Sports Participation

Dr. Cobble gives tips on protecting young athletes

Dr. Douglas Cobble, Greeneville PediatricsDr. Douglas Cobble with Greeneville Pediatrics believes that sports medicine actually begins prior to the young athlete ever suffering an injury, and overall health and nutritional issues can prevent an athlete from performing to his or her greatest potential. The following is his advice to assist parents in a better understanding of how to protect children who are involved in athletics.

Sports participations is an integral part of maintaining a healthy lifestyle, but there are potential adverse health issues that can result including permanent disability and possibly even death when some precautions are not addressed. Below are some simple suggestions to follow that can help in protecting the young athlete.

  1. YEARLY PHYSICAL EXAMS: Pre-participation physical exams for athletics can sometimes be taken too lightly.  Your child’s primary care provider knows your child the best and is a better alternative to group physical exams.  Your child’s primary care provider will do a thorough yearly physical exam as part of the sports physical.

  2. Boy playing baseballPROPER EQUIPMENT AND ATTIRE: Sports differ in their requirement for protective equipment and attire, but no matter what the gear is proper fit is always important.  Helmets should be in good condition and fitted by an expert who is knowledgeable.  Shoes are specific for different sports and foot size and dynamics differ among athletes.  One style may not work for all.  Unless eyeglasses have a special impact frame, which can be obtained from the athlete’s eye care physician, they will not withstand impact and never should be worn during sports.  Take protection seriously regardless of sport.

  3. PROPER CONDITIONING: It is important to remain physically active year round, season to season, so that the athlete will already be in shape when it’s time to play the  sport.  Balanced muscle strength helps to protect the joints like the shoulders, knees, and ankles.  Good conditioning aids in quicker adaptation to environmental sports stressors such as temperature extremes.

  4. GOOD NUTRITION: Proper nutrition is a very important aspect for athletic performance.  The body needs proper fuel for energy, and the type of fuel determines how well the body performs.  Energy stores need to be properly replenished after training and athletic events to prepare for the next event and to repair body tissues.  Forget the junk foods, avoid sugary drinks, and limit fast foods.  Educate your young athlete abut proper nutrition.  If not sure, then talk with your physician or dietician for proper advice.  Good nutrition also improves academic performance.

  5. Soccer kid drinking waterPROPER HYDRATION: Proper hydration allows the body to perform optimally.  Water is the main component of the body and proper water intake all day long, not just during athletic events, is imperative for optimal performance.  The body is already 1% to 2% dehydrated when thirst sensation kicks in.  That 1% to 2% dehydration can decrease performance as much as 10%.  Avoid caffeinated drinks which actually dehydrate, and energy drinks that not only dehydrate but are potentially deadly in that they can precipitate cardiac arrhythmias that can result in sudden death.

  6. GOOD SLEEP: Quality sleep is required to rejuvenate the body and mind, and the lack of that  quality sleep produces a tired and underperforming athlete both on the field and in the classroom.  Young athletes need no less than eight hours of quality sleep daily for optimal performance.   Establishing regular sleep times is most important.  Turn off the computers, cell phones, portable electronic devices, and the TV’s.  Take them out of the child’s room as they are the biggest detriments to establishing quality sleep times.

  7. AVOID TRAINING SUPPLEMENTS: The majority of training supplements are sold as nutritional supplements, meaning there are no federal regulations as to the quality of, or to the claims that the product promises.  Most lack true scientific studies as to their effectiveness and some steroid products or steroid precursors are illegal and pose significant health risks.  Low fat chocolate milk drank within twenty minutes of physical activity is the best energy replacement and muscle repair and growth.  Good nutrition, proper hydration, good sleep patterns, and proper conditioning are really the necessary ingredients for optimal athletic performance.

  8. Kids playing flag footballPROTECT FROM ENVIRONMENTAL EXTREMES: Environmental extremes can range from frost bite(hypothermia) to heat strokes(hyperthermia).  These same conditions can lead to death if severe enough.  Temperature acclimation is dependent on many factors including age, level of conditioning, hydration, length of exposure, and type of sport.  Proper hydration and conditioning plays an important role in both hot and cold climates.  Warm climates require vigilant monitoring of the heat index which dictates the level of practice or play, dress, and whether or not competition/practice is held or cancelled.   Parents should always insist that the heat index be monitored not only before but continuously during competition or practice.  If specific heat index values and guidelines cannot be given, then do not allow participation and report official/coaches for not protecting your young athlete.  Many sources are available online for recommendations as to the level of activity per various ranges of heat index values.  Remember that the body cools by transferring heat to the cooler external environment.  As the heat index approaches that of normal body temperature, then cooling becomes less efficient and the continuation of sports activity becomes much more dangerous, even deadly.  Cold temperatures require proper clothing and layering to prevent heat loss.  Bare skin has to be protected from freezing/frost bite.  Cold water/wet clothing can produce significant hypothermia in even mildly cool environments.  Preparation and common sense is imperative for surviving environmental extremes.

  9. ONE TEAM, ONE SPORT,  and ONE SEASON: Too many young athletes participate in multiple sports and teams during a season, resulting in multiple practices and /or excessive training sessions.  Many believe this will make them a better athlete, but studies do not support this hypothesis.  The only guaranteed outcome is a higher rate of burn-out and increased risk of injury, especially overuse injuries.  Some overuse injuries can result in permanent damage if not allowed to heal.  Little league pitches are counted, but practice pitches are ignored.   Playing through elbow pain can lead to permanent elbow damage thus possibly ending a young pitching career.  Any persistent pain lasting for a couple of days should be evaluated by a physician who has specialty training in sports medicine.

  10. PROPER TRAINING AND CONDITIONING TECHNIQUES: How one trains can predispose one to injury.  Various training guidelines and recommendations can be found online but many are without merit and can possibly impede conditioning and lead to injury.  Know the source and validity of the information, for it is important  in providing safety for the young athlete.  Training needs to be taught and supervised by licensed coaches, physical therapists, and/or certified athletic trainers.

  11. Boy playing soccerCOVID-19 INFECTIONS AND SPORTS: Fortunately the Covid-19 infection in children and teenagers for the most part has been a relatively minor illness.  One potentially serious complication from this infection involves the heart muscle clinically producing an infectious myocarditis.  Many of these infections are without significant symptoms, but at the same time can place the patient at risk for some serious complications.  For this reason, any young athlete should have a clearance exam by their pediatrician before returning to sports.  In general, it is recommended that anyone that has had Covid-19 not to return to sports for a minimum of 2 weeks from the last day of symptoms resolution.  Those with more complicated or prolonged illness may require longer periods of rest before returning to sports.  Electrocardiograms and possibly other test that evaluate cardiac status may be required before being cleared to return to sports.    School based athletics require medical clearance before returning to sports.  Take these recommendations seriously:  consult your pediatrician who is knowledgeable about these potential complications.  Some require consultation with pediatric cardiology before being allowed to return to sports.  Other viral illnesses such as the Flu also have potential serious complications, and one should always follow their pediatrician’s advice as to when it is safe to return to sports.

For more information or to schedule an appointment with a Greeneville Pediatric Clinic provider please contact them at 423-787-6050.

Greeneville Pediatrics

(423) 787-6050
221 N Main St
Greeneville, TN 37745


  • Monday: 8 A.M. to 5 P.M.
  • Tuesday: 8 A.M. to 5 P.M.
  • Wednesday: 8 A.M. to 5 P.M.
  • Thursday: 8 A.M. to 5 P.M.
  • Friday: 8 A.M. to 5 P.M.
  • Saturday: CLOSED
  • Sunday: CLOSED

We are proud to serve children in Greeneville, Tennessee and surrounding communities. Our longstanding practice gives families easy access to provide friendly, professional care for all types of illnesses and problems. We take most insurance plans and offer well appointments in addition to same-day sick appointments.

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Greeneville Pediatrics is Recognized as a Patient Centered Medical Home (PCMH) practice by the National Committee for Quality Assurance (NCQA)