healing andfeeling better, there's gotta be
some sort of happy medium here.
Yes, I think we need to achievea more healthy relationship with
the concept of pain, and alsotry and redefine what pain is,
and when do we act on it?
There's also just differentnuances. It's not just pain. Do
(22:25):
you have it or not? It's like,Do you have pain because
something is seriously goingwrong? Is that sharp sensation
in a joint or in a bone thattells you Something is
definitely wrong, or is itmuscle soreness, meaning that
you trained yourself reallywell. You worked some things
that you're not used to working.
(22:45):
And so if we can learn thosenuances more, then we'll all be
in a much better place as theyget older, and just as a society
as a whole,I agree. I think there's some
general principles I thinkabout, for example, can they
bear weight? Does the pain feelexcruciating and sharp, or does
it feel like muscle soreness?
And so some of that, I think,will come with experience and
(23:08):
time, and some of it, I think,for anyone listening who has
questions, that's when it'sgreat to see a doctor like Dr
Edison or your pediatrician.
Absolutely, yeah, the more wetalk about and communicate about
it, the better.
I also want to say that I'mreally glad you pointed out that
when it comes to supplements,the only supplement that you
endorse is sleep, becausethere's so much noise out there
right now about peptides andcreatine. So I love that you
(23:33):
said that the only supplementyou truly believe in is sleep.
Yeah, absolutely, one of thegreatest athletes, I think that
this planet has seen KobeBryant, I had the pleasure and
honor of talking with histrainer. He said that he took a
very natural approach towardshis training. He emphasized just
(23:56):
eating well, have a nice diet,prioritizing sleep and making
sure that he was training andmoving in the right way, which I
think is the way to go, if wedon't need to load ourselves the
latest and greatest from GNC andall of that, it's more so you
know, we need to go back to thebasics, if we keep a strong
(24:17):
foundation with that that willHelp Us overall
and help the kids. The basicsabsolutely thinking about
getting your sleep, getting awell rounded nutritious diet,
thinking about keeping yourstress low, not over training. I
couldn't agree more that thebasics are what really give us
that foundation to be the bestathlete that we can be. So in
(24:39):
terms of recovery, do you haveany advice? Yeah, from an injury
prevention standpoint, it'sreally trying to take an
individualized approach to thatyoung athlete's development and
training that can really helpdevelopment and puberty can come
at varying different times. Agesand ages for kids. So we can't
(25:02):
just go based on age. Then theyshould be able to do X, Y or Z.
We can't do that. And so knowingthat during those times of rapid
growth, there can be lots ofphysical differences between
kids, and can be very dramatic.
And so again, it's not thatwe're letting what someone else
does guide our own actions. Wecan't do this keep up with the
(25:26):
Joneses type approach with youthsports, in particular with your
own child, because that canreally set them up for failure
and for injury. Instead, we wantto look at individual growth
spurts, because those can affectcoordination, balance and the
ability to perform a particularskill. So given that when an
(25:48):
athlete is going through thoseperiods of rapid growth, it can
actually be beneficial to pullback a little and refocus on
those fundamentals and reestablishing a strong base, re
establishing good confidence,and then advance. Because as a
kid is rapidly growing, theircenter of gravity changes, and
(26:09):
so their movement profilechanges. Their muscles get
stretched super tight. Soeverything changes, and so
they're not moving the same waythat they did three weeks ago.
So they have to relearn all ofthat, recalibrate, basically.
And so if you're trying todemand them to stay at a super
(26:30):
high level performance and asuper high level of training as
they're trying to relearn that,then that's when things happen
and they end up with theinjuries. That's an
excellent point you make,because you're right. There's so
much change happening that, ofcourse, they're going to need to
reevaluate the movements they'redoing and the exercises they're
(26:52):
doing to prevent injury. Soquestion, there's some myths
that come up when it comes totraining that I would love to
clear up with you, or just askyou about. The first is
stretching. How much doesstretching really matter in
terms of injury prevention?
Yeah, stretching can be verybeneficial. So everything is
connected to everything else,from basically from your feet
(27:17):
all the way up to your centercore and your trunk. And so if
one of those kind of links areoff, then it throws everything
else out of whack. And so forinstance, let's take the
hamstring, which is in the backof your thigh. When you go
through a rapid growth spurt, ifyour femur, your thigh bone,
(27:38):
grows super fast, it can pullthose muscles, particularly that
hamstring. If that's reallytight, then it's hard to engage
that muscle, and then it's hardto engage the muscle that's
really close by to that, calledthe glute muscle, which is your
powerhouse, the source of a lotof strength and stability. If
(27:58):
it's hard to engage that, thenother muscles are going to
overcompensate, particularly inthe front of your thigh, your
quad muscle, which is attachedto your kneecap and can pull
really tautly and cause a lot ofknee pain. That's what we call
patellofemoral syndrome. It'snot that if you don't stretch,
it's going to be detrimental,but what I say is, if you don't
(28:23):
stretch, then it's hard toengage everything together so
everything can be coordinated toprovide you with the proper
strength that you need. Thenyou're going to overuse certain
areas, and it's going to causepain, and then it can lead to
downstream negative effects. Sodo you have general guidelines
when you talk to parents interms of how and when kids
should be stretching. So what Isay is you should be doing a
(28:46):
good warm so your muscles arenice and warm and pliable. You
should be doing what we calldynamic stretching. Research has
shown that dynamic stretchingparticularly when you
incorporate that into an ACLprevention program, those like
the FIFA 11 plus and those sortof things for soccer and
whatnot, that it can reduce yourinjury risk for ACL tears, those
(29:10):
sort of things after practicewhen you're doing a nice cool
down stress, so things don't getso tight when you're about to
leave and go home. But you alsowant to prevent over stretching
too, because I'll see some of mydancers or performing arts
athletes who are using chairs orbolsters or someone else to push
them. So that can be dangerousas well, because you're putting
(29:33):
so much stress on the jointswhere it can cause a
lot of damage.
Yeah, and I think that goes backto also letting pain be your
guide with some nuance. If it'sa little bit of pain, okay, and
it feels good, but if it'shurting, I think that's obvious.
The body saying, do not do thisto me. No, yes. Now, what about
ice? Do you have any thoughts onice? When should ice be
(29:55):
implemented? And does itactually work to help with
healing the body after aninjury?
There's. Been a lot of researcharound ice and its utility, or
its futility, actually, and whatit's meant for in our sports
medicine realm, it's been shownto be useful for really acute,
immediate kind of uses, such asif you a fewly sprain your ankle
(30:19):
and you get a lot of swellingthat can help for comfort and to
help decrease that swelling, butlong term or chronically, that
ice really hasn't been shown todo
much, if anything. I feel likewith my kids, for example, it's
a great placebo. After mydaughter stubs her toe. If I
hand her some ice, it seems toat least calm her down. I'm
(30:41):
giving her something to refocuson. It's all very interesting,
because even if we don't havegreat data on how much something
may benefit somebody, I like togo by how you feel afterwards.
So if you put ice on yourswollen ankle and it makes you
feel better, detract from thepain, great in moderation, it
certainly can't hurt, right?
Okay, a couple more commonquestions that I hear from
(31:03):
parents. One is, do you have anythoughts on the use of Motrin or
Advil, any of the antiinflammatories? What would you
say in general when yourecommend those anti
inflammatories? Those should beused only if you really need
them.
And it goes back to thisinteresting relationship that we
have with pain and also tryingto avoid pain. So what I
(31:24):
absolutely recommend against iswhat we call pre medicating. So
some families will ask, What ifI just give them some motion
before the gain? That waythey'll be fine. But really,
that can mask a more seriousinjury or the patient might not
feel pain, that would clue themin that, hey, something's going
(31:48):
on, then they push themselves tothe brink where it's even more
serious injury. So definitelyrecommend only use it when it's
needed. It should not be usedchronically, because if you're
having pain so much where youfeel that you need ibuprofen or
Motrin on a regular basis ordaily basis, that's when you
really need to talk to yourpediatrician or family doctor or
(32:10):
sports medicine specialist tofigure out what's going on. Why
are you having this ongoingpain, or what do we need to do
about it? Because that shouldnot be happening.
So it sounds like for short termuse, okay, but to be careful not
to use it in a way that you'reband aiding pain, because if you
take some ibuprofen before youexercise to hide whatever pain
you're feeling, you may actuallymake your injury worse, because
(32:32):
the body is sending you thosepain signals for good reason.
That's absolutely true. And thena question that comes up a lot.
I'm just curious your thoughtson this. I know a lot of parents
that are gym goers themselves,and they want to include their
children. And a lot of parentswant to know if they can bring
their kids to weight lift withthem. Yeah, okay. And there's a
lot of myths that I've heardthat float around about
(32:54):
weightlifting and kids. Somepeople say, Oh, I heard it
stunts their growth. Some peopleare worried that they're going
to enter themselves. Do youthink that weight lifting is a
healthy form of exercise forkids? Do you have any guidelines
in terms of when kids shouldimplement weight lifting?
So the shortanswer is, yes, it can be
beneficial. The longer answeris, as far as strength training,
I want to try and expand thatnotion of that concept beyond
(33:17):
weights, and offer up the termresistance training, and the
question now is not what happensto our kids if they lift
weights. Instead, the pressingquestion should be, what happens
to our kids if they don't and soour professional organizations
to include, again, the AmericanAcademy of Pediatrics and its
(33:37):
Council on sports medicinefitness and American Medical
Society for sports medicinerecommend resistance training
for you because it can offertremendous benefits to include
better muscular and bone health,better fitness and those
strength gains occur withdifferent types of resistance
(33:58):
training, but you have to do itfor extended period of time, so
minimum duration of at leasteight weeks, frequency of about
two to three times per week.
That can be bands. It can be theequivalent of their body weight,
but there's no apparent negativegeneral effect on a child's
(34:20):
growth trajectory on theirgrowth plates, on their
cardiovascular system withresistance training, and it is
part of our recommendations fromthe CDC and the WHO that two to
three times a week we should beimplementing weight based or
Resistance based training thatneeds to be done with proper
(34:43):
technique, and that reallyshould be done with someone who
knows the proper form. If you'rea parent who has set training,
great, take them with you to thegym, but if you don't, then
involve someone who's a strengthand conditioning coach. Coach or
an athletic trainer to make surethat the kid is doing it the
(35:04):
right way. It makessense what you're saying that if
they have proper form, they'resupervised, and they enjoy doing
it great, but if it looks liketheir form is off, they're going
to injure themselves. That's athat's a good sign to not do it.
I always laugh, because wheneverI'm in the office with a 15
month old, they often do asquat, and their form is
perfect. Squat beautiful. It'sbeautiful. I always tell adults,
(35:26):
if you want to know how tosquat, well just look at your 15
month old. They're doing it justright. So there, I do think
there's also a lot of truth thatkids naturally want to move.
It's healthy for them to movetheir bodies. They can do it in
natural, proper form. And ifthey're doing that great, let's
continue to encourageit. Yeah. Now there are certain
things that we recommenddefinitely in terms of the
(35:47):
amount of weight. If you'regoing to implement weights
involved, the kids should startto fatigue after that 13th to
15th repetition, if they canonly lift that particular weight
twice and they're reallystruggling, that's way too much
weight. We don't recommend whatwe call power lifting, where
(36:08):
you're putting so much weighton, where you can just do one or
two and then it leads to a lotof injuries, where they end up
back with us. So for anybodyconsidering, for your kid,
starting a resistance trainingregimen, it's really important
to consult with your child'spediatrician or sports medicine
specialist to discuss thosenuances.
(36:29):
And I do think there's an extraadded layer of pressure for kids
these days because of the socialmedia influence. I meet a lot of
kids, they'll look at bodyimages online and online fitness
content, and they think thatthey should be emulating that.
So it's important for parents tobe aware of those normal
pressures out there.
Oh, absolutely. And just havinghand those conversations about
(36:51):
what is healthy and what'sstrong, not what's pretty, not
what's masculinized, all ofthose things, it's about, okay,
what do we need to do? So youstay healthy, so you stay
strong, so you stay loving whatyou're doing each day within
your respectivesport. And I'm just curious, out
of all your experience dealingwith athletes and parents, if
(37:12):
you could talk to parents whofeel that natural, normal
feeling that their kid isfalling behind. Because a lot of
parents can have that feeling astheir kids get older and the
competition gets fiercer and thesport becomes harder, what would
your advice be to parents?
Yeah, I would say trying torescind falling behind according
to what and really having thatquestion, is it that you think
(37:35):
they're falling behind based onwhat is a typical performance?
Do you think that they'refalling behind based on that
super elite club team, and whatyou're seeing, is it falling
behind based on what you see onsocial media? Is it falling
behind because you don't thinkthat they're going to score a
particular scholarship down theroad? What are we talking about
(37:57):
here? And then hearing thoseconcerns, we can address that
with the right and properinformation, but also trying to
re center that conversation,that there is a bell curve or a
scope of what is typical andeverybody is different, and that
(38:22):
we need to meet the child that'ssitting in front of us, based on
where they exist right now, andhear from them what their goals
are. So I try to ask kids thatcome in to see me, what's your
short term goal? What's yourgoal within the next kind of six
months? Where do you seeyourself in five years? If you
(38:42):
want to dream about it, what doany of those look like without
even asking the parent first?
Because then that helpseverybody in
the room hear about whichdirection we need to go in.
So what I'm gathering from ourconversation is we want to
encourage our kids to lovesports, and our job is to help
our kids have a healthy,balanced relationship with
movement, so that hopefullyexercise and moving their body
(39:07):
is something that they do fortheir life to be emotionally and
physically healthy.
Yeah, absolutely. And so we'restill having a healthy
relationship with movement forthe duration of their lifetime,
and really recentering ourpriorities with youth sports,
that in reality, the likelihoodof gaining a d1, full time
(39:33):
scholarship or an n, i l deal,as we look at What's happening
now, or gain crow the likelihoodof that is very small, however,
the likelihood of your childaccruing the amazing skills that
(39:54):
sports provide in terms of timemanagement, learning how to. Get
yourself up from a defeat or afailure, learning how to
interact with different people,coming together as a team for a
shared goal, learning how tointeract with different adults
(40:14):
on a regular basis, learning howto goal set, achieve those and
honor that journey. Thelikelihood of that by
participating with sports isvery high. So we need to focus
on that, because that sets themup for success as adults, as
successful individuals withinsociety, as people who will then
(40:36):
take over the responsibilitiesof this world. So we need to do
that and change everything thatwe're putting into and funnel it
into those priorities, becausethat will help all of us, not
just a very small percentage ofthe kids who play wonderful Dr
Edison, this has been such anenlightening, enjoyable
(40:58):
conversation. Can you tellpeople who are hearing your
advice and maybe want to taketheir child in to see you for a
consultation or to meet you as adoctor? Where can they find you?
Well, I am part of the fantasticsports medicine and Orthopedic
Group at Children's Hospital LosAngeles, and we have varying
(41:19):
locations with our satelliteclinics, I myself am
concentrated in the South Bay,but my partners are located in
Los Angeles, near downtown andArcadia in Valencia and Encino,
and any of us would be more thanhappy to help the families and
(41:39):
kids continue to be strong andhealthy, amazing.
So for us parents, I'm going toremember to listen to our kids,
to emphasize the fun, toencourage exercise, but looking
at the child following theirbody cues, following their
psychological cues, and the restshould fall into place.
Communication is keywhen giving them the space to
speak up, advocate forthemselves, or speak up when
(42:02):
something doesn't feel right, isso Golden.
Thank you so much. Dr Edison, itwas so fun to connect with you.
Thank you for being here. Thankyou so much for having me. Thank
you so much for listening toyour child as normal. I'm so
grateful you're here and part ofthis community. If you're
enjoying this podcast, it wouldmean the world if you shared an
episode with a friend,subscribed and left a five star
(42:23):
review, and don't forget tofollow me on Instagram at ask Dr
Jessica for more parenting tipsand updates. See you next
Monday. Thank you so much forlistening, and if you enjoyed
today's episode, it would meanthe world to me if you could do
two things, share this episodewith a friend or another parent
who might find it helpful, andleave a five star review
wherever it is you listen topodcasts, it really helps other
parents find the show and jointhis community. See you next.
(42:46):
Monday. Bye.
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