Sports Medicine

Proper daily hygiene practice is important both in athletics and in life. Developing proper hygiene habits can prevent issues that can negatively affect cosmetic appearance, participation in sports, and overall quality of life. It is particularly important that you practice these habits in athletics due to the community nature of sports participation. Certain diseases such as skin infections are far more prevalent in athletics, due to the close proximity between athletes on and off the field, and the possibility of skin damage occurring through contact or trauma. Because of the close proximity you share with others both on and off the field, poor hygiene can result in disease spreading from one individual to several throughout an entire team. The hygiene habits you practice can not only ensure that you stay healthy, but also prevent problems from spreading between teammates, coaches, and opponents.

Athletes should shower after every practice, preferably with antimicrobial soap.

Wash hands regularly with antimicrobial soap and water, especially when hands are visibly dirty.

Regularly wash personal uniforms and equipment. These items carry disease due to their proximity to the skin and environment, and in addition to unpleasant smell and stains that can present if left in a locker, they can be an easy way for infection to spread between members of an athletic team. Uniforms should be washed regularly, and should not be left in a locker or gym bag. This includes braces or sleeves that are worn regularly during participation.

Athletes should not wear dirty practice clothing over the course of multiple days in a row.

Avoid sharing equipment, towels, water bottles, razors, or clothing with other teammates. This is the easiest way for disease to transfer between athletes besides direct skin-to-skin contact.

Lockers and locker rooms should be cleaned and disinfected regularly.

Several simple, easy steps can additionally be taken to eliminate the possibility of spread of infection, in addition to proper hygiene habits:

If you are sick, do not come to practice. If you are coughing or sneezing regularly, or are experiencing flu-like symptoms such as nausea, fever, or chills, the odds of transferring a contagious illness to a teammate are high. If you are too sick to come to school, you are too sick to come to an athletic event.

• Regularly inspect your skin for open wounds or cuts.
• Report all cuts, abrasions, or lacerations to the Athletic Training Staff for proper wound care. All open wounds should be covered during athletic participation until fully healed to prevent contact with infected lesions, surfaces, or items.
• Recognize the signs of infected wounds or skin lesions. General signs and symptoms of possible infection include: Redness, warmth, tenderness to the touch, swelling, crusty or oozing pus from the wound, and/or scaly skin around the wound. If you are experiencing these symptoms, report this to the Athletic Training Staff immediately.-Identify signs and symptoms of common skin diseases. Some examples of more common infections are presented below (courtesy of NATA)

If any of these infections are discovered, the athlete will be removed from competition immediately and referred to a physician to be prescribed appropriate medication.

In the event of skin infection, the following steps will be taken. The time of removal from competition depends on the type of infection, but below are basic guidelines:

• The athlete will be removed from practice and competition and referred to a physician, who will prescribe medication.
• For fungal infections (ringworm, athlete's foot, etc.), athletes must take antifungal medication for at least 72 hours before returning to play. At that point, any active lesions must be adequately covered.
• For viral infections (Herpes simplex, molluscum contagiosum), the athlete should take antiviral medication for at least 120 hours. The athlete should have no new lesions for at least 72 hours, and be free of systemic symptoms (fever, nausea, etc). Active lesions may not be covered for participation.
• For bacterial infections (MRSA, impetigo, furuncle), the athlete should take antibiotics for at least 48 hours. They should have no new lesions for at least 72 hours. Existing lesions should not be open or have liquid pus present. Active lesions may not be covered for participation.

Proper nutrition and hydration will allow the student-athlete to perform optimally. Food and drink act as the athlete’s fuel and without sound nutrition and hydration, an athlete will not be able to perform at his highest level. The two examples below (where the athlete is the car and food/drinks are the gasoline) help simplify the importance of nutrition and hydration:

Imagine trying to drive a car without any gasoline; it will not run.

Now, imagine driving a high-end sports car, but fueling it with low quality gasoline, it is not going to function at its highest potential.

The athlete needs to be very conscious about what he is putting in his body- what fuel he is using. Failure to do so will likely result in some type of decrease in performance. Below you will find some general guidelines to help you fuel your daily and performance needs.

General Nutrition Tips

Eating frequently throughout the day can help to keep your energy level up for workouts and classes. In order to achieve this benefit, keep your body moving on an energy surplus during the day. To maintain this benefit and keep your energy high, follow these tips:

• Always begin your day with breakfast, even if it is something small
• Eat a meal every 3-4 hours. It is also important to maintain consistency with your meals. -Skipping meals can cause depletion of carbohydrate and protein stores, which can cause a decrease in performance.
• Don’t be afraid to snack during the day or after your evening meal. If you are hungry you need to be fed, but make good choices in regards to snacking options. Opt for nuts, pretzels or crackers over chips, cookies or candy!
• Avoid fast food as it generally has high amounts of fat and proteins and carbohydrates that are not easy for your body to use optimally.
• Understand your body and hunger cues rather than watching a clock to determine when to eat
• Your activity level will dictate how many calories you consume in a day. If your activity level is down, don’t continue to eat as if you were practicing every day
• Plan ahead for your day as it will allow you to have meals and snacks at appropriate times
• Try to eat a high-energy snack prior to workouts such as a cereal bar, grapes, apple juice, or sports drink
• Consume carbohydrates and proteins within 2 hours following a workout (see "post-activity considerations" below)
• Vary your diet and sources of protein. This will ensure that you are getting all of your essential nutrients and different types of carbohydrates and proteins that will help your body in different ways
• Try to consume 8-10 servings of fruits and vegetables per day, working up to 12-13 servings per day during peak activity levels
• Check the color of your urine to help determine hydration status. Dark colored urine can be a sign of a dehydrated state. Light colored urine (the color of lemonade) indicates that you are appropriately hydrated
• To make a successful change in weight (either up or down), it should be done over time. Do not try to gain or lose weight quickly because you will usually compromise your energy level or overall performance in doing so
• In attempting to make a successful weight change, you should change the amount that you eat, instead of what or how often you eat. These should stay the same in order to promote adequate nutrition and consistency.
• Log your exercise and eating daily to better understand your dietary habits and needs, and to reach your goal.

• It is important to point out that a high school aged male should consume approximately 2500-3000 calories per day and that these caloric needs increase with activity.
• For females, this number is around 2200 calories per day.
• Nutrition labels on foods and beverages are based on a 2000 calorie diet, so daily nutritional requirements need to be adjusted for high school aged males and females.

When figuring out how much "fuel" one should consume, the following numbers should guide you:

• Carbohydrates should make up 55-60% of an individual’s daily caloric intake
• Fats should make up 25-30% of an individual’s daily caloric intake (with most of this coming from unsaturated and polyunsaturated fats)
• Protein should make up 12-15% of an individual’s daily caloric intake (NOTE: Most athletes already consume 2-3 times the daily recommended amount)
• With regard to hydration, an individual should drink 8-10 cups (64-80 fluid ounces) of water per day (Additional depending on activity level and weather)

Pre-activity considerations:

Pre-game meal

A pre-game meal should be consumed 3-6 hours prior to the event. This meal should be balanced, but should avoid large amounts of fat and protein as these nutrients are harder to digest. It is important that the athlete consume foods that he/she has eaten before to avoid gastrointestinal issues.

Pre-game snack
A pre-game snack should be eaten 30-45 minutes prior to the event. To allow for adequate digestion, the athlete should eat a snack that is rich in carbohydrates, but is not too "heavy." Carbohydrates are the primary source of energy; thus it is important to have an ample amount of them prior to the event. For some athletes it may be difficult to eat this close to the activity secondary to pre-game anxiety, but even a small amount of carbohydrates has been shown to help improve performance.

Pre-training snack
Fifteen minutes prior to a training session, a small snack can be consumed. Again this snack should be "light" and consist primarily of carbohydrates. (Examples include fruit juice, crackers, and pretzels.)

Pre-Event Hydration

It is important to hydrate regularly, but especially before activity. Water is a catalyst for many of the reactions that occur in your body during athletic performance, and drinking an adequate amount before training or competition helps to prevent dehydration. It is recommended that you drink about two cups of fluid about two hours before activity in order to ensure proper hydration levels.

Water

During activity, it is recommended that the athlete hydrate to replace fluids lost through sweat. This is very important as it helps one function optimally by regulating body processes, maintaining cellular balance, and preventing heat illness. It is recommended that athletes drink approximately 8 ounces of water every 20 minutes of activity, and these needs increase if you are a "heavy" sweater, or if you are exercising in a hot environment. Replacing lost water is vital in optimizing athletic performance. Our bodies do not tell us we are thirsty until we have lost 1.5-2% of our body weight. Therefore, if an individual waits until he is thirsty to drink, then he is already at a disadvantage. Research has shown that as little 1.5-2% dehydration can result in decreased performance; thus, it is important to be proactive and avoid this to function at one’s highest potential.

Sports Drinks

Before talking about the positive effects of sports drinks, it is prudent to identify what classifies as a sports drink. Sports drinks are not the same as energy drinks. Sports drinks, like Gatorade, are electrolyte-enhanced beverages that usually contain carbohydrates as well. Sports drinks are highly beneficial to athletic performance and should be consumed during prolonged or intense performance. As mentioned earlier, athletes sweat when they train, but the sweat is not just water. Instead, sweat is a mixture of water and electrolytes (sodium, potassium, calcium, etc.). The white lines that can be seen on baseball hats and undershirts worn during activity are salt (sodium) stains that stay there after the water has evaporated.

Sports drinks help replenish the electrolytes lost in sweat, and they also provide carbohydrates that help replenish one’s primary energy supply. Failure to replenish both of these nutrients can lead to decreased energy, electrolyte imbalances, and muscle cramping (which happens as a result of electrolyte loss), all of which will result in decreased performance.

Post-game meal

A post-game meal should be consumed within 1-2 hours of the event. This meal should be well-balanced with carbohydrates, fats, and proteins to replenish all of these nutrients that have been used during participation. The athlete should also drink 2-3 cups of water for every pound of body weight lost.

Post-training snack and hydration

Within 30 minutes of a training session (and no more than two hours after), the athlete should eat a post-training snack that consists of both carbohydrates and a small amount of protein. The athlete should also drink 12-16 oz. of water for every pound of body weight lost. By replenishing this will allow the athlete to get back to a baseline but will require additional fluids to hydrate for the next practice or activity.

NOTE:

Research has shown that carbohydrates consumed at 30 minutes post training (and within a 2 hours window after) results in increased carbohydrates stores for the next training session.

Additionally, eating carbohydrates improves the body’s ability to use the protein to help repair muscle damage that occurred during training. Protein consumption without carbohydrates is less effective at repairing and building muscles tissue (aka protein synthesis). The athlete should consume 1.0-1.5 grams of carbohydrates for every 2.2 pounds of body weight (e.g. a 180 pound athlete should consume approximately 81-122 grams of carbohydrates).

Lastly, only a small amount of protein, 20-25 grams, needs to be ingested to stimulate protein synthesis. This is the equivalent of 3 ounces of chicken, beef, pork, or fish. If this is done repeatedly (5-6 times throughout the day), muscle protein synthesis will be maximized. Protein amounts over 20-25 grams have not been shown to produce any increase in muscle protein synthesis.

In fact, repeated over-ingestion of protein can actually have a negative effect on the body’s ability to make muscle protein.

(courtesy of Dr. Berning, PhD, RD, CSSD)

• Energy or sports bars – 19 to 50 g CHO; 10 g PRO
• Bagels with peanut or almond butter – 58 g CHO; 16 g PRO
• Sub sandwiches – 36 g CHO; 13 g PRO
• Granola with milk or yogurt - 45 g CHO; 12 g PRO
• Crackers, cheese and grapes – 40 g CHO; 10 g PRO
• Vegetarian burritos with rice and beans – 19 g CHO; 8 g PRO
• Fresh fruit like apples, bananas, oranges, grapes with low fat cheese – 12 to 26 g CHO; 10 g PRO
• Vegetables such as carrots and celery with hummus and pita bread– 25 g CHO; 10 g PRO
• Fruit smoothies (prepackaged) – 16 ounces 67 g CHO; 3 g PRO
• Smoothie with yogurt and milk – 16 ounces 50 g CHO; 10 g PRO
• Fruited yogurt and banana-1 cup 57 g CHO; 8 g PRO
• Trail mix – 16 g CHO; 5 g PRO
• Chocolate milk – 26 g CHO; 8 g PRO
• Animal crackers with almonds and banana – 40 g CHO; 8 g PRO
• Sports drink – 15 g CHO per 8 oz
• Recovery beverage- up to 40g CHO; 10-20 g PRO

The athletic training staff at De La Salle encourages student-athletes to engage in sound nutrition practices and avoid supplements if possible. By practicing sound nutrition and eating healthy, one will not need to use supplements as he/she will already be ingesting all the needed nutrients for his goals. Additionally, eating nutritious foods has been proven to be more effective at delivering nutrients to the body.

Student-athletes need to understand that taking supplements has the potential to be dangerous. Supplements are not regulated by the Food and Drug Administration in the same way that foods are regulated; therefore they may contain dangerous ingredients. Supplements are also often produced in factories where other supplements may be produced, which can increase the risk of cross-contamination, which means they may be ingesting a substance that is not on the ingredient list or is potentially a banned or unhealthy substance.

We encourage those individuals who are taking supplements to come and talk with us so that we can help them determine its relative safety and understand their rationale for taking the supplement. By speaking with us, we may be able to provide them with some healthier and more nutritious alternatives to meet their goals.

On occasion athletes may be provided with Muscle Milk following activity. They are not required to take the product but it is offered to help with the bodies’ recovery following activity.

Sleep is an important and often neglected aspect of athletic training. Sleep is a period for the body and mind to recover from the stresses of the day, and is important in maintaining important mental processes, such as formation of memory, focus, and judgment. Lack of sleep can impair these processes, and can also cause lowered immune system function and muscular recovery. A consistent sleep schedule is important to maintain for athletes because lack of ideal mental and physical function can negatively affect athletic performance. Unfortunately, athletes commonly lack ideal sleep schedules, getting 6.5-7 hours of sleep a night compared to the 8-10 required for healthy adolescents.

Maintaining a regular sleep schedule while participating in athletics and being a full-time student is a challenge. However, proper sleep schedules are easily maintained through effective time management and simple changes you can make to your daily schedule that can allow you to get quality, regular sleep, such as:

• Do not leave homework for the last minute. Plan ahead so that you can budget your time effectively and allow for you to participate in athletics, get all homework done on time, and sleep at least eight hours a night.
• Avoid caffeinated beverages or sugary snacks after 4 p.m.
• Avoid watching TV or playing video games for at least 15-30 minutes before bed. Prolonged staring at an electronic screen can make it harder for you to fall asleep.
• Stretch before bed. This can prevent soreness and stiffness in the morning and also helps you get quality sleep.