SAFETY
HEAT AND COLD ILLNESS
- Children are more susceptible to heat illness than
adults. - Children have a larger body surface area to body mass
ratio than adults. This makes children more likely to
gain heat from the environment in hot conditions and
lose it in cold environments (Sullivan and Anderson,
2000). - Heat loss in children is even more apparent in water
because of the high thermal conductivity of water. - Compared to adults exercising at a given level, children
have increased heat production per kilogram of body
mass. This leads to faster increases in body temperature
in warm weather, but can be protective when exercise is
performed in cold environments (Smolander et al,
1992). - Another disadvantage for children exercising in warm
environments is that the sweating rate in children is
lower than in adults. This is particularly important
when the temperature of the environment exceeds the
skin temperature. In this type of environment, sweat
evaporation from the skin is the only means for cool-
ing the body. - When dehydrated, a child’s temperature rises faster
than an adult’s, increasing the risk for serious heat
injury (Sullivan and Anderson, 2000).
HYDRATION
- Children should be well hydrated prior to starting any
physical activity (Sullivan and Anderson, 2000). - During activity, children should be encouraged to
drink 120 mL (5 oz) of water every 20 min. Older,
heavier children will require 250 mL (9 oz) every
30 min (Sullivan and Anderson, 2000).
•For activities lasting longer than 1 h, a 6% carbohy-
drate solution with sodium and chloride should be
used.
•Beverages should be cold to improve palatability. - Lightweight clothing should be worn to facilitate
sweat evaporation.
SUN EXPOSURE
- Sunscreen with SPF 15 should be applied 20 min prior
to sun exposure to reduce the risk for sunburn. - Sun exposure during childhood has been linked to the
development of skin cancer in adulthood.
PROPER EQUIPMENT- Children should be provided with appropriately
sized equipment in good condition for sport partici-
pation.
•Padding for football, hockey and soccer is made in
children’s sizes.
•Weight training equipment can be found in sizes and
with weight increments appropriate for children. - Mouthguards should be worn for all contact sports to
prevent dental injury. There is some evidence that
mouthguards can prevent head injuries as well.
PRESEASON MEDICAL EVALUATION- The preparticipation physical examinaton can prevent
injury by identifying medical conditions that may be
exacerbated by sports participation and musculoskele-
tal issues that can be addressed and rehabilitated
before sports participation.
GROWTH AND DEVELOPMENT- Some debate exists over whether or not sports partic-
ipation has an effect on growth.
•Regular physical activity does not appear to have any
adverse effects on growth (Sullivan and Anderson,
2000). - There is some evidence that intense, high-volume
training may adversely affect growth. - It appears that young athletes who experience atten-
uated growth during training will exhibit catch-up
growth when training levels decrease. High inten-
sity exercise, alone, may not account for these
effects on growth; inadequate nutritional compensa-
tion for a given training volume may also play a
role.
STRENGTH TRAINING- Strength training by children and adolescents when
properly supervised is considered safe and effica-
cious. - Strength training is often recommended for
improvement in sports performance, injury rehabili-
tation, injury prevention and general health benefits
(AAP Committee on Sports Medicine and Fitness,
2001). - Studies have shown that when properly structured,
strength training can increase strength in preadolescents
564 SECTION 7 • SPECIAL POPULATIONS