Ep 201: Youth Sports & Overtraining: Insights from Dr. Bianca Edison

In this episode, we welcome Dr. Bianca Edison, a pediatric sports medicine and orthopedic physician, to discuss the critical issues surrounding youth sports. Dr. Edison shares her journey into sports medicine and emphasizes the importance of balancing athletic activities for young athletes. The discussion covers overtraining, the significance of rest and recovery, the impact of burnout, and practical advice for preventing common sports injuries in children. We also dive into the importance of sleep, quality nutrition, and healthy exercise habits. This episode offers valuable insights for parents, coaches, and young athletes aiming for long-term health and enjoyment in sports.

 Dr. Bianca Edison is a pediatric sports medicine and orthopedic physician at Children’s Hospital Los Angeles and Clinical Associate Professor of Orthopedic Surgery at USC’s Keck School of Medicine. She received her MD from Baylor College of Medicine, completed pediatrics internship and residency at UCLA (where she served as Chief Resident), and pursued a sports medicine fellowship at CHLA. Bianca’s clinical work focuses on overuse injuries, injury prevention, dance medicine, and concussion—helping young athletes stay healthy and love movement for life.

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Transcript

Unknown: 0:00

Hello listeners. This is Dr Jessica Hochman. I'm excited to share that I am now booking sponsorships for your child as normal for this fall. If you have a product, service or a message that you think our listeners would benefit from, whether it's for parents, kids, healthcare or family life in general, this could be a great opportunity. You can find details on how to sponsor by checking the show notes. Just click the link that says how to sponsor an episode, and I'll let you know for a good match and get back to you. Hi everyone, and welcome back to your child's is normal. I'm your host. Dr Jessica Hochman, today I'm thrilled to introduce you to my friend and incredible physician, Dr Bianca Edison. Dr Edison is a pediatric sports medicine and orthopedic specialist at Children's Hospital Los Angeles, and a clinical associate professor of orthopedic surgery at USC Keck School of Medicine. She earned her MD at Baylor College of Medicine. She completed her pediatrics residency at UCLA, which is where I had the privilege of training alongside her, and then went on to complete a sports medicine fellowship at Children's Hospital of Los Angeles. If your child plays sports, whether it's soccer, baseball, dance, gymnastics or anything in between, you won't want to miss this episode. We talk about preventing injuries, avoiding burnout in youth sports, and most importantly, how to help your kids build a healthy lifelong relationship with exercise. I learned so much from this conversation with Dr Edison, and I know you will too. So without further ado, let's dive in. Everybody meet Dr Bianca Edison, good friend of mine, amazing doctor. Thank you so much for being here, and I cannot wait for everybody to learn from you, gain from your expertise, and to know who you are. So thank you again for coming on your child as normal. Thank you for having me. It's an honor to be here with you today. So Dr Edison, tell everybody what kind of a doctor are you and how did you get interested in youth sports medicine? So I am a pediatric sports medicine and orthopedic physician. How I got into this field, actually, it was by happenstance. Towards the end of my training, I thought I was going to go into general pediatrics, honestly, however, there was an elective in sports medicine, and I chose to do that elective to just get more training. And after working in that practice, it just opened my eyes. And I thought, What is this magical place? You get to work with athletes all day long. And so that was my parlay into it. So I did further training with a fellowship, and here I am, and I love it. I get to work with young athletes and people who just want to be active or get back to their respective love and sport and just helping them and their families and the community. And out of curiosity, were you yourself an athlete when you were a child? I mean, I take a very broad definition of athlete the growing up. Yes, sports was the vehicle for my parents to get myself and my siblings out of the house and keep us entertained, and so I participated in several different sports growing up, but primarily danced for many years, and also played tennis and track. Those were and the main ones, but tried out a whole bunch of things. I tried out a Taekwondo, I tried out volleyball, I tried out basketball, I tried out gymnastics, I swam, we skied as a family, so lots of different things. I'm looking forward to having a conversation with you about overuse injuries in kids. Because I think everybody can agree that sports are fantastic for kids. They provide a great vehicle for exercise. There's so much value in learning how to participate on a team, how to lose, how to feel the joy of winning. But at the same time, I know a lot of parents talk about how youth sports today are different than they used to be. There's a lot more stress involved that there's a lot more time commitment that's expected of these kids. And so I wanted to ask you, what would overtraining look like for a kid or a teen that's in a sport? Yes. So I'll start off by saying, I love my field, but I don't necessarily love where we exist right now in this youth sports kind of ethos atmosphere, because there is a lot of over training that is happening with our youth and our young athletes. And so balance is really the key. And so by definition, from both our professional sports medicine and pediatric societies such as the American Medical Society for sports medicine and the American Academy or pediatrics over training. Or over training syndrome refers to all these symptoms that result from excessive exercise over time. Mind with insufficient recovery, basically, to facilitate the body's adaptation to that kind of exertion. And so in other words, a kid is doing way too much in their respective sport without proper recovery, and when that particular athlete does not take the necessary rest that they need. That's when they fall into the realm of overtraining, which creates a lot of negative outcomes for their body as well as their mental and emotional state. And so if you have those training loads, there more the recovery that's allowed for a period of time, then their performance decreases, and that can result in physical stress, detrimental fatigue, injury, burnout, and so things that parents can really see is if their child feels really fatigued, to the point that it interferes with their school, with their athletic training, with their daily tasks, if they just can't bounce back basically from their intense workouts, or if they start having more frequent injuries, if they're in my office much more, or if they start to show signs of burnout, all of those are signs of that over training. And as I think about it, with kids, you can have burnout, both physically and mentally. Oh, absolutely, we have about 60 million youth that are participating in organized sports. However, a staggering statistic from the Aspen Institute shows that upwards of 70% of children drop out of organized sports by the time they turn the age of 13, fewer than four in 10 students play sports in public high schools. Only 23% of kids reach the recommended level of daily physical activity that they should be achieving, and that's decreased from 2011 which was at 29% in your opinion. Do you have any thoughts as to why that is, why so many quit sports by the time they're teenagers? Do you think it's cost? Do you think it's commitment? Do you think it's burnout? So I led a group where we looked at a research study and we followed kids. It was a longitudinal study, so basically, we started out with them in middle school, and we followed the same group all the way through high school. Primarily we wanted to look at sleep, but we looked at sports participation, burnout, anxiety, all of those things. What we found was that burnout what's more common in high school than in eighth grade, both academically and sports related burnout. What we found that one in four students had sports related burnout. And so I think there's a myriad of different things that can really contribute towards this. Unfortunately, youth sports have become a multi billion dollar interest, and we're asking kids to perform at levels really, that sometimes it can be too much. A lot of times it gets to be too much. Some are doing 2025, hours a week of their respective sports. And if that's all you're doing during these formative years, either it gets to be too much, or when something happens that pulls you out, such as an injury, it can cause a lot of heartache and emotional stress. And if you feel that, the focus is on the end result, be it either a college scholarship, playing pro, getting endorsements, those sort of things, then the child themselves sometimes can feel that they're not really being honored as their own individual self. And so all of these things, and this pay to play model in sports puts a tremendous amount of pressure on these young kids they're trying to just grow and develop into who they are as individuals and learn themselves. And so when the Aspen Institute did a very large survey nationally to look at kids and ask them why they stopped playing, the number one reason is that it's just not fun anymore. There are definitely kids that I meet that just love the sport they're participating in. They can't get enough of it. Let's say it's baseball or basketball or dance, and they truly seem to enjoy that sport. In that situation, are there any limits that parents should be thinking about for their kids, or if they're enjoying it and their body feels strong, can they do that activity as much as they want. So the research shows that there still should be some limitations, and it could be based on their age or their stage of development, their capabilities from both a physical and a social emotional level and also. So looking at what we know about what the body can withstand, so all of that kind of grasp upon what we call the American development model of sports participation. And that came about in 2014 and it was started by the US Olympic Committee, along with the national governing bodies for sports, and it's really based on looking at each kid individually, but also knowing within the realm of their development, based on their age, what should be done for them, just to help them succeed and really thrive in sports. And really love that for a long term, because really our goal should be that we should have a society and a group of this rising generation that really loves to move, and should keep moving to keep ourselves healthy and strong. And so it says that within that model, we recommend between the ages of zero to 12 years that children participate in activities and sports that promote really discovery learning and fun, and you're honing those skills of problem solving and confidence boosting and conflict resolution. How do you deal with something that doesn't go your way? And then it's not until after age 10 that we recommend more challenging skill development, and then not until that foundation is solidified after age 13, that one trains at a much higher level and actually competes through that we collectively help support a more broader, more inclusive participation in physical activity and sports, we help cultivate stronger athletes and just maintain, again, more active and healthier society for those kids that have that strong foundation really love what they're doing, we want to make sure that they are also taking proper rest, because the body needs certain time to rest from the high intense physical activity to allow the muscles to repair and regenerate. So we avoid kind of burning out a particular area of the body and avoid injury. Our national societies and organizations recommend that, for kids, you take at least one day per week of full rest. You know, we're in California, we can afford to play sports year round from a weather perspective, but we shouldn't, and that you should take at least two to three months of rest away from that particular sport where you do something else complimentary and that to avoid again, that burn down some of those overuse injuries. I heard a general guideline, whatever age your kid is, think about doing that many hours of that sport per week. So, for example, a four year old shouldn't do more than four hours of dance a week, and so on and so forth. Is that something that you would agree would be a quick motto for parents to pay attention to for most kids in most sports. Yes, it's the rule of ages that come about from the American Academy of Pediatrics and the Council of medicine and Sports Fitness that you do generally use that guideline, depending on the age that your child is, that should not exceed the hours per week of what that kid is doing for that particular sport, and that helps protect them. I tell the parents accrue frequent flyer points in my office so they keep having fun on the field and they're not broken and battered. I had on the past Dr Skaggs, he's a wonderful orthopedic doctor, and he also mentioned a study that he conducted where teenagers that slept over eight hours were actually even better at their sport, that they made more of their free throws and they had less injuries. Is sleep something that you also notice plays a big role as well with children in terms of preventing overuse injuries and injuries in general. So sleep is part of that rest component, and it's the one supplement that I recommend to take. It's free. You know, everybody is so over scheduled and their Go, go, go all the time, but it's really important. And that study did show that those students who achieved the recommended hours of sleep by the National Sleep Foundation actually had less rates of injury. They were two thirds more protected from injury. And if you look at athletes such as LeBron James and Michael Phelps and Serena Williams, and you know these greatest of all times, you will see that they are athletes who actually prioritize their sleep. And again, it's that time where the body is allowed to regenerate and it allows the kids to get stronger, their performance actually goes up. There's one sleep health specialist. Her name is Dr. Are Sherry Ma. She does a lot of work in this field in terms of research, and works with some of the pro athlete teams, and she's conducted some research with some NCAA athletes as well as some pro athletes, and has shown that those who actually prioritize the sleep, they get good quality sleep as well that they perform better, and I really want to emphasize quality sleep, because we also did a study where we looked at the athletes when they went through middle school and high school, and we had them document their sleep via sleep journal, but we also monitored objectively their sleep via after graph watches. And so we noticed that kids really overestimate how much sleep they're getting, sometimes upwards of one to two hours, where they think they're getting eight hours of sleep, and in reality, they're only getting six because they're in bed, they're on their phone, so it's not really sleep that they're getting. So I also emphasize that when I talk to families that you want to implement the nice, healthy sleep hygiene habits that will achieve not just the number, but the quality. To summarize what we've discussed so far in terms of injury prevention, it sounds like in the younger years, you want to go slow. You want to keep it fun. You want to avoid over training. You want to include a rest day. And then once they're teenagers, you can think about training with a little more intensity, specializing and really following what the child is interested in. If they seem like they're burning out follow those cues, and if they seem like they're interested, then that's great. You can continue on that path exactly, keeping the catered at the center, because that really helps to guide everybody. It should be a team effort, but if we keep the actual individual athlete at the center, let them have agency to guide how they would like this and making sure that all the needed kind of resources are there to help them thrive in a healthy way, then we'll all win. I could not agree with that statement anymore. I think following the child is the answer now for yourself. Dr Edison, as a sports medicine doctor, I'm curious, are there certain injuries that you see over and over again with kids that you would love parents to hear about so that they can think about prevention with their children. Yes, absolutely. So I'll give you another staggering statistic, on average, one child under the age of 18 once every 25 seconds, it's seen for a sports related injury in the ER so that doesn't even include all the stuff that we're seeing in our clinics or in urgent care or just on the field that you haven't yet to come in to be seen. I'll say injuries are a little bit different than adults, because they're growing and physically and developing emotionally, and they have open growth plates, which can make them more vulnerable. They have rapidly growing bones and muscles that are attaching to those bones which make them more vulnerable, paired with high intense training, okay, allows for the right recipe for these overuse injuries that we see, and we see them in the knee. We see them in the ankle, the arm, the back, the shoulder, and so again, it's that unequal balance where they're doing too much, they're having improper either technique or improper recovery time, for example, so a baseball pitcher who is 11, and they're working on throwing, they've been put in position of pitcher, the coach says, Yeah, I just really want you to concentrate on that. And they're throwing harder than they should, or with improper technique. They're not allowing proper rest in between their practices, they might not realize all the muscles that they need to engage in order to have proper form when they're throwing and then it results in a tear in a ligament that's in the elbow, called the ulnar collateral ligament. They're coming in because they can't fully extend their arm. They're having a lot of pain there? Or, for example, someone who just started their entering freshman year of high school and they want to try out for the cross country team, the coach gets encouraged and says, Hey, we're going to go from 20 miles a week to 40 miles a week, just like that, without kind of a ramp up. And so then they're in my office with a stress fracture, either in their foot or in their lower leg, or a gymnast who just suddenly learned how to do a back walkover. And they just do it over and over again in practice, and they're practicing 25 hours a week. And so they end up in my office with a stress. Back to in their lower back. So all these things that can come about that we see that come through those doors, but again, the basis of all of those can be just improper training, deconditioning, sub optimal readiness, sub awful fueling, improper or poor sleep, improper technique. They don't have the right equipment or something to support them and biomechanical issues. Do you find that for a lot of children, they get signals of pain from their body? I always feel like pain comes from the body for good reason. I tell kids to listen to their body when they're feeling pain, and that that's the time to rest. Do you agree with that? Because I feel like a lot of people try to mask the pain with medications and whatnot, and that, right? Truly, most of the time, that's a signal from your body that it's time to take it easy. Yes. So we need to debunk all the dodge that pain is weakness leaving the body. I've heard coaches say that to athlete, and it's scary, because that is not what we should be doing. We should not be ignoring those signals. I tell my athletes and families all the time, those are the body communicating that something is going on, something needs to change quick, faster than a hurry, or else we're going to end up in trouble. And so if we ignore those signals, and that's when they end up with a really bad injury, and we have a weird kind of relationship with pain right now, I think, as a society, it's either that we need to ignore it, because if we admit to it, it's a sign of weakness, or that we should never, ever experience it. And so we need to take something to get rid of it, rather than really honoring those signals that the body gives us and doing the right thing, and figuring out what's causing that pain in the first place and dealing with that? I think that is so true, because I myself feel like when I'm uncomfortable, I try to work through it. I want to feel like I'm tough. I don't feel like, oh, I should mask all of this pain, that it's there for a reason. And then I definitely agree with you, we have pain medication. Why should people suffer? So there's also that piece of it that, especially if it can aid in healing and feeling better, there's gotta be some sort of happy medium here. Yes, I think we need to achieve a more healthy relationship with the concept of pain, and also try and redefine what pain is, and when do we act on it? There's also just different nuances. It's not just pain. Do you have it or not? It's like, Do you have pain because something is seriously going wrong? Is that sharp sensation in a joint or in a bone that tells you Something is definitely wrong, or is it muscle soreness, meaning that you trained yourself really well. You worked some things that you're not used to working. And so if we can learn those nuances more, then we'll all be in a much better place as they get older, and just as a society as a whole, I agree. I think there's some general principles I think about, for example, can they bear weight? Does the pain feel excruciating and sharp, or does it feel like muscle soreness? And so some of that, I think, will come with experience and time, and some of it, I think, for anyone listening who has questions, that's when it's great to see a doctor like Dr Edison or your pediatrician. Absolutely, yeah, the more we talk about and communicate about it, the better. I also want to say that I'm really glad you pointed out that when it comes to supplements, the only supplement that you endorse is sleep, because there's so much noise out there right now about peptides and creatine. So I love that you said that the only supplement you truly believe in is sleep. Yeah, absolutely, one of the greatest athletes, I think that this planet has seen Kobe Bryant, I had the pleasure and honor of talking with his trainer. He said that he took a very natural approach towards his training. He emphasized just eating well, have a nice diet, prioritizing sleep and making sure that he was training and moving in the right way, which I think is the way to go, if we don't need to load ourselves the latest and greatest from GNC and all of that, it's more so you know, we need to go back to the basics, if we keep a strong foundation with that that will Help Us overall and help the kids. The basics absolutely thinking about getting your sleep, getting a well rounded nutritious diet, thinking about keeping your stress low, not over training. I couldn't agree more that the basics are what really give us that foundation to be the best athlete that we can be. So in terms of recovery, do you have any advice? Yeah, from an injury prevention standpoint, it's really trying to take an individualized approach to that young athlete's development and training that can really help development and puberty can come at varying different times. Ages and ages for kids. So we can't just go based on age. Then they should be able to do X, Y or Z. We can't do that. And so knowing that during those times of rapid growth, there can be lots of physical differences between kids, and can be very dramatic. And so again, it's not that we're letting what someone else does guide our own actions. We can't do this keep up with the Joneses type approach with youth sports, in particular with your own child, because that can really set them up for failure and for injury. Instead, we want to look at individual growth spurts, because those can affect coordination, balance and the ability to perform a particular skill. So given that when an athlete is going through those periods of rapid growth, it can actually be beneficial to pull back a little and refocus on those fundamentals and re establishing a strong base, re establishing good confidence, and then advance. Because as a kid is rapidly growing, their center of gravity changes, and so their movement profile changes. Their muscles get stretched super tight. So everything changes, and so they're not moving the same way that they did three weeks ago. So they have to relearn all of that, recalibrate, basically. And so if you're trying to demand them to stay at a super high level performance and a super high level of training as they're trying to relearn that, then that's when things happen and they end up with the injuries. That's an excellent point you make, because you're right. There's so much change happening that, of course, they're going to need to reevaluate the movements they're doing and the exercises they're doing to prevent injury. So question, there's some myths that come up when it comes to training that I would love to clear up with you, or just ask you about. The first is stretching. How much does stretching really matter in terms of injury prevention? Yeah, stretching can be very beneficial. So everything is connected to everything else, from basically from your feet all the way up to your center core and your trunk. And so if one of those kind of links are off, then it throws everything else out of whack. And so for instance, let's take the hamstring, which is in the back of your thigh. When you go through a rapid growth spurt, if your femur, your thigh bone, grows super fast, it can pull those muscles, particularly that hamstring. If that's really tight, then it's hard to engage that muscle, and then it's hard to engage the muscle that's really close by to that, called the glute muscle, which is your powerhouse, the source of a lot of strength and stability. If it's hard to engage that, then other muscles are going to overcompensate, particularly in the front of your thigh, your quad muscle, which is attached to your kneecap and can pull really tautly and cause a lot of knee pain. That's what we call patellofemoral syndrome. It's not that if you don't stretch, it's going to be detrimental, but what I say is, if you don't stretch, then it's hard to engage everything together so everything can be coordinated to provide you with the proper strength that you need. Then you're going to overuse certain areas, and it's going to cause pain, and then it can lead to downstream negative effects. So do you have general guidelines when you talk to parents in terms of how and when kids should be stretching. So what I say is you should be doing a good warm so your muscles are nice and warm and pliable. You should be doing what we call dynamic stretching. Research has shown that dynamic stretching particularly when you incorporate that into an ACL prevention program, those like the FIFA 11 plus and those sort of things for soccer and whatnot, that it can reduce your injury risk for ACL tears, those sort of things after practice when you're doing a nice cool down stress, so things don't get so tight when you're about to leave and go home. But you also want to prevent over stretching too, because I'll see some of my dancers or performing arts athletes who are using chairs or bolsters or someone else to push them. So that can be dangerous as well, because you're putting so much stress on the joints where it can cause a lot of damage. Yeah, and I think that goes back to also letting pain be your guide with some nuance. If it's a little bit of pain, okay, and it feels good, but if it's hurting, I think that's obvious. The body saying, do not do this to me. No, yes. Now, what about ice? Do you have any thoughts on ice? When should ice be implemented? And does it actually work to help with healing the body after an injury? There's. Been a lot of research around ice and its utility, or its futility, actually, and what it's meant for in our sports medicine realm, it's been shown to be useful for really acute, immediate kind of uses, such as if you a fewly sprain your ankle and you get a lot of swelling that can help for comfort and to help decrease that swelling, but long term or chronically, that ice really hasn't been shown to do much, if anything. I feel like with my kids, for example, it's a great placebo. After my daughter stubs her toe. If I hand her some ice, it seems to at least calm her down. I'm giving her something to refocus on. It's all very interesting, because even if we don't have great data on how much something may benefit somebody, I like to go by how you feel afterwards. So if you put ice on your swollen ankle and it makes you feel better, detract from the pain, great in moderation, it certainly can't hurt, right? Okay, a couple more common questions that I hear from parents. One is, do you have any thoughts on the use of Motrin or Advil, any of the anti inflammatories? What would you say in general when you recommend those anti inflammatories? Those should be used only if you really need them. And it goes back to this interesting relationship that we have with pain and also trying to avoid pain. So what I absolutely recommend against is what we call pre medicating. So some families will ask, What if I just give them some motion before the gain? That way they'll be fine. But really, that can mask a more serious injury or the patient might not feel pain, that would clue them in that, hey, something's going on, then they push themselves to the brink where it's even more serious injury. So definitely recommend only use it when it's needed. It should not be used chronically, because if you're having pain so much where you feel that you need ibuprofen or Motrin on a regular basis or daily basis, that's when you really need to talk to your pediatrician or family doctor or sports medicine specialist to figure out what's going on. Why are you having this ongoing pain, or what do we need to do about it? Because that should not be happening. So it sounds like for short term use, okay, but to be careful not to use it in a way that you're band aiding pain, because if you take some ibuprofen before you exercise to hide whatever pain you're feeling, you may actually make your injury worse, because the body is sending you those pain signals for good reason. That's absolutely true. And then a question that comes up a lot. I'm just curious your thoughts on this. I know a lot of parents that are gym goers themselves, and they want to include their children. And a lot of parents want to know if they can bring their kids to weight lift with them. Yeah, okay. And there's a lot of myths that I've heard that float around about weightlifting and kids. Some people say, Oh, I heard it stunts their growth. Some people are worried that they're going to enter themselves. Do you think that weight lifting is a healthy form of exercise for kids? Do you have any guidelines in terms of when kids should implement weight lifting? So the short answer is, yes, it can be beneficial. The longer answer is, as far as strength training, I want to try and expand that notion of that concept beyond weights, and offer up the term resistance training, and the question now is not what happens to our kids if they lift weights. Instead, the pressing question should be, what happens to our kids if they don't and so our professional organizations to include, again, the American Academy of Pediatrics and its Council on sports medicine fitness and American Medical Society for sports medicine recommend resistance training for you because it can offer tremendous benefits to include better muscular and bone health, better fitness and those strength gains occur with different types of resistance training, but you have to do it for extended period of time, so minimum duration of at least eight weeks, frequency of about two to three times per week. That can be bands. It can be the equivalent of their body weight, but there's no apparent negative general effect on a child's growth trajectory on their growth plates, on their cardiovascular system with resistance training, and it is part of our recommendations from the CDC and the WHO that two to three times a week we should be implementing weight based or Resistance based training that needs to be done with proper technique, and that really should be done with someone who knows the proper form. If you're a parent who has set training, great, take them with you to the gym, but if you don't, then involve someone who's a strength and conditioning coach. Coach or an athletic trainer to make sure that the kid is doing it the right way. It makes sense what you're saying that if they have proper form, they're supervised, and they enjoy doing it great, but if it looks like their form is off, they're going to injure themselves. That's a that's a good sign to not do it. I always laugh, because whenever I'm in the office with a 15 month old, they often do a squat, and their form is perfect. Squat beautiful. It's beautiful. I always tell adults, if you want to know how to squat, well just look at your 15 month old. They're doing it just right. So there, I do think there's also a lot of truth that kids naturally want to move. It's healthy for them to move their bodies. They can do it in natural, proper form. And if they're doing that great, let's continue to encourage it. Yeah. Now there are certain things that we recommend definitely in terms of the amount of weight. If you're going to implement weights involved, the kids should start to fatigue after that 13th to 15th repetition, if they can only lift that particular weight twice and they're really struggling, that's way too much weight. We don't recommend what we call power lifting, where you're putting so much weight on, where you can just do one or two and then it leads to a lot of injuries, where they end up back with us. So for anybody considering, for your kid, starting a resistance training regimen, it's really important to consult with your child's pediatrician or sports medicine specialist to discuss those nuances. And I do think there's an extra added layer of pressure for kids these days because of the social media influence. I meet a lot of kids, they'll look at body images online and online fitness content, and they think that they should be emulating that. So it's important for parents to be aware of those normal pressures out there. Oh, absolutely. And just having hand those conversations about what is healthy and what's strong, not what's pretty, not what's masculinized, all of those things, it's about, okay, what do we need to do? So you stay healthy, so you stay strong, so you stay loving what you're doing each day within your respective sport. And I'm just curious, out of all your experience dealing with athletes and parents, if you could talk to parents who feel that natural, normal feeling that their kid is falling behind. Because a lot of parents can have that feeling as their kids get older and the competition gets fiercer and the sport becomes harder, what would your advice be to parents? Yeah, I would say trying to rescind falling behind according to what and really having that question, is it that you think they're falling behind based on what is a typical performance? Do you think that they're falling behind based on that super elite club team, and what you're seeing, is it falling behind based on what you see on social media? Is it falling behind because you don't think that they're going to score a particular scholarship down the road? What are we talking about here? And then hearing those concerns, we can address that with the right and proper information, but also trying to re center that conversation, that there is a bell curve or a scope of what is typical and everybody is different, and that we need to meet the child that's sitting in front of us, based on where they exist right now, and hear from them what their goals are. So I try to ask kids that come in to see me, what's your short term goal? What's your goal within the next kind of six months? Where do you see yourself in five years? If you want to dream about it, what do any of those look like without even asking the parent first? Because then that helps everybody in the room hear about which direction we need to go in. So what I'm gathering from our conversation is we want to encourage our kids to love sports, and our job is to help our kids have a healthy, balanced relationship with movement, so that hopefully exercise and moving their body is something that they do for their life to be emotionally and physically healthy. Yeah, absolutely. And so we're still having a healthy relationship with movement for the duration of their lifetime, and really recentering our priorities with youth sports, that in reality, the likelihood of gaining a d1, full time scholarship or an n, i l deal, as we look at What's happening now, or gain crow the likelihood of that is very small, however, the likelihood of your child accruing the amazing skills that sports provide in terms of time management, learning how to. Get yourself up from a defeat or a failure, learning how to interact with different people, coming together as a team for a shared goal, learning how to interact with different adults on a regular basis, learning how to goal set, achieve those and honor that journey. The likelihood of that by participating with sports is very high. So we need to focus on that, because that sets them up for success as adults, as successful individuals within society, as people who will then take over the responsibilities of this world. So we need to do that and change everything that we're putting into and funnel it into those priorities, because that will help all of us, not just a very small percentage of the kids who play wonderful Dr Edison, this has been such an enlightening, enjoyable conversation. Can you tell people who are hearing your advice and maybe want to take their child in to see you for a consultation or to meet you as a doctor? Where can they find you? Well, I am part of the fantastic sports medicine and Orthopedic Group at Children's Hospital Los Angeles, and we have varying locations with our satellite clinics, I myself am concentrated in the South Bay, but my partners are located in Los Angeles, near downtown and Arcadia in Valencia and Encino, and any of us would be more than happy to help the families and kids continue to be strong and healthy, amazing. So for us parents, I'm going to remember to listen to our kids, to emphasize the fun, to encourage exercise, but looking at the child following their body cues, following their psychological cues, and the rest should fall into place. Communication is key when giving them the space to speak up, advocate for themselves, or speak up when something doesn't feel right, is so Golden. Thank you so much. Dr Edison, it was so fun to connect with you. Thank you for being here. Thank you so much for having me. Thank you so much for listening to your child as normal. I'm so grateful you're here and part of this community. If you're enjoying this podcast, it would mean the world if you shared an episode with a friend, subscribed and left a five star review, and don't forget to follow me on Instagram at ask Dr Jessica for more parenting tips and updates. See you next Monday. Thank you so much for listening, and if you enjoyed today's episode, it would mean the world to me if you could do two things, share this episode with a friend or another parent who might find it helpful, and leave a five star review wherever it is you listen to podcasts, it really helps other parents find the show and join this community. See you next. Monday. Bye.