Ask Me Anything About Sports Medicine

Alexandra Abbott, MD (right) examines an x-ray at the Children’s Orthopedic and Sports Medicine Center in Sunnyvale, Calif.

Drawing from her experience as a former collegiate athlete at Cal Poly Pomona and with a history of providing care for young athletes and pro teams like the Los Angeles Lakers, Alexandra Abbott, MD, pediatric sports medicine specialist at Stanford Medicine Children’s Health, discusses the rise in professionalization of youth sports, consequences of overtraining, risk factors for burnout and attrition, diversification, how to identify a concussion, and more.

Based on our “Ask Me Anything” series on Instagram, this Q&A has been lightly edited for clarity and length.

Tell us about your experience as a collegiate athlete and how that impacts the care you provide.

I’m grateful and proud to say that I made the cut and got to play college soccer, especially because not very many athletes get to have that experience. I came away from that experience being a doctor who can relate to kids who are going through that period and trying to be college athletes. I’ve reflected on what it means to have longevity in sports and try to find the importance of things like reducing injury risk, reducing burnout, and trying to be a life-long athlete. It’s important that we try to keep kids active in sports and also make them want to be active adults as well.

What was it like providing sports medicine care to the Los Angeles Lakers?

While training at UCLA in Los Angeles I worked with athletes from the Los Angeles Lakers, the Los Angeles Sparks, and the Dodgers. I learned about the commitment and dedication and teamwork that those athletes need to be successful on that level. I also came away with the reflection that the health care providers need those qualities as well, to take care of the teams and help them maintain success.

When is the right age for a child to focus on only one sport?

Parents are increasingly encouraging their children to pick one sport and specialize in it, usually, to try and improve the outcomes of likelihood for college scholarships. We’ve found that there’s an increased risk in specialization before the age of 12 and the risk for injury or things we describe as burnout, or psychological burnout, where you’re wanting to quit your sport or withdraw from all sports at once. We’d like athletes to remain active through adolescence and adulthood, so having a child focus on one single sport, and then getting injured or burned out or both, doesn’t necessarily promote those kinds of outcomes.

If a child does decide to specialize, especially if they’re a late specializer after age 12, there are three rules of thumb that are backed by our studies of youth athletes.

Take one day off per week from that sport to allow for some weekly recovery and rest.

Limit your participation so that you have at least one off-season. If you have a primary sport, your off-season should look like three or four months of the year prioritizing a different sport or rehab and recovery.

Limit your participation weekly to the number of hours corresponding to your child’s age or less in years. For example, a 12-year-old should not be playing 13 hours or more of a single sport.

How can parents tell if their child has a concussion?

We’ve had to study this specifically. When we ask kids whether they’ve ever had a concussion in the past, we find it’s most effective to ask if they’ve ever had dizziness or a headache after being hit on the head. When you apply this broad definition, many people will say it’s happened to them, but when it happened, they dismissed it as not that bad or not really a concussion. A concussion can look like a mild headache right after a hit to the head or more severe symptoms, especially for a prolonged period of time, such as for weeks.

If you think your child has a concussion, it’s important to see your child’s pediatrician or a sports medicine doctor. If your school has an athletic trainer, they can also help with returning them to sports safely. In general, we promote a gradual return to sport that takes at least a week for diagnosis and concussion. If your child has more severe symptoms, it’s always OK to take your child to an emergency room if you have a concern that’s more serious than concussion.

How great of an impact does stretching have on injury prevention?

Stretching, mobility, flexibility—these are all crucial components of healthy muscles, and subsequently healthy joints and bones. A lot of times my strongest athletes are my least flexible, and they’ll come in with a specific type of pattern of injuries that can be mitigated if they make stretching a part of their routine. What can be helpful is dedicating a specific part of your exercise routine to stretching specifically, and not just on-the-fly quad stretching throughout your session or choosing to stretch things just when they hurt. Flexibility is just as important as the recovery process and the strengthening processes. Try and figure out how many minutes you want to dedicate to that on a routine.

What’s the next innovation in sports medicine you’re most excited about?

There’s a lot of cool technology coming down the pipeline and evidence to support treatment, like injections, imaging modalities, and surgical techniques. I’m more excited though about a potential culture shift for youth athletes, where we’re getting away from how do we fix injuries once they’ve occurred to trying to prevent these injuries. Diversification is key.

The Children’s Orthopedic and Sports Medicine Center is ranked No. 1 in the Bay Area according to U.S. News & World Report and offers consultation and the latest treatments for children with orthopedic and musculoskeletal conditions.