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What Parents Need to Know About Helping Kids with Pain

  • September 1, 2018
  • Preparation & Recovery
Parents

Dad helping son who hurt leg after falling off bike.Kids get injured in sports. It’s an inevitable reality that parents accept when they support youth sports participation, knowing that kids are more likely to learn teamwork, respect, hard work, and accountability during their time in sport. And while the rewards from sport are great and the risk of injury is usually low, the way pain from a sports injury is managed can make a significant impact on a young athlete’s recovery, as well as their long-term physical and mental well-being.

For example, research shows that when a child’s pain isn’t addressed quickly and effectively, the long-term results can include a lower pain threshold, anxiety over future treatment, and decreased response to painkillers.

With that in mind, parents should take some time to learn more about pediatric pain and the different ways to help kids deal with pain after a sports injury.

 

Where does pain and pain management start?

Approximately 30 million kids and teens play organized sports in the United States, resulting in more than 3.5 million injuries annually. Sports specialization, which has become more prevalent in recent years, also increases the risk of injury due to overuse.

It’s important to remember that pain is an important physical response because it tells the body to stop when something is wrong. “This is where the parental role is so important,” explains Dr. Gary Green. “Early recognition and treatment of an overuse injury, for example, can result in a few days off from sport, but continuing to play will cause a more severe injury that can take weeks to months off from sport to resolve.”

In youth sports, pain may come as the result of overuse, muscle tears, sprains, concussions, broken bones, and other injuries, as well as related procedures like surgery. When it comes to treating pain, it’s important to first identify the source of pain so that the treatment addresses the cause of the pain, rather than simply treating the symptoms.

 

Are there different levels of pain?

Pain is typically identified as acute or chronic, and treatment should vary based on the type of pain. Acute pain is brought on by injury or a specific illness and has a valuable biologic purpose, while chronic pain is is ongoing with no identified end-point and no biologic purpose. For children, acute pain is most common, especially in relation to sports injuries, and chronic pain is fairly rare.

In addition to the different types of pain, it’s important to recognize that everyone perceives pain differently, which is why the assessment and ongoing evaluation of pain is key to effectively treating pain.

 

What are the different ways to manage a young athlete’s pain?

Treatment of a child’s pain should be specific to the child, the source of their pain, the type of pain, and the level of pain. Taking time to understand and properly treat your child’s pain is critical, in part because effectively managed pain is connected to fewer complications and faster recoveries.

There are a number of ways to manage pain, including non-pharmacological methods (i.e. physical therapy), non-opioid medications (i.e. acetaminophen), and opioid medications (i.e. oxycodone). The use of these different methods should be based on an ongoing assessment of the level of pain, as described below:

 

What are some pain management methods that don’t involve medication?

Hot or cold compresses, massage, and relaxation techniques are non-pharmacological methods that can help young athletes recover physically and mentally after a sports injury. For example, RICE (rest, ice, compression, and elevation) is often an effective way to respond to small sprains or other minor injuries. After treating acute pain, physical therapy may also be recommended to help facilitate healthy recovery following a serious injury or surgery.

“Parents often ask me if they should use heat or cold to treat sports injuries,” notes Dr. Green. “In general, you can never go wrong with cold treatment. Cold is effective in reducing both acute and chronic inflammation and has been shown to markedly decrease pain. For acute injuries in particular, swelling is the major limitation in return to play, and the standard RICE treatment will help reduce swelling and pain. Of course, parents should take care not to compress an area too tightly or directly to avoid frostbite and skin damage.”

 

When should parents consider using non-opioid pain medications?

In both children and adults, mild acute pain is typically addressed with non-opioid pain medications and nonsteroidal anti-inflammatory drugs (NSAIDs) like acetaminophen, ibuprofen, aspirin, diclofenac, and etodolac, all of which can be obtained over the counter.

 

As Dr. Green explains, “The first line treatment for acute pain would be the RICE protocol. If the pain is not controlled with that, then acetaminophen at the appropriate dose for age and weight would be the next recommendation. If that is not effective, adding a NSAID, such as ibuprofen, should be considered.”

“Just as parents are encouraged to use acetaminophen with a NSAID to bring down high fevers, they can also be used together for acute pain. They each act differently on pain and some studies in adults show that the combination is as effective as narcotics in treating pain. Of course, the dosages should be adjusted for age and weight. NSAIDs can affect the stomach, so they should also be taken with some food.”

“As with all medications, parents should check with their physicians to ensure that there are no contraindications for either acetaminophen or a NSAID. If these do not control the pain, then this would be an indication to seek immediate medical attention. Finally, while pain is a symptom that can be treated, the most important thing is finding the source of the pain and treating the underlying cause.”

 

What do parents need to know about opioid pain medications?

Opioids, such as oxycodone and hydrocodone, remain the most common option for treating moderate to severe acute pain, and opioid pain medications like Oxycontin and Codeine are more likely to be prescribed after a severe injury or surgery.

Your child’s physician is responsible for selecting pain management methods appropriate for the circumstances and type of pain, but medical best practice requires that medications “be prescribed at the lowest effective dose for the shortest period of time.”

Dr. Green further notes, “Parents often have prescriptions for opiate pain medications left over from when they had their wisdom teeth removed or some other painful condition that required narcotics. It is NEVER appropriate to share these medications with anyone, let alone children. In fact, unused narcotics should always be disposed of properly to avoid accidental ingestion by kids. In addition to accidental overdoses, there are many examples of child addicts who began their addiction with medication found in the house.”

 

Takeaway

Parents should choose the most appropriate pain management option based on the circumstances, and often in consultation with a primary care physician. If needed, parents can also consult with a specialist in orthopedics and sports injury in pediatric patients.

For more information on the best practices for treating pain with medication, click here. You can also find more information on the alternatives to pharmacological treatment of sports injuries here.

Dr. Gary Green is board-certified in sports medicine and clinical professor in the UCLA Division of Sports Medicine. He is the medical director for Major League Baseball and has a practice in Pacific Palisades, California. He also serves on the Scientific Board of the Partnership for Clean Competition.

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Goal-Setting Lesson Video Transcript

Hi. I’m Trevon, Trey, Jennifer. Team USA wheelchair basketball player, paralympian, and true sport athlete. Today, I want to talk to you about goal setting. And there are three things that I would like you to know. First, successful athletes set goals and a planned roadmap. Second, goals should be written down, assessed over time, and changed if necessary. And third, goals need to be challenging in order to be worthwhile. As a freshmen at Edinboro University, I was a part of a team that made the national championship game. And at that time I recognized I was the low man on the totem pole, but I felt in my heart that I knew my dreams were so much bigger than winning a national title. I wanted to make Team USA. I knew what achieving my lofty goal was not going to be easy and that I would need to work hard every day.

So, as a reminder, I created a pyramid of goals that I kept right above my bed. This pyramid reminded me of the accomplishments that I was working towards and visually represented my need to create a solid foundation underneath me before reaching the top. In the bottom roll of my pyramid of goals I listed goals such as obtaining my bachelor’s degree, becoming a scholar athlete award recipient, and becoming an All-American. The middle row listed winning a national title and playing for a professional team. And at the top row, the most challenging of them all, I listed becoming a gold medalist for Team USA.

By understanding that there are smaller stepping stones to achieving my ultimate goal of being on Team USA, I was able to stay motivated and to stay focused on completing the smaller stepping stones fully before moving onto the next one. Now I’ll be the first to admit that not every goal that I listed on my pyramid was accomplished, but seeing my goals every day when I went to bed, I was able to push through the days that I felt like doing nothing in hopes of achieving the bigger picture. Remember, create a clear goal roadmap, assess your goals often, and continue to challenge yourself. I hope that you never stopped dreaming big or reaching for the stars. And I look forward to seeing where your roadmap takes you.

Body Image Lesson Video Transcript

Hi, I’m Kara Winger, Olympic javelin thrower, and true sport athlete. Today I want to talk to you about body image and I have three things I’d like you to know. First, healthy thoughts often lead to healthier bodies. Second, there are varying body types and no one’s body is exactly like another. And third, true beauty goes deeper than the skin. As a multi-time Olympian, I’ve experienced a lot of variation and progression in my training. My coaches and I adapt to my training frequently, all with the goal of supporting my long-term success and health in the sport of javelin. I’m talking to you about body image today because sometimes even with the best of intentions and a common goal in mind, the changes you make to your training habits can prove to be detrimental if made for the wrong reasons. In the lead up to the 2012 Olympic trials, I was told in order to improve my performance on the field, I should try to become a leaner, skinnier version of myself.

So I changed my diet. I went along with what I was being told to do, even though I’d had great success at a slightly heavier weight and higher body fat percentage, and became much leaner than ever before. It seemed like a successful change at first, but I didn’t have nearly the results I’d had before. And I believe becoming leaner than my body naturally wanted to be was what caused my ACL to tear. In the end, it cost me heavily going into the 2012 London games. The takeaway for me, and hopefully for you, is that it’s important to know what works for you and your body and to not compare yourself to others. You should do your research and experiment with your diet to find what makes you feel the best, rather than focusing on what you look like. Today, if I feel like having a chocolate chip cookie, I have one, just not every day.

I’ve learned what a properly balanced meal for my body looks like and I recognize food as the fuel that keeps me throwing. I hydrate and allow myself time to recover. And I listen to and communicate with my body so that I can be the best version of myself. In the end, you are in control of how you see, treat, and respond to your body. We only get one and it’s amazing to discover how many things our bodies can do. Be a true sport athlete. Love who you are in this moment and get excited for all the places your body will take you.

A Good Sport Lesson Video Transcript

Hi, I’m Izy Isaksen, Team USA, Modern Pentathlon, Olympian, US Army Sergeant, and True Sport Ambassador. Today, I want to talk to you about being a good sport. There are three things I’d like you to know. First, real winners act the same toward their opponent, whether they win or lose. Second, follow the rules and be a gracious winner and respectful loser. And third, sportsmanship reveals your true character.

I started competing in Modern Pentathlon eight years after my older sister and three-time Olympian, Margaux Isaksen, began competing. I soon realized that people often compared the two of us. I would overhear spectators and teammates asking, “Who’s the better athlete,” and “Who’s going to beat the other.” Instead of letting outside pressures create a negative experience for us, I chose to practice winning and losing with grace and respect. I know that it would have been easy to let our hyper competitive mindset affect our relationship, but instead we decided to support and cheer for each other, regardless of our own performance. My experience of competing against and being compared to my older sister, taught me to focus on how to perform at my best, rather than putting wasted energy into wishing for others to fail.

I believe that sportsmanship reveals true character. So, no matter what situation I encounter during competition, I know it’s important to always treat people with respect and be a good sport. Remember, be a fierce competitor, find grace in all your victories and losses. And I hope to see you out there.

What Kind of Coach Do You Want to Be? Video Transcript

Edwin Moses: You’re a coach. Maybe what you want is very simple, for everyone to just run in the right direction, score for their own team, to try and try again and again. Maybe you want your athletes to become all stars. You want them to earn trophies, medals, win titles. You want them to reach the highest height their sport allows. And wanting all of that, of course, that’s good. But as every great coach discovers, developing a great athlete means nurturing, nurturing the even greater person within. Truth is, you have even more influence than you know.

You have the ability to affect even deeper change, to take what’s in your hands and do something even more extraordinary. You can be both the coach who provides the skills needed to win the game and the coach who helps them learn and succeed beyond the sport, to become all stars wherever they land in the future, and to enjoy their lives more now, because the confidence and courage they find working with you will stay with them when they need it the most. There are games to be won, lives to change. Coaches have the power to do both.

I’m Edwin Moses, and the lessons I’ve learned through sport have challenged me, guided me, and shaped my life forever. What kind of coach do you want to be?

THE SIMPLE TRUTH: DECODING THE SUPPLEMENT INDUSTRY VIDEO TRANSCRIPT

At first glance, dietary supplements look the same. They seem safe and healthy, but just because the label says a product is a dietary supplement, that doesn’t mean it’s safe. Unfortunately, you can’t tell whether a product is safe or not just by looking at the label. Most vitamins, minerals, fish oil, and other supplements containing nutrients are probably just fine, but supplements are not evaluated or approved by FDA before they are sold. Although it is rare for vitamins or minerals to be contaminated with drugs, there has been at least one case of a vitamin containing an anabolic steroid.

At the other extreme are products that contain drugs, stimulants, anabolic steroids, or other hormones. Even though these are not technically dietary supplements, many of them are labeled as supplements. For example, body-building products sometimes contain anabolic steroids or Selective Androgen Receptor Modulators, known as SARMs, or other hormones. Some pre-workout or energy products contain illegal stimulants like DMAA, ephedra, or other amphetamine-like stimulants. Weight loss products might contain prescription drugs like sibutramine, or hormones, like human chorionic gonadotropin, also known as hCG. All natural or herbal sexual enhancement products might contain hormones or Viagra-like drugs. Products like these can harm your health and career, but they’re for sale online, in some nutrition stores, and they’re labeled as dietary supplements.

When you pick up a supplement, especially one that promises performance enhancement, you don’t know if it belongs in the “Mostly O.K.” pile or in the “Dangerous” pile. After all, two products might look the same, but one might contain just amino acids and other legitimate ingredients, while the other also contains anabolic steroids. Because of this, FDA has issued a warning about certain categories of supplements: body building products, weight loss products, and sexual enhancement products. Be extremely careful when considering a supplement in one of these categories. We strongly recommend that you avoid products in these categories.

Even when FDA tests supplements and finds dangerous ingredients, companies sometimes refuse to recall them. Sometimes, they simply repackage their product and continue selling it under a new name. Just because a product is on a store shelf doesn’t mean it is safe. You need to do your research and be an informed consumer. The dietary supplement industry is enormous. Supplements that appear to be safe could actually be dangerous products in disguise. If you use dietary supplements without doing your research, you may be taking serious risks with your health and your career. Please visit USADA’s Supplement 411 for more information about dietary supplements.