Dr. Cindy Chang, MD

It is ok for your pre-teen son to lift weights as long as he has proper supervision and technique. Ask him why he wants to join you, it might be a good answer. Incorporate resistance bands, body weight exercises, and outdoor activities into his routine. Have fun and ask more questions if needed.
 
Transcript: "First of all kudos to you for your son wanting to join you, that's awesome. Really enjoy that bonding time. Of course it's OK. There's a low risk of injury for teens and pre-teens to lift weights as long as they have proper supervision and they have the correct technique. Understand that his growth plates are still open, so you don't want him to do max weights. Low weights and high reps are the way to go to build healthy bones and to build a healthy body. I would suggest that you ask him why he wants to join you. I think you may be surprised at the answer. But if it ends up being that he has any concerns about his body, in terms of his body image, that would be a good answer. That would be a good question to ask him. So you can find out why he wants to do it. And if there is a tendency towards he's feeling insecure about his body image, et cetera, that will be really helpful for you in terms of working with him or involving a health care professional to work with him should there be any concerns that you have. Regardless, when we get to talking about weight training though, besides doing the free weights, also important is resistance bands, which the gym could offer, as well as body weight type of exercises, like even doing bodyweight squats or planks. And those are exercises that you can incorporate even at home. Understand that a child should have three days a week of weight training. And that's not only being in the gym and lifting weights, but it's also being outside and climbing a tree, or being on a rope swing, those types of things. Those are all important things that a kid can do to build healthy bones and also to be healthy overall. So kudos again to you. Have fun with your son. And if you have any more questions, ask. Take care."

Get a standing desk or, at the very least, a stool that can go up and down. Avoid any kind of cracking or manipulation until you have seen a professional. See a physical therapist or chiropractor for stretches and strengthening exercises to help reduce sciatic pain. Many states have direct access to physical therapy so you don't need a referral.
 
Transcript: "What are your top tips for reducing sciatic pain? While waiting to get in to see a professional? First of all, I would encourage you to listen to the recommendations from dr. Olson. They're all spot on and I agree with everything. He said a couple things to add is if you haven't gotten a standing desk yet since you've been working at home, for example, with covid, that I would encourage you that this is the time to get a standing desk. We know that when you're sitting those are when your disc pressure are the East. And when you're sitting and your disk pressure is high that creates more low back pain and can create more static pain. And if you're saying to yourself, I there's no way I can stand. I'm not strong enough to stand the whole time that I encourage you to get a standing desk which can go up and down, but also then to get a stool, which can go up and down. So, for example, this is what I have in my household. You can see that this is a stool and this will go up and down. What I can do is sometimes I can go all the way down. Move my desk all the way up and down, or Can then purchase a little bit so you're not really sitting fully sitting but you're still standing the bit and you're perching back against the stool and that will help you. In terms of when you feel fatigued, the second thing that we know will work based on evidence is that seen a physical therapist or a chiropractor to work with you on gentle stretching and strengthening. So any type of low back mobilization, type of exercises will work. Now I until you figure out the reason for Attica. Absolutely do not have anyone do anything like mobile manipulation? Don't do any cracking of the back. We don't want that until you've seen someone to really take a look at your back and examine you. But certainly someone that can give you again stretches and strengthening to do, within the limits of your pain will, definitely help you get better. And a lot of states have direct access to care including physical therapy. So, you don't need a referral to see. If it's go therapist and a good physical therapist and a chiropractor, will know what to do. So again, good luck with that. If you'd have sciatica, they're definitely things that you can do to help you with your pain into can get in to see a healthcare professional. Happy Thanksgiving."

If you can't walk four steps after a sprain or if there is pain at certain points on the ankle, then it's a good indication to get an X-ray.
 
Transcript: "Hi. That's a great question. You certainly don't want to be running to the urgent care or emergency room if you think that this may be something that's going to get better. So, in general, there are some rules that you can apply that we as physicians use when we're trying to evaluate whether or not an X-ray is needed for a sprained ankle. Now, just know that most sprained ankles are soft tissue injuries and you're not going to see any changes on the X-ray. But here's some general rule of thumb. First of all, if you can't walk after you've sprained your ankle, you can't walk for four steps or more, or even if you decide to wait a few hours, or 12 hours later, or even the next morning and you still can't walk four steps, that would be a good indication for an X-ray. The other things are locations of where your pain is, where you may think to yourself, it's sore there, it hurts there. This may be an indication for an X-ray. I'll show you on my own foot. If on the inside of the ankle you have pain at the tip of the ankle bone here, or along the back part of the ankle bone here, then you may need an X-ray in this region. And then on the outside of your foot, if you have pain at the tip of your ankle bone here, or behind that ankle bone on this side, then that is also an indication for an X-ray. Sometimes someone may have a foot pain. And if your foot hurts in the mid zone here, and you have pain right at the base of what we call the fifth metatarsal on the outside of your foot, right at the base of this phone here, this is the outside of your foot-- or if you happen to have pain in that same foot, right along this bone called the navicular bone, in the in the midfoot, then those are all good reasons to go ahead and seek medical care and get an X-ray of either your ankle or your foot. And of course, if you have any concern at all, seek medical care. And then your health care provider can follow up and determine whether or not you need an X-ray. Thanks for the question."

Ask youth athletes why they are feeling nervous and open a dialogue with them to figure out what their fear is. Make sure they are having fun and playing in a skill level that is right for them. Have a postgame ritual no matter if they win or lose and have them set their own goals to accomplish during the game/practice.
 
Transcript: "What are some mental strategies for youth athletes who get nervous before competitions? I first want to say that I'm answering this as a sports medicine physician and team physician and parent and with my years of experience and not as a licensed mental health professional. I do want to say, also, that it's not unusual for kids to feel stressed-- a little bit stressed or nervous before a game. But really get down to the meat of the matter and ask them, why? Why are you nervous? Let's talk about it. Try to have an open dialogue with your youth athlete, whether or not it's your child or whether or not it's someone that you're coaching. And is it because they're afraid of failing-- the coach failing their parents or their teammates? And if so, why is it? Is it because they don't feel like they can perform to their full potential? And figure out what the reason is. What is their fear? If they have heard parents yelling from the sideline or a coach yelling from the sideline, and they feel like they're being critical, well, then you may want to have a conversation or tone it down to the crowd. Tone it down to the parents. Or talk to the coach. The coach may not understand, especially if it's a youth coach and not a professional coach, how their comments can be perceived by the youth athlete. You want to make sure that the youth athlete's having fun. If they feel this competition is too much above their skill set, then move them down to recreational level. The other thing is sometimes, too many times it's a reward. Like if they win a game, well, then we're going to go get ice cream. Make sure that there's a postgame ritual that happens, no matter if it's win or lose. It's important that your child has fun and that there's a ritual that you can talk about, well, what did you do well? And sometimes, that child can't really do visualization. And I've heard a youth athlete say to me, I visualize a ball going through the hoop, but then it doesn't, and I feel bad. But have them set their own little goals in terms of, what do they want to accomplish for that game, for that practice? And hopefully, that'll be helpful. Thanks."

Tennis elbow is inflammation of the extensor tendons on the outside of the elbow, and golfer's elbow is inflammation of the flexor tendons on the inside of the elbow. To avoid developing golfer's elbow, make sure to warm up properly before playing golf including stretching and using lighter clubs, practice good technique, and maintain strength and flexibility in your core, shoulders, and hips.
 
Transcript: "Hi, that's a great question. And number one, kudos for you for wanting to play golf with your girlfriend. It's great to be outside with friends, and especially being able to exercise in the great outdoors. So first of all, to explain, tennis elbow is much more common in people. And it's on the outside of the elbow. And outside the elbow in the, what we call inflammation of the extensor tendons, the tendons that help you extend your wrist. And it doesn't have to be just in tennis players, it can be in anyone, any type of racket sport. But also people who are just outdoors in the garden and they're using shears, for example, constant squeezing. Or people that are working on a home project and using a hammer can all get tennis elbow. Golfer's elbow, on the other hand, is inflammation or overuse of the flexor tendons. There are ones that help you flex your wrist, of the inner part of the elbow, that is golfer's elbow. And no matter if you're right-handed or left-handed, it happens because of the constant follow-through of this type of motion on your swing. And so how to avoid that, well, number one, you definitely want to make sure that you're nice and stretched out prior to going on to the golf course and starting to swing. Your technique is paramount. So if you're just learning how to play golf, you want to make sure that you get some good lessons. Either from your girlfriend if your girlfriend is a good golfer and can teach you, or to invest in some good lessons because technique is everything from that perspective. And the other thing is as you're going to start to golf is make sure that your strength is good. So besides having the strength in your forearm and your shoulders, also your upper body. But also you want to make sure that you have good strength in your core because swinging a golf club is all about maintaining that strength and flexibility in your core and your hips as well. Certainly, also you can get fatigued if you're walking on the course. So you may want to start playing, for example, nine holes and therefore you don't get too tired. The other thing is once you start to warm up, you should always warm up before you play golf. And certainly, warm up with your lighter irons, like this is a sand wedge, and take those easy swings first. And don't rush to get on the golf course and start pulling out your driver and practicing or warm it up that way because that is a sure-fire way to develop tennis elbow-- excuse me, golfers elbow. All right."

Before starting pickleball, it is important to assess the level of activity you have been doing for the past 10 years. If you have been able to do activities like cutting and pivoting without your knee feeling like it's shifting or swelling, then you are likely a coper. However, if you have only been doing straight ahead activities such as running or cycling, then it is important to seek out an athletic trainer, physical therapist, or sports medicine physician to learn exercises that will help you avoid injury on the pickleball court. Additionally, it is important to start to load your tendons, especially in your Achilles, before playing pickleball.
 
Transcript: "I tore my ACL 10 years ago skiing, decided not to have surgery, but now I want to take up pickleball with my group of friends. Will it be safe for my knee? A couple of my colleagues have already answered this question. I just want to add my thoughts. First of all, congratulations on deciding that pickleball is a sport that you want to try. It's a great social activity. It's good for cardiovascular health. And because it's a weight bearing activity, it helps to maintain your bone health. So, kudos to you and your friends. First of all, what have you been doing in the last 10 years? If you have been already participating in cutting type of sports, and you've been able to do that successfully without your knee feeling like it's shifting, without your knee blowing up or swelling, then you are perhaps a coper. A coper means that you have that neuromuscular facilitation, you have the ability to be able to do activities like cutting and pivoting, without your knees shifting, and you probably have a pretty good core and good hamstrings and quad muscles. So that that is going to give you a lot of success for being able to be successful on the pickleball court. If however, for the past 10 years, all you've done is cycling, running, straight ahead of activities, then I encourage you to start to add in some of those other activities or motions that you'll be doing on the pickleball court. Perhaps seek out an athletic trainer, seek out a physical therapist or a sports medicine physician, and ask them some of the exercises that you can do to make sure that you avoid injury on the pickleball court. If you feel, under the supervision of these health care specialists, that you're starting to shift, then perhaps you may benefit from a ACL brace, and that will help your knee from shifting as you develop strength and balance. The other thing is, also if you haven't done much in the last 10 years, you now you need to start loading your tendons, your tendons especially in your Achilles, which is especially at risk for developing tendonitis, and also for a rupture. That's probably one of the most serious injuries that I've seen from pickleball patients of mine. So you want to start to develop the loading on that tendon. Don't jump into pickleball right away. Because as you lunge for a ball, that's when your Achilles tendon may pop. So seek care, seek assistance, seek guidance, and have a great time."