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Prakash Chandran: Young athletes have been facing many challenges due to COVID-19. From changes in practice and play schedules, taking safety precautions, and deciding when it's safe to return to sports after a COVID-19 diagnosis, they face many unknowns. Today, we're going to offer advice for young athletes when it comes to playing sports during COVID-19. This Children's Health Checkup COVID-19 podcast was recorded on February 18, 2021.  

This is Children's Health Checkup where we answer parent's most common questions about raising healthy and happy kids. Here to give advice for athletes during COVID-19 is our expert, Dr. Troy Smurawa, Director of Pediatric Sports Medicine at Children's Health Andrews Institute for Orthopedics and Sports Medicine. This is the Children's Health Checkup. The podcast from Children's Health. My name is Prakash Chandran.

So first of all, Dr. Smurawa, it is great to have you here today. My first question is really around how have you seen the COVID-19 pandemic affecting student athletes?

Dr. Troy Smurawa: Yes, the COVID-19 pandemic has affected athletes in several ways. And the first thing we know is that athletes face both physical and mental challenges from not being able to train or play during this period of social distancing time off. So what we find is that athletes will lose motivation or actually lose access to facilities and coaches that they need for successful training and conditioning.

During this prolonged period of decreased productivity, they can affect the athlete negatively in certain ways such as their athletic performance and their physical fitness as well as their mental health and wellbeing. When an athlete is not active or not training, their body begins to decondition such as losing muscle strength, speed and skills.

Also, they actually lose mental skills and motivation to continue with their training and participation in their sport. Many athletes do rely upon coaches and trainers to help with their training. And when they don't have this access, they have to achieve this at home and that can be challenging in itself.

So when an athlete is away from the sport, they feel like they don't have the guidance and direction that they need to participate in sports. So that further enhances their loss in motivation and the skills that they'll need to participate in that sport.

And then lastly, I think that when athletes are away from their sport, they also rely upon their sport for stress release. And because these athletes are not with their peers, they also lose that social aspect of playing this sport.

Prakash Chandran: Yeah, that totally makes sense to me. It must be so challenging, both from a physical and mental standpoint, as you mentioned. I'm curious if you have any advice for the parents of these student athletes with regards to keeping them motivated during this time.

Dr. Troy Smurawa: Yes. You know, as a young athlete returns to sports and training, they may notice some physical and mental effects that occur because of this period of detraining such as decreased endurance, lack of concentration, lack of motivation. And then, he may have poor technique and reduced strength and speed, and this all affects their ability to return to sports. So parents and coaches should recognize that there may be some frustration, impatience in the part of the young athletes.

So with this, it's important to talk to the student and talk to your child and make sure as a parent that they can keep their athlete healthy and safe and keep them motivated. The first thing that they do is just making sure that they're ready to offer support. Make sure that the athlete is mentally prepared to work on the things that they need to do to get back into sport and not be impatient.

I think the second thing. Is that they should take it one step at a time and that the parents should also lead by example, that they know that, you know, during this time of restrictions, a lot of things have changed and parents as well have had to face different challenges with their work life and social life. So I think if you, as a parent lead by example, that will also show the young athlete what they need to do to progress back into the sport.

Also I think it's important that they should let the athlete know that they're not alone. Everyone in the whole country is facing the same thing. So it's not them only, but everyone is in this together. And that may help motivate them, knowing that their teammates and people they normally are training with are undergoing the same condition. I think also help them to make a plan and look forward to what they're going to do as they go forward going back to their sport.

And I think lastly, they should try to help them calm their fears because as they go back into the environment, some kids may feel more hesitant or fear of getting infected and what that means. And I think that's important that the parents really focus that they can go back into playing sports in a safe way.

Prakash Chandran: Yeah. Just related to that last

point, there are going to be some athletes that have to take a break from the sport due to COVID-19 exposure or an infected teammate. So what are they supposed to do while they're at home to stay active?

Dr. Troy Smurawa: I think it's important that an athlete when they're at home, is, really make sure that they're doing the best they can to stay healthy and fit. so some things that we recommend that they do is that they make sure, that they have some type of plan, going forward. as far as exercising, and having some type of routine, I think, first thing is really to, really take it one step at a time.

And making sure that they regain their physical abilities to do it in slow stages and steps to make a plan, have a plan and a set of training schedules and then focus on nutrition, they can do a lot of things virtually, that we haven't had. in the past and that way they can look at virtual resources, training resources to give them an idea of how to work out. They should really focus on maintaining their fitness level and not trying to increase their performance level, because if they try to push too hard, they might burn themselves out or, obtain what we call over-training or burnout. so it's, a lot easier to maintain strength and speed and overall fitness. than it is to try a higher level of strength and speed for, competition and participation. So we should really focus on that, and try to find ways to, put variety in their workouts. again, in the warmer, times a year, you can go running outside, do some activities outside different types of exercises inside, as well.

As I mentioned, you can look to for virtual training resources to help them and keep active. And I think also it's important to, focus on the mental aspect of it. You can reach out to your friends socially with the new social media platforms. you know, in the past, we've kind of told our kids to kind of tone down on how much social media they do, but this is maybe that one time where we can, let them involve more in their social media to reach out and have a connection with their friends and teammates that are not able to, because they're not in school.

Prakash Chandran: Yeah, really good. And I think that quote that you said encapsulates it well. They want to increase their fitness level, but not necessarily their performance level. So the importance of staying active, going outside and doing things to keep that baseline of fitness is going to be critical.

You know, there's going to be a lot of student athletes that opt into play, so if they do choose to do that, what precaution should they be taking when they come back to sports?

Dr. Troy Smurawa: Well, I think it's important that both the parents and the coaches emphasize to the students and the athletes that it is safe to return with precautions. The things that we need to look at is basically preventing or reducing the risk of spreading or getting an infection. And that's reinforcing things that we already know. That's encouraging athletes to keep their hands away from their face, not sharing water bottles, cleaning their equipment frequently, washing her hands as often as they can. And then, we encourage minimizing contact between athletes in practice as much as possible and using social distances during training and competition.

The biggest thing I think is also monitoring for illness. If an athlete feels sick or have a fever, then they should let their parents know or the coach know right away. That way, it allows them to get treated and also prevents them from spreading an infection to other athletes as well.

Also, I think it's important to let them know that sometimes the virus can be spread through contact on equipment and clothing. So make sure they're not sharing the equipment, washing equipment and washing their clothing frequently.

Prakash Chandran: So if an athlete gets diagnosed with COVID-19, even if they're not experiencing any of the symptoms, when is it safe for them to return to playing?

Dr. Troy Smurawa: That's a good question. We look at the different guidelines about when it's reasonable for an athlete returning to play after COVID-19. I think the first to know is that we do have those athletes that have exposure and don't have any symptoms. Those athletes, we recommend a 14-day quarantine before returning to sports activities.

But those that have symptoms with COVID-19, then what we really recommend is a quarantine for 10 days from the date of infection so that's important that they make sure that they're healthy before they go back to play.

There are some athletes that may potentially have lung or heart effects from having a COVID-19 infection. So those athletes that have had illness because of COVID-19, we do recommend that they get evaluated by their pediatrician and possibly a cardiologist or pulmonologist to make sure that their lungs and heart are safe to return to play in sports.

Prakash Chandran: Yeah. Related to that, I wanted to ask you if there were any long-term COVID-19 side effects with regards to being an athlete. You know, you mentioned the heart and the lung one potentially having lasting effects, but can you expand a little bit more on that?

Dr. Troy Smurawa: The evidence doesn't show that an athlete is in long term a higher risk. I think an athlete might be at higher risk because if they returned to do an activity while they're still having the effects of the COVID-19, that may predispose them to cardiac or pulmonary issues. We do know that athletes that exercise with a viral infection may develop a condition called myocarditis, which is inflammation infection of the heart muscle, and that can lead to prolonged symptoms. So that's something that it has been a concern. But over the past several months or past year since we have studied this, it's not as prevalent as we thought it would be, which is good for athletes, but it still is important that gets monitored.

Also, we do know with COVID-19 infection, that some people will have inflammation in the lungs and that potentially could have some problems with short-term or long-term problems with the lungs as far as their breathing effects. So again, there is some potential, but not a real risk that we've seen over long-term for the majority of the people that get infected with COVID-19.

Prakash Chandran: And, you know, just as we close here, is there any parting words of advice that you might have for either student athletes or their parents during this time?

Dr. Troy Smurawa: I think the most important thing is to know that this is a new type of virus. And as each month and time goes down, we learn more and more about how it affects or doesn't affect athletes. I think it's important that we motivate athletes to continue to participate in sports despite the interruptions that have occurred and are occurring. And that parents should be very supportive of their athletes to know that at some point, we will get back to some form of a normal schedule, but be patient with the schedule interruptions that do occur because of COVID-19

Prakash Chandran: Well, I think that is the perfect place to end, and I truly appreciate your time today. That's Dr. Troy Smurawa, the Director of Pediatric Sports Medicine at Children's Health Andrews Institute for Orthopedics and Sports Medicine.

You can find out more information about the Children's Health Andrews Institute at children.com/andrews and find more resources to stay healthy during the pandemic at childrens.com/COVID-19.

If you found this podcast helpful, please rate and review or share the episode and please follow Children's Health on your social channels. This has been Children's Health Checkup from Children's Health. Thank you so much. And we'll talk next time.