Tips for Keeping Young Athletes Safe and Healthy

Sonal S. Avasare, MD, FAAP
Medical Director of Swedish Pediatric Specialty Care
Swedish Pediatric Nephrology

We all know exercise is an important factor in maintaining an active and healthy life. However, over-exercising can lead to the rare, but serious complication of rhabdomyolysis. There has been a recent increase in rhabdomyolysis among teen athletes, so it is important to recognize the warning signs and learn how to prevent them.

The classic triad of rhabdomyolysis is dark urine, muscle weakness or fatigue, and muscle pain. Although exercise can be the primary factor, other key contributing elements such as dehydration, genetic conditions (e.g. sickle cell), metabolic disorders, nutritional supplements, drug use, nonsteroidal anti-inflammatory drugs (NSAIDs) and heat stress can exacerbate muscle damage. Without appropriate medical evaluation and care, rhabdomyolysis can cause permanent damage to the kidneys and may even be life-threatening. Here are some tips to share with young athletes so they remain active and healthy:

  • Maintain adequate hydration – preferably with plain water.  Sports and energy drinks may contain caffeine and excessive amounts of sugar which can actually cause dehydration.  It is important to increase fluids with increased activity due to the additional fluid losses that occur. The fluid intake goal will vary for each child based on age, weight and other health conditions. Pediatric health care providers can provide guidance to families regarding their child’s specific needs.
  • Eliminate protein supplements. A recent study by the American Academy of Pediatrics found that about a third of teens participating in sports use supplements containing protein, creatine, or whey. Many times, this is because of the belief that they are not getting enough protein in their daily diet or that they need to increase their intake in order to build muscle mass. However, the average teenager gets 1.5-2x the daily recommended amount of protein in their daily diet, so protein supplements are not needed and may cause harm.  Excessive amounts of protein increase the risk of dehydration, kidney stone formation, and high blood pressure. In addition, supplements are not regulated by the FDA, so the quality and exact contents are not monitored. 
  • Maintain consistency. Avoid sudden strenuous workouts – particularly those that target one muscle group to the point of exhaustion – as these may increase the risk of muscle injury. Instead, maintain consistency in workouts and increase intensity gradually with appropriate rest in between.
  • Try to exercise in a well-ventilated area. If the workout is in a hot room or outdoors during the summertime, make sure to increase fluid intake to prevent dehydration.