The Importance of Heart Screenings for Athletes

Parents of young athletes should talk to their pediatrician about getting pre-participation sports physicals that include heart  screenings.

After all, sudden cardiac death is 2 ½ times more likely to occur in young athletes than in non-athletes. Hypertrophic cardiomyopathy, the most common cause of sudden cardiac death in young athletes, occurs in one of every 500 people.

Young athletes are encouraged to have a physical that includes a general exam, a complete health history and family history, a 12-lead EKG screening and, for athletes with an abnormal EKG or family history, an echocardiogram. An exercise test may also be recommended.

To address the growing rate of sudden cardiac arrest in young athletes, CHOC Children’s Sports Medicine collaborates with the CHOC Children’s Heart Institute to offer the Life-Threatening Events Associated with Pediatric Sports (LEAPS) program. CHOC cardiologists work one-on-one with area schools on several fronts:

• Educate coaches and staff about heart conditions.
• Offer electrocardiogram (EKG) screenings to identify athletes at risk.
• Encourage CPR training and the installation of automatic external defibrillators (AEDs) near gyms, fields and other sports facilities.

CHOC also hosts a regular conference for Orange County school board members, high school coaches, school nurses, community pediatricians and parents who want to lower the incidence of sudden cardiac death in local teenage athletes.

To learn more, contact the CHOC Children’s Heart Institute at 714-532-7576.

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Kids and common sports injuries


“One of the most common sports injuries I see every week is pain in an extremity from chronic repetitive stress, whether it is at the elbow, the wrist, the ankle, the knee or the foot,” says Dr. Schlechter. “Those are definitely the most common sports-related injuries in children that are less traumatic and nonoperative, most of the time. They can be prevented by activity modification, rest, ice, anti-inflammatories and a good stretching program,” he recommends.


A general rule of thumb to reduce injury, says Dr. Schlechter, is for children to not play one sport year-round. They should engage in multiple sports. “For instance, if your child is a baseball player, they should probably cross-train and participate in maybe football, track, and basketball instead of baseball year-round, with a three-month period of rest. That’s a good preventative strategy,” he suggests. Another  piece of advice: Don’t play through pain.


“In general, most musculoskeletal injuries, for them to be fully healed, can take 12 to 16 weeks. Most children  start feeling better after resting two  to four weeks. They tend to go back  to sports too soon. Definitely take the  full time to recover,” he says.


“Every football season and the start of soccer season, I’ll see a flurry of patients with foot and ankle pain and those are usually growth plate-related conditions, stress injuries to the bone of the feet,” he says. Dr. Schlechter suggests saving the cleats for game situations only, not every day conditioning.


  • The number of minutes you should apply ice to an injury: 15 to 20 minutes
  • The number of childhood sports injuries in the U.S. each year: 3.5 million
  • The amount of time children should rest between sports activities: 3 months

View the full feature on Kids and Common Sports Injuries

Dr. John Schlecter
Dr. John A. Schlechter
CHOC Orthopedic Surgeon


Dr. Schlechter completed his orthopedic surgery residency at Riverside County Regional Medical Center, where he is the director of orthopedic education and research. He completed a pediatric orthopedic and scoliosis fellowship at Rady’s Children’s Hospital San Diego as well as a post-fellowship preceptorship in sports medicine and arthroscopy at the Orthopedic Specialty Institute in Orange, CA.

Dr. Schlechter’s philosophy of care: “I try to treat the child and not the parent, and make sure the athletes understand their conditions and the rationale of why they might need to have some rest and what  the potential unwanted outcomes could be if they don’t get rest.”

New York College of Osteopathic Medicine

Orthopedic Surgery

More about Dr. Schlechter | More about the CHOC Orthopaedic Institute

This article was featured in the Orange County Register on November 19, 2013 and was written by Shaleek Wilson.

Dr. John Schlechter Talks About Overuse Injuries in Children

In this CHOC Radio expert interview, Pediatric Orthopaedic Surgeon Dr. John Schlechter dropped by Seacrest Studios to talk about overuse injuries in children. Many children today are involved in sports and some kids even specialize in one type of sport at a young age. Repetitive use of the same bones and joints can cause stress on growing bodies and may result in injury. Dr. Schlechter talks about common overuse injuries, what causes them and how they are treated. He emphasizes that recovery is key and that kids need to recover slowly before they can get back into the game.

Dr. Schlechter is a board certified fellowship trained Pediatric Orthopedic Surgeon specializing in sports medicine and arthroscopy for children and adolescents.

Enjoy the show.

Click here for more CHOC Radio episodes.

Learn more about the CHOC Children’s Sports Program.

Muscling out the Myths: on Protein

By Jessica Brown, RD, CNSC, CSP, clinical dietitian at CHOC Children’s

As the summer is approaching student athletes start thinking about their goals for the upcoming sport’s season.  Attempting to gain weight and bulk-up in the off season is a common goal of athletes in competitive strength and power sports.  Here are a few tips to gain weight safely and effectively to improve performance in one’s sport.

 Ten Quick Tips for Weight Gain:

1. It’s not just about the protein
Sufficient calories and strength training are required to build lean body mass.  In fact, energy intake is more important at eliciting increased muscle mass than protein alone.

2. Robustness was not built in a day
A safe weight gain is 1 pound per week.  To achieve this weight gain, an additional 300-400 calories per day are required.  Adequate daily protein intake for weight gain is 0.75g/pound of body weight (for example: an athlete with a weight of 150 pounds would require 110 grams of protein per day).  Weight gain should be gradual, rapid weight gain may result in excess fat.

3. Time to think about protein timing
Studies have demonstrated that 10-20 grams of protein consumed in close proximity to exercise promotes increases in muscle mass.  Consuming protein at regular intervals throughout the day (5-6 times per day) can maximize muscle building.

4. Pondering protein quantity
Thinking a little is good more is better is not the case when it comes to protein.  It has been shown that 20 grams protein is the maximum amount to build muscle.  Frequently consuming protein in excess of 20 grams per meal may actually lead to decreasing the body’s response to smaller amounts of protein resulting in decrease muscle building.

5. It may be cliché, but breakfast is the most important meal of the day
Protein breakdown continues after an overnight fast until adequate energy and protein are consumed.

6. Don’t fall victim to the “Train but Less Gain” club
Eating at regular intervals throughout the day without skipping meals leads to improved training outcomes, and faster recovery.  Additionally, athletes who do not skip meals during the day have lower body fat percentages and higher lean body mass.

7. Remember the three R’s of recovery to optimize training outcomes:
Rehydrate – consuming fluid after exercise replaces what your body lost from sweat
Replenish– consuming carbohydrates after exercise replenishes your stores and decreases muscle breakdown
Repair – consuming protein after exercise improves recovery and growth of muscle

8. Be supplement smart with “weight gain” powders and shakes
Dietary supplements are not well standardized.  What is stated on the label and what is actually in the product may be two different things.  Some supplements contain ingredients not listed on the label that are prohibited by the doping regulations of national and international sport governing bodies.  Athletes should attempt to obtain their protein requirements from whole foods.  Current research demonstrates that protein supplements are no more effective at building muscle than whole foods.  In fact, the average American diet far surpasses the protein requirements of the athlete.

9. “Natural” does not equal “Safe”
If it sounds too good to be true, it most likely is.  Evaluate the quality of supplements through organizations that test products:
ConsumerLab (

10. Get crazy for carbs
Adding carbohydrate to protein after workouts stimulates muscle building more than protein alone.

Example snacks: (each snack provides 400 calories & 20 grams protein)

6 Graham cracker squares
1 TBS Peanut butter
8 fl oz low-fat fruited yogurt smoothie

1 oz Pretzels
6 oz Greek low-fat fruited yogurt
8 fl oz Orange juice

½ cup Grapes
12 fl oz low-fat Chocolate milk
1 Granola trail mix bar

1 cup dry Cereal
1.5 oz Beef jerky
1 medium Apple


1. Promotion of Healthy Weight-Control Practices in Young Athletes.  Pediatrics.  2005;116(6):1557-1564.
2. Moore DR, Robinson MJ, Fry JL, et al.  Ingested protein dose response of muscle and albumin protein synthesis after resistance exercise in young men.  The American Journal of Clinical Nutrition.  2009;89:161-168.
3. Norton LE, Layman DK.  Leucine Regulates Translation Initiation of Protein Synthesis in Skeletal Muscle after Exercise.  The Journal of Nutrition.  2006;136:533S-S537.
4. Deutz RC, Benardot D, Martin D, et al.  Relationship between energy deficits and body composition in elite female gymnasts and runners.  Medicine & Science in Sports & Exercise.  2000;32(3):659-668
5. Tipton KD, Witard OC.  Protein Requirements and Recommendations for Athletes: Relevance of Ivory Tower Arguments for Practical Recommendations.  Clinics In Sports Medicine.  2007;26:17-36.
6. Kerksick C, Harvey T, Stout J, et al.  International Society of Sports Nutrition position stand: Nutrient timing.  Journal of the International Society of Sports Nutrition.  2008;5:17.
7. Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance.  Journal of the American Dietetic Association.  2009;109:509-527.
8. Coleman E.  Evaluating Popular Sports Supplement.  SCAN.  2008.

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Kinesio Tape – More than Just a Summer Olympics Fashion Statement?

Along with their work-out attire, this year’s Olympic athletes have been sporting colorful tape.  Spectators have seen the images – strips in various shades running up, down and across the bodies of athletes. Curious to learn if this trend was more than a fashion statement, we asked one of our pediatric orthopedic surgeons, Dr. John Schlechter, who specializes in sports medicine, a few questions.

What’s the deal with that colorful tape we’re seeing on this year’s Olympic athletes?

That colorful tape is called Kinesio tape, and has actually been to the Olympics before.  Beach volleyball player Kerri Walsh Jennings, who just won her third gold medal, wore a colorful mesh pattern on her operated shoulder when she competed in Beijing four years ago. Now, during the London games, many athletes, especially divers, swimmers and volleyball players, have been seen with the tape.

Who developed it?

Dr. Kenzo Kase, a Japanese chiropractor, invented the method about 30 years ago when he started taping Sumo wrestlers to relieve their pain.

What is it used for?

Kinesio tape can be used for many reasons.  In some cases, it helps to relieve pain and inflammation. But more often in the Olympics, it is used to help stabilize injured joints or help to unload injured and aching muscles. The tape gives the athlete support for aching muscles that might hamper performance.

How is it different from other athletic tape?

Regular athletic tape is rigid and does not move with the athlete. It’s better used when you need to stop motion. Kinesio tape, on the other hand, stretches in one direction and then as it’s stretched, it snaps back like a rubber band.  That’s how it is used to help the muscles and joints, and why it’s also popular with athletes.  It allows the athlete to move with less pain.

Is there a special technique for applying the tape?

There is a special technique for applying the tape.  It’s best to learn from an athletic trainer or physical therapist.

Where can people get the tape?

Most sporting goods stores carry various kinesio tape options.

Dr. John Schlechter is a board certified pediatric orthopedic surgeon specializing in sports medicine and arthroscopy for children and adolescents. He is an active part of the clinical faculty for the Western University of Health Sciences and serves as the team physician for several local high schools. Learn more about CHOC’s Orthopaedic Institute.

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