When Illness Sidelines a Young Athlete

baseball_athlete_illnessBeing sidelined by illness can be difficult for dedicated young athletes, as well as their parents who question when to keep their child off the field and when to send them back.

Depending on symptoms and energy levels, children can often still participate in sports when under the weather, says Dr. Jacqueline Winkelmann, a CHOC Children’s at Mission Hospital pediatrician who works to provide health tips and guidance for young athletes.

If a child’s symptoms are “above the neck,” he or she can usually participate in athletic activities so long as energy levels are appropriate. “Above the neck” symptoms include a runny nose, nasal congestion, sneezing and minor sore throat, she says.

“If you have a mild cold and no fever, and have enough energy, you can still play,” Dr. Winkelmann says.

But even if a young athlete feels well enough to exercise while in the final throes of a cold, he or she must plan on scaling back the intensity of play, she cautions.

“You need to understand that you won’t be able to practice at the same level,” Dr. Winkelmann says. “You need to speak up and tell your coach that you’re not 100 percent.”

However, a child with symptoms “below the neck” – chest congestion, respiratory ailments, gastrointestinal concerns, fatigue, fever or muscle aches – should stay off the field until well, Dr. Winkelmann says.

And though being sidelined by illness might be frustrating for committed athletes, taking a few days – even weeks – off from practice will not result in a significant setback in performance.

“It may take you a while to get back to where you were, but it’s much more prudent to take the time to rest your body when you’re sick,” Dr, Winkelmann says.

Young athletes can do some things to help speed the recovery process and get back on the field faster: Focus on rest by going to bed 30 minutes earlier than usual, Dr. Winkelmann advises. Also, limit dairy, sugar and processed foods, and increase fruits and vegetable intake.

When comes to returning to play, a child, especially one who suffered a respiratory illness, should first feel normal for one to two days after recovery, she says.

And above all, a child needs to trust her body, and mom and dad should listen to their parental instincts.

“I tell kids to listen to your body, not your coach or trainer or parents,” Dr. Winkelmann says. “Parents should trust their gut. They know their kid and their personality.”

More articles about sports:

Athlete Nutrition Fit for a Champ

The new spring sports season means reasoccer_athlete_nutritionrranging schedules and picking up extra equipment, but parents of young athletes should also examine their meal plans to ensure young athletes are eating enough.

“They absolutely need to eat more,” says Dr. Jacqueline Winkelmann, a CHOC Children’s at Mission Hospital pediatrician who works to provide nutrition tips and guidance in youth sports.

“Young athletes are still growing, and their metabolic demands are so high,” she says. “They need to take in the necessary amount of calories for growth and whatever the sport demands.”

How much, when to eat

Parents can estimate the amount of calories a child’s activity burns by using this tool. That number can help guide the week’s menu and ensure a consistent healthy diet – a key factor for top athletic performance, Dr. Winkelmann says.

“It isn’t true that if you eat badly all week and have one good meal before you play, you’ll be fine,” she said.

Here’s why: Glycogen is an energy source that fuels exercise in humans, but it’s built days before use, Dr. Winkelmann explains. That’s why eating well in the days preceding a game is crucial to optimal performance.

Pre-game eating particulars

Nonetheless, both the timing and type of food an athlete eats right before a game is also important. Whether a snack or a meal, she advises that pre-game fuel should be about 70 percent carbohydrates, 25 percent protein and 5 percent healthy fats. Carbohydrates are a key source of energy for children, adolescents and teens, Dr. Winkelmann advises.

“A meal can be anything from a whole wheat sandwich, a wrap, or chicken noodsoccer_athlete_nutrition_2le soup with bread,” she says. “But if you have less than two hours before competition, focus on a snack that will fill up your tank, and then wait until after the game to eat a full meal.”

Post-game eats matter too

Indeed, what’s eaten after the game is also important. After vigorous activity, the body’s muscles can absorb more nutrients and can produce glycogen two times faster than normal. Dr. Winkelmann calls this time the “golden window.”

“We want to take advantage of it,” she explains. “That’s what your body will soak up. It’s important to have the right kind of fuel at that time.”

To that end, Dr. Winkelmann recommends food with a carbohydrate-to-protein ratio of three-to-one:

  • Chocolate milk
  • Fruit with cheese cubes
  • Yogurt and granola
  • Pretzels and nut butter

Tips for tournament eating

An athlete’s road tournaments also present new challenges for healthy eating, but a little preparation can go a long way, Dr. Winkelmann says.

Try traveling with a cooler so that healthy foods like yogurt, cheese, fruit and nut butters are always nearby. Technology can also help track down healthy fast food and restaurant options. For example, www.healthydiningfinder.com finds eateries nearby that offer healthy choices, Dr. Winkelmann says.

More articles about sports:

Teens and Drugs

Pills_in_handPAINFUL TRUTH

Prescription and over-the-counter drug abuse is the fastest-growing drug problem in the U.S. “In South Orange County, the three most common drugs teens are experimenting with for recreational purposes are oxycodone and hydrocodone (narcotic pain killers) and methadone, a drug used to help heroin addicts kick their addiction,” says Dr. Winkelmann. “A percentage of kids are being prescribed narcotics for their own injuries, but many find them in the medicine cabinets of friends, family members and even in their own homes,” she says. “They have “pharming” parties, where everyone brings their pills, put them in a bucket and take handfuls. It’s pretty scary how creative these kids are.”


Talking to your child early about this dangerous and potentially deadly problem is critical, says Dr. Winklemann. “I think middle school is certainly the time to have the talk,” she says. If you need help, there are resources available. “The documentaries, ‘Overtaken’ and ‘Behind the Orange Curtain’ are very good. Both address this issue specifically for our area.

Parents should take precautions when it comes to having prescription drugs in the home, says Dr. Winkelmann. Some tips:

    • Make sure parents are in charge of dispensing medication
    • Set clear rules about teens taking the right amount at the right time
    • Take care to understand the purposes and side effects, using the medications as a last resort, especially for pain control
    • Keep medications in a secure location

It’s important to dispose of prescription drugs properly and that means NOT flushing them down the toilet, says Dr. Winkelmann. “Crush them, mix with coffee grounds or cat litter, put them in an empty can or bag and throw them in the trash,” she says.

Created by CHOC Children’s at Mission Hospital nurses, Karen Caiozzo, Dottie Tagan and Chris Venable and championed by Dr. Jacqueline Winkelmann, the physician-to-physician prescription drug education program informs the staff, suggests doctors consider decreasing pill  counts to only what’s absolutely necessary and ensures that parents and teens know about the hazards of having prescription drugs in the home.


      • The peak age for prescription drug experimentation: 12 to 13 Years Old
      • The number of pediatric patients admitted to CHOC Children’s at Mission Hospital for overdoses (5/2009-5/2010): 61
      • Percentage of teens who have said they have taken drugs without a prescription: 20 %

View the full feature on Teens and Drugs

Dr. Jacqueline Winkelmann
Dr. Jacqueline Winkelmann
CHOC Children’s at Mission Hospital

PHYSICIAN FOCUS: DR. Jacqueline Winkelmann

Dr. Winkelmann is currently Chief of Staff Elect at CHOC Children’s at Mission Hospital. She attended the University
of Illinois College of Medicine and completed her residency training at Hope Children’s Hospital in Chicago, where she held the position of Pediatric Chief Resident.

Dr. Winkelmann’s philosophy of care: “I really truly believe that taking care of children is a partnership between parents, nurses, doctors and the patients themselves.”

University of Illinois at Chicago College of Medicine

General Pediatrics

More about Dr. Winkelmann

This article was featured in the Orange County Register on December 17, 2013 and was written by Shaleek Wilson.