This article was provided by Training-Conditioning

By Dr. Erin Hassler, DAT, MS, ATC, LAT, PES

Athletes, coaches, parents and fans want thee winning edge. Well, as athletic trainers, we can be that edge. The level of care that we are able to provide for our athletes and patients, can be the difference in the next touchdown, buzzer beater or first place medal. In order to provide this care, athletic trainers must stay abreast of the latest information and current standards in healthcare.

One of the things that makes athletic training so unique is the ability to develop your own approach to an injury. Let’s take a lateral ankle sprain for example. Athletic trainer “A” may choose to apply pre-wrap, while Athletic Trainer “B” applies the tape to bare skin. AT “A” may choose to apply the figure-8 first, while AT “B” opts for the stirrups and horseshoes first. Both clinicians provide a reliable form of protection and support to the ankle, but is one better than the other?

ankle injuryHow many of us are asked questions like this in our everyday lives? Last week at my son’s basketball game, another player sustained a lateral ankle sprain. Because you know who always has a fully stocked kit and table in the “mommy wagon”, and I am an awful spectator, of course I performed a quick evaluation and taped this player. It was then that he told me that this was a reinjury.

After the game, I gave the care instructions to the parents. I recommended that the ankle needed to be protected and supported by ankle tape or bracing for at least the rest of the season. From the crowd of surrounding parents came a load of comments and suggestions on care like:

• “Soak it in Epsom salt.”

• “Don’t walk on it.”

• “Make sure to ice it.”

• “Braces make your ankles weak.”

Enough! I was reminded at this point how athletic trainers are sorely missed at the youth sports level. The opportunity to change the trajectory of these athletes and keep them healthy by educating them and their parents is wide open. So I’ll get the ball rolling.

Here are Doc’s 5 Tips on ankle injury care and prevention for youth athletes:

Prepare – Do your homework. No matter whose name is on the shoe, injury prevention is no guarantee. Most athletic shoes are mass produced and designed to fit a wide range of people. It is important to know what shoe is appropriate for what sport. For example, using a running shoe in a court sport is not wise. It places the foot in a less stable position when landing from a jump. Does the athlete pronate or have a narrow foot? An off the shelf orthotic or heel cup may lend some stability to things.

Protect, protect, protect – By ensuring that an ankle is taped or braced in high impact sports, the severity of injury is reduced. One of the great debates is whether this weakens the ankles or not. Regardless of varying opinions on the matter, I recommend that an injured ankle be taped or braced during athletic activity until full strength has returned. Ligaments are generally slow to heal and the athlete may need to play with tape or bracing the entire season. The opportunity to be taped properly prior to a youth competition may be difficult based on access to the properly trained professionals. In the interim, ankle braces a reasonable alternative. One of the benefits is that the braces can be applied whenever and wherever, no professional required.

R.C.E. – No, it’s not a typo. The acronym R.I.C.E. (rest, ice, compression and elevation) has been used to manage acute injuries. Recently in my clinical practice, I have relied less heavily on the application of ice. While ice is useful for the reduction of pain, I have found that many my athletes and patients respond and recover more quickly with early active rest, compression and elevation without ice application. The goal for me is to keep the body’s natural inflammatory process going and allow the blood flow to continue carrying the healing agents to the injury. Lowering the temperature at the site can slow this process.

Put in the work – The mobility of the ankle and power that can be generated at the joint is dependent upon the development and training of the surrounding tissues. This can be accomplished by incorporating flexibility, balance and strength rehabilitative exercises into a training regimen.

Advocate – Properly credentialed athletic trainers can be the difference in not only the outcome of a competition but the outcome of the athletes. By requesting that athletic trainers be employed for youth sporting events, injury prevention and safe competition become more of a priority and not an afterthought.

Dr. Erin Hassler has almost 2 decades of hands-on experience at multiple levels of Sports Medicine and Sports Performance Enhancement. Credentials include but are not limited to: Advisory Board of Athletic Trainers, Board of Certification and National Academy of Sports Medicine Performance Enhancement Specialist.

Twitter: @drhassler

Facebook: @drerinhassler

Instagram: @drerinhassler

This article was provided by Training and Conditioning. In this article Micah Kurtz discusses the Romanian Deadlift. This is an exercise that he believes helps to prevent ACL injuries when landing and jumping. This exercse would be a great addition to your off-season training program

By Micah Kurtz
Micah Kurtz, MS, CSCS, RSCC*D, USAW, FMS, NASE, is in his eighth year as Director of Strength and Conditioning at AC Flora High School in Columbia, S.C., which was won 14 state championships in the past five years, including the 2016 boys’ basketball championship. He also serves as Strength and Conditioning Consultant Coach to nine-time high school basketball national champion Oak Hill Academy, which won the Dick’s High School National Basketball Tournament in 2016. Kurtz is the 2016 National Strength and Conditioning Association (NSCA) National High School Strength and Conditioning Coach of the Year and is the State Director of its South Carolina Chapter and a member of the Subject Matter Expert Committee. You can follow him on twitter and Instagram @KurtzM3 or visit his website at: www.TheAthleteMaker.com.

In training athletes at AC Flora High School in Columbia, S.C. and Oak Hill Academy in Mouth of Wilson, Va., one of my go-to exercises is the single-leg Romanian deadlift. This exercise targets the hamstrings and glutes, and because it is a single leg movement, it also trains balance and can help eliminate any asymmetries in the body from right leg to left leg. Additionally, when athletes perform the exercise with one dumbbell, it trains the core in anti-rotation.

Many athletes have weak hamstrings and weak glutes. The demands of sports like basketball, soccer, and volleyball place a high emphasis on jumping, quick burst running, and abrupt stopping—and all these movements are very quad dominant. It is vital, especially for these athletes, to target both the hamstrings and glutes when strength training to balance out that strength imbalance. One of the reasons I want my athletes to have strong hamstrings and glutes is because these muscles play a major role in protecting the ACL when landing from a jump and planting and cutting.

The Romanian deadlift (RDL) is a staple in my programs because it trains the posterior chain, a group of muscles on the backside of the body. All athletes should train both the muscles in their backside and frontside.

The single-leg RDL does this—and more, because the hip hinge occurs while standing on one leg. This movement is much more difficult to perform. It is great for athletes as they are on one leg a lot of the time in their sport.

As a first step, athletes should be taught the double legged RDL. They can then progress to the single leg RDL. The cues for the Romanian Deadlift are as follows:

1. The feet should be about hip width apart.

2. The knees should be slightly flexed.

3. As you descend, your back should stay flat and the shoulders should be pulled back.

4. The hips should hinge and be pushed back as you go down while the knees stay slightly flexed.

5.The barbell should stay close to the body during the entire movement and should be lowered to just below the knee.

6.As you bring the bar back to starting position, focus on squeezing the glutes.

 

The cues for the single-leg RDL are similar to the above, with these two additions:

1.The rear leg should stay in line with the torso for the entire movement. Lock in the rear leg by squeezing and extending the glute.

2.Hinge at the hips and feel a stretch in the hamstrings of the leg that you are standing on.

When doing the single-leg RDL for the first time, the athlete should first practice the movement with no weight. When adding weight, I like to use a contra-lateral load. That means the weight is in the opposite hand so the exercise is also working the anti-rotation of the core.

Below is a video that shows the movement in more detail.

 

This post originally appeared on www.coachesnetwork.com

In the pursuit of making athletes bigger, stronger, and faster, today’s strength and conditioning coaches and sport coaches are faced with many obstacles. Outside the realms of program design and individual instruction, a coach is challenged with scheduling, staffing, and time constraints. A constant question is: With a limited amount of time to spend with athletes, which conditioning components take precedent?

More often than not, flexibility is the first component that ends up being neglected. However, many athletes today have very poor flexibility, and ignoring this can make your entire strength program inefficient.

WHY STRETCH?

Why is flexibility so important? Without adequate range of motion, an athlete will not get the most out of a strength program. When an athlete begins Olympic lifting, they usually exhibit common technical faults. Errors include improper back position, incorrect weight distribution, excessive trunk flexion, and poor knee tracking. These errors are directly related to lack of flexibility in the hips, upper and lower legs, and shoulders.

Increased flexibility in the hips, shoulders, and lower legs can dramatically increase the athlete’s practical range of motion. This increased ROM then allows the athlete to move more efficiently in their Olympic lifting sessions.

Greater flexibility also improves speed and agility. Most athletes have some technical flaws in their running and movement mechanics, and without adequate flexibility, fixing those flaws is difficult. For an athlete to powerfully accelerate, quickly decelerate, and efficiently change directions, they must be able to lower their center of gravity and manipulate their limbs with little to no internal resistance. Flexibility is the key to proficiently and efficiently executing these biomechanics.

A flexible athlete is also less likely to become injured. Functional flexibility allows athletes to move fluidly and efficiently without resistance into athletic positions. When a certain joint or joint complex is limited in range by tightness, the athlete is limited in function and there is increased risk of injury.

Above all, athletes who can sprint without having their stride length limited by tight hamstrings, hip flexors, or anterior shoulders, and who can quickly drop their center of gravity in the acceleration or deceleration phase uninhibited by tight hip rotators, are athletes who can perform closer to their greatest athletic potential.

When athletes have poor flexibility, many coaches simply tell them to stretch on their own without any instruction or supervision. This is where a strength and conditioning program can break down. The strength coach or sport coach needs to provide a specific program for the athletes and make sure that the athletes know proper stretching technique.

Todd Rice, currently the Head Strength & Conditioning Coach at the University of Pittsburgh and formerly at Boston College, takes a proactive approach to increasing an athlete” flexibility. Todd’s program primarily employs active isolated stretching principles (AIS). AIS is the innervating of a muscle (the agonist) to contract resulting in the opposite muscle (the antagonist) becoming inhibited and relaxed. The principle of reciprocal inhibition allows the muscle to lengthen without evoking a stretch-reflex contraction. This creates greater muscle length without any associated micro-trauma.

In Todd’s program, athletes stretch one muscle group at a time, thus actively contracting the muscle opposite the targeted group. The muscle is stretched gently (not to full range or discomfort) for two to three seconds. The stretch is released before the muscle senses the stretch and utilizes the protective contraction, facilitated by the excitatory proprioceptor, or the “The Muscle Spindle.” This is repeated four to 12 times each session.

Some of the stretches are performed with partners and others are conducted without assistance. At the beginning of each season, the coaches do more of the stretching to assure proper form and execution. Once the athletes learn the stretches, they stretch each other while the coaches supervise.

Below is a sampling of some of the stretches used in Todd’s program. Note that the first three are part of the “Sprinters Series,” which develops flexibility in the deep rotators of the hips. Each of these three stretches are done twice, first with active static stretching for 30 seconds, and then again for four to 12 reps with AIS.

Single-Leg Stretch: In this stretch, the athlete lies supine with the left leg straight and the right knee bent into the chest with the foot externally rotated and dorsiflexed. A partner kneels on his or her right knee facing the athlete, and places their right hand above the athlete’s left knee on the thigh to minimize iliopsoas shortening. The partner places their left hand below the athlete’s left bent knee with the athlete’s right foot on the partner’s abdomen, and the partner applies pressure down (toward the floor) and back (toward the shoulder). The process is repeated for the other leg.

Double-Leg Heels on Thighs: Have the athlete lie supine with both knees bent in toward the chest. The feet are externally rotated and dorsiflexed and in line with the knees. The athlete places his heels low on the partner’s thighs. The partner faces the athlete, takes a wide stance, and applies pressure down and back with hands low on the hamstrings.

The athlete should visualize and try to focus on the six deep rotators (piriformis, gemellus superior, gemellus inferior, obturator internus, obturator externus, and quadratus femoris), which collectively originate from the inferior lateral portion of the sacrum and various portions of the ischium and insert on the greater trochanter. With this focus, the athlete should be able to contract the deep rotators through external rotation of the hips. This contraction technique takes both time and good instruction to accomplish.

Double-Leg Feet on Shins: This stretch is quite similar to the heels on thighs stretch. With the legs wider and lower than with the heels on thighs stretch, this movement involves both the deep rotators and the adductor complex.

Hamstring Stretch: Lying on his or her back, the athlete lifts the right leg up to their potential range of motion either with a stretch rope or with assistance from a partner, and straightens the left leg. They first contract the quadriceps muscle group and pull with the hip flexors, then stretch the hamstrings for two to three seconds. This is repeated four to 12 times. Dorsiflexion of the foot will incorporate the gastroc and soleus complex, where plantar flexion will isolate the hamstrings.

Four-Point Lateral External Rotator: This stretch is often performed incorrectly. To start, the athlete gets into the “all fours” position, with knees and forearms on the floor. The athlete allows the knees to spread until a comfortable adductor stretch is achieved. The main focus of this stretch is for the athlete to push his or her hips straight back focusing on the deep rotators of the hips. The buttocks do not move inferior, but slide straight back. Normal range of motion is minimal.

The intent of this stretch is to target the pectineus and the iliacus muscles, which are internal hip rotators. Since both muscles insert on and just below the lesser trochanter of the femur, it is important to keep the pelvis neutral and the back flat while pushing the pelvis away from the femur.

Hip Flexor Stretch: The lunging hip flexor stretch is performed by the athlete on both sides of the body. The left leg is extended into the lunge position with the knee over the arch of the foot, yet not protruding over the toes. The right leg is extended straight back with the weight on the toes. It is very important that the athlete’s back is flat and the torso is upright.

This stretch is enhanced and can be active static if the athlete contracts his or her right gluteus maximus muscle to incorporate reciprocal inhibition for the iliopsoas muscle (iliacus and psoas major and minor). Because the psoas major and iliacus portions of the iliopsoas complex insert on the lesser trochanter, slight internal rotation of the right hip (by pointing the toes in 20 degrees) will lengthen the iliopsoas and increase the stretch.

After these static and active isolated stretches are completed, athletes perform a dynamic flexibility warm up. These exercises consist of knee tucks, butt kicks, triples, walking lunges, and hip rotators, among others.

Flexibility training does not start and end with increasing the athlete’s range of motion. With a program in place that incorporates flexibility training into a full strength and conditioning regimen, your athletes will be able to successfully complete their strength and speed workouts, and they’ll carry these improved fitness levels onto the field.

 

Syndicated from AthleticManagement.com with permission.

Factoring in a busy lifestyle, puberty, and the pressure to look a certain way, the nutritional considerations of high school athletes differ from other age groups. Our expert serves up advice.

By Emily Edison

The challenges are numerous. They have hectic schedules, possess an aversion to breakfast, and combine socializing with eating junk food. They inhabit bodies that are rapidly changing and they tend not to take responsibility for their food choices.

I’m talking about high school athletes (who else?), which can be one of the toughest populations to design effective nutrition programs for. They want to be the best they can be at their sport, but they struggle with embracing good nutritional practices.

The available research on nutrition for high school athletes supports a meal plan that incorporates eating multiple times a day and balancing macronutrients to maintain performance. It also requires consuming a lot of calories and limiting packaged food in favor of dreaded vegetables and whole grains.

How can you help them follow such guidelines? I’ve been working to answer this question for the past 10 years in my role as coordinator for the Washington Interscholastic Nutrition Forum (WINForum), a science based sports nutrition resource geared toward high school athletes, coaches, athletic support staff, and parents. The keys to progress, I’ve found, are explaining the basics and giving them specific fueling strategies.

BASIC NEEDS

When it comes to macronutrients like carbohydrates, protein, and fat, it’s important that high school athletes are getting adequate intake. To start, they should get more than half of their daily calories from high-quality carbohydrates, such as grains, fruits, and dairy.

Unfortunately, this does not always happen because many high school athletes misunderstand carbohydrates. They are quick to adopt fad diets that restrict gluten or cut out valuable sources of carbohydrates such as bread, rice, and pasta. Of course, any athletes with medically diagnosed conditions, like Celiac disease, should stay away from gluten. But for the rest of the population, carbohydrates play a valuable role in their growth and performance.

Protein also needs to be a significant component of a high school athlete’s diet to maximize muscle growth and repair. Generally, teenage athletes require between .7 and .9 grams of protein per pound of bodyweight each day. Because the body can only process about 25 grams of protein per feeding interval, athletes should focus on consuming small, high-quality doses throughout the day. Dairy, eggs, meat, fish, tofu, edamame, and soy milk are all high-quality sources.

Additionally, new research suggests that a pre-bed snack consisting of 20 to 25 grams of high-quality protein can help the body assimilate muscle tissue during sleep. Acquiring muscle while they sleep? This should be an easy sell to high school athletes.

It can be hard for teenagers to figure out how to consume protein throughout the day, so I find it helpful to provide them with ideas and examples. Here’s a sample eating plan I drew up for Sara, a 16-year-old, 5-foot-11-inch, 150-pound basketball player. She needed 120 grams of protein per day to maintain stamina and gain muscle during her offseason training.

Breakfast: Two-egg scramble on two pieces of toast with avocado and tomato and eight ounces of milk          = 24 grams of protein.

Snack: Six ounces of Greek yogurt and fruit = 12 grams.

Lunch: Three ounces of tuna on two slices of bread, granola bar, carrots and hummus, and fruit = 24    grams.

 Pre-practice snack: Half of a peanut butter and jelly sandwich and a fruit leather = 7 grams.

Post-practice snack: 12 ounces of chocolate milk = 12 grams.

Dinner: Three-ounce portion of grilled pork tenderloin, steamed broccoli, baked sweet potato, and fruit salad with yogurt = 25 grams.

Pre-bed snack: Cottage cheese and fruit = 15 grams.

Finally, high school athletes need fat— the good kind. Be sure to educate them on the importance of consuming healthy fats from fish, nuts, vegetable oils (e.g., olive and canola), and avocados. These support energy, muscle growth, immune function, and recovery

TAILORED TO TEENS

In my years of working with high school athletes, I’ve learned to conquer the three main roadblocks of getting them to fuel properly. The first is convincing them to eat a quality breakfast.

I’ve yet to meet a teenager who willingly wakes up earlier than they absolutely have to, so it can be difficult to convince high school athletes that consuming a morning meal is more important than a few extra minutes of sleep. It helps to explain that those who skip breakfast won’t have enough gas in the tank for a focused afternoon practice. This missing fuel can lead to muscle loss—not to mention the potential loss of a starting spot on a team.

Two other ways I’ve had success getting athlete buy-in are through visual aids and by organizing team breakfasts. I use Pinterest to create visual boards that I share with athletes, so they can see how easy it is to make a microwave egg sandwich or toaster waffle “Big Mac” (layer toaster waffles with peanut butter and bananas). For team breakfasts, I suggest making oatmeal in a large slow cooker and assigning players to bring their favorite toppings, such as nuts, granola, milk, and fruit.

Just because breakfast is the most important meal of the day, doesn’t mean it has to be the most complicated. There are tons of quick, high-carbohydrate, moderate-protein options that will keep athletes energized and their muscle tissue intact. Some I recommend are a bagel with eggs, a banana, and milk; yogurt, oatmeal, and an orange; and waffles with peanut butter and strawberries.

You’ll notice that none of my go-to options include a bowl of cereal. This common breakfast item for high schoolers is often loaded with sugar and rarely provides long-lasting energy. Advise athletes to ditch their corn flakes and honey-nut O’s for something more substantial. If they must have cereal in the mornings, it should serve as an appetizer to a heartier breakfast.

The second challenge is getting high school athletes to snack throughout the day. Approximately 25 to 30 percent of their total calories should be consumed after waking up and prior to lunch. For the athlete who needs 3,000 calories per day, this means 750 to 1,000 calories should come in the form of breakfast and a morning snack.

Snacks for the rest of the day should contain carbohydrates for energy and protein for repairing muscles and keeping athletes full. Since time between classes is short and many schools limit eating and drinking, good snack options should be nonperishable and easy to store in lockers or book bags. One of my clients, Luke, a freshman cross country runner, recently learned the benefits of all-day fueling. When we started working together, Luke complained of fatigue and felt his performance was lacking. His eating habits reflected, well, a typical high schooler’s. His breakfast consisted of one bowl of cereal (“if there was time”). Lunch was finely crafted cafeteria pizza or chicken nuggets, chips, fruit snacks, and a carbonated drink, and he capped off the day with a home-cooked dinner after practice.

Together, Luke and I developed a performance nutrition game plan that better suited his dietary needs. Here’s what it looked like:

Breakfast: Waffles with peanut butter and bananas, yogurt, and coffee

Snack: Trail mix Lunch: Sandwich, veggies, fruit, goldfish crackers, and a granola bar

Pre-practice snack: Dried fruit and peanut butter pretzels

Post-practice snack: Chocolate milk and an energy bar

Dinner: Grilled fish, veggies, salad, bread, and milk

Pre-bed snack: Peanut butter and jelly sandwich with fruit.

After a short time practicing his new meal plan, Luke reported significant improvements in his performance. He broke two freshman school records, made first team all-freshman in his conference, competed in the state championship meet, and is now ranked nationally.

Finally, the third challenge of working with teenage athletes is accepting that they won’t always make healthy choices. That’s actually okay, as good nutrition doesn’t have to be all or nothing. Creating rules like “no sweets” or “no fries” sets athletes up for failure and increases the likelihood of binge eating and secretive eating behavior.

Instead, try to balance high-performance fueling with realistic expectations. I recommend high school athletes follow the 80-20 rule. If they focus on high-performance foods 80 percent of the time, 20 percent is left for eating “cheat” foods.

I also tell athletes to use some of their favorite treats to fuel performance. For example, if an athlete loves her dad’s chocolate chip cookies, I suggest including them as a pre-practice snack with milk. This way, her body can use the carbohydrates and protein for energy and muscle growth, and she feels guilt-free about her choice.

OUT TO EAT   

   Between Friday night pizza with friends and stopping for dinner when traveling to away games, high school athletes go out to eat a lot. A few easy tips can help them stick to their nutritional game plans, even when their meals are handed out a drive-through window.

The following terms generally indicate high-performance food choices when eating out: broiled, steamed, poached, gardenfresh, in its own juice, tomato sauce, marinara sauce, roasted, wood-fired, stir-fried, and grilled. Wraps, sandwiches, and baked potatoes are often good choices—just lay low on sauces and dressings. Where is fat hidden? Watch for words like mayo, aioli, au gratin, creamed, creamy, crispy, deep-fried, and gravy.

At typical teen hangouts like pizza joints, fast food restaurants, and movie theaters, my advice is to limit fat intake whenever possible. When ordering a pizza, athletes should select lower fat toppings like ham, pineapple, veggies, and chicken sausage, and order the pie with half the amount of cheese. At fast food restaurants, I tell athletes to follow a “pick-a-fat” method—they can have avocado or mayonnaise on a sandwich but not both. And at the movies, they should aim for “healthier” snacks like pretzel bites, trail mix, or chocolate-covered raisins as alternatives to popcorn and candy.

Fueling while traveling for away games or weekend-long tournaments can bring additional challenges for high school athletes, as they aren’t always in control of when or where they eat. Remind them that foods high in fat delay digestion and slow the passage of high-energy carbohydrates to the body’s muscles and liver. If food is still sitting in an athlete’s stomach come game time, it hasn’t been converted into energy to fuel muscles for optimum performance.

It takes at least three hours to digest a regular meal, so if there is less than two hours before a contest, have athletes try one of the following mini-meals:

• Fruit and dairy-based smoothies
• Turkey sandwich with mustard and lettuce
• Instant breakfast drinks with fruit
• Low-fat chicken wraps
• Burrito minus the sour cream and guacamole
• Bowl of cereal with milk and fruit
• Dry cereal and yogurt.

LOSING & GAINING

   High school athletes do a lot of looking in the mirror, and they aren’t always happy with what they see. Like most teenagers, high school athletes can struggle with selfesteem, and some may want to make their bodies look a certain way through fat loss or muscle gain. It’s important that they pursue either option in a healthy manner.

Athletes’ weight and body composition desires are influenced by coaches, athletic trainers, media, teammates, parents, and their own athletic and aesthetic goals. These influences and pressures can tempt young athletes to restrict calories and eliminate food groups in order to lose weight.

I recently worked with a high school swimmer, Ciera, who wanted to lose weight after she heard her coach say that dropping a “few pounds” can help athletes swim faster. She quickly put his blanket statement of, “Stop eating sweets to lose weight,” into action.

Ciera removed all things with sugar in them from her diet, including her pre-practice snacks, which cut about 800 calories from her daily intake. The frequent praise she received on her appearance once she started losing weight encouraged her to continue with her calorie restriction. She created a new rule, “No White at Night,” and cut out all carbohydrates that were white, such as bread, pasta, and rice.

For an athlete with extremely high carbohydrate needs like Ciera, restricting these foods can lead to low energy availability, amenorrhea, fear of eating with friends and teammates, and the potential for developing an eating disorder. With a starting body composition of 19 percent body fat (already low for a teen swimmer), Ciera did not need to lose a few pounds, and the calorie restriction was too great for her to maintain muscle and bone mass, as well as energy.

While I worked alongside Ciera’s physician and therapist to adjust her eating habits, she took a break from competition. After six months, she was able to face her fears around eating, get back to a healthy, strong weight, and gradually return to the pool. She is now swimming faster than ever.

To prevent a frustrating and potentially damaging battle against the scale, encourage athletes to ask themselves three important questions before they start a weight-loss plan:

   Why do I want to lose weight? There are many reasons athletes think they need to lose weight, and improving their overall health is not typically one of them. Some think it will increase their athletic performance, but many are fueled by a desire to look “better.” As Ciera’s case shows, calorie restriction for the wrong reason can be dangerous.

   Do I need to lose weight? Athletes frequently hear that losing weight improves sports performance, but that is not always the case. In many circumstances, cutting calories can lead to nutrient deficiencies, muscle loss, and performance declines if energy needs are not met.

   Communicating best practices and choices for an athlete’s health and performance should be a “team” effort that includes coaches, athletic trainers, parents, nutritionists, and family physicians. This will help ensure athletes reach their goals without compromising well-being.

Is this the right time to lose weight? Optimal timing for weight loss is in the offseason to ensure it has minimal effects on performance. In addition, periods of high stress (e.g., finals weeks, family conflicts) and times of growth (puberty) can make weight loss more difficult to attain.

There are a few select situations where fat loss could be appropriate for a young athlete: if they have been diagnosed with high blood pressure, high cholesterol, or type 2 diabetes, or when injuries occur due to excessive weight. In these instances, the best way to lose body fat while preserving muscle is to focus on eating the most when the body is active and consuming less when the body is at rest. Weight-loss athletes should also fuel every three to four hours, eating smaller meals more frequently.

Learning to be self-aware of hunger and satiety can help athletes stick to this fueling schedule. Remind them to listen to their bodies for true hunger cues, such as a growling stomach. Some may benefit from keeping a hunger and fullness chart (rating hunger and fullness on a scale of one to 10 throughout the day) or setting an alarm on their phones to eat every few hours.

High school athletes looking to gain weight may think their road has to be paved with muscle-building supplements. Contrary to popular belief, simply consuming extra protein in the form of powders and pills and hitting the gym on occasion is not enough to gain muscle. To see results, high-quality protein must be consumed in multiple small portions (20 to 25 grams) throughout the day and combined with a well-planned strength program. I advise a three-step “Ready, Set, Go,” approach when working with athletes who are looking to increase muscle mass:

Ready: Have athletes start a strength based, sport-specific lifting program designed to maximize muscle gain. Then, create an eating plan to support growth that includes a meal-snack-meal-snack pattern and caloric distribution spread around practices and games.

   Set: Be realistic when helping athletes set goals for muscle gain. A good target is to add 400 to 500 calories per day, which will build half a pound to a pound of muscle per week.

   Go: Provide consistent support for the athlete. Advise them to fuel during training by consuming extra energy sources.

   It is vital to remind high school athletes about the importance of recovery and repetition in a muscle-gaining program. Encourage a recovery snack after each training session that includes carbohydrate and protein. Good options are chocolate milk, yogurt and cereal, banana and peanut butter wrap, frozen yogurt, or a protein/fruit smoothie. Stress that staying consistent with eating and training habits will ultimately help them reach their goals.

While there are roadblocks to overcome, engaging high school athletes in sports nutrition can be rewarding and effective. Building a solid nutrition game plan in their teens will help them continue to enhance performance as they move along in sport.