“This is a great community event for us and for Fort Worth to support our patients and for our patients to feel empowered,” said Pamela J. Sherman, M.D., Orthopedist at Cook Children's. “A lot of these patients have started with us as babies. Rock climbing really is a way for them to feel empowered and for them to see that it's different but it still works.”

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Does your child look like one of these pictures when they head off to school?

Then this article is for you to improve the future of your child’s spine.

Backpacks are routinely bought because of how pretty they are, what super hero or cartoon character is on them, or how much can they hold. These are all very important to your child, but there are a few more criteria that parents should be looking at:

Top 10 things to know about a backpack to prevent injuries:

1. The American Academy of Pediatrics recommends that a backpack should not weigh more than 10 to 20 percent of the child’s body weight. If the child is complaining of discomfort, always keep it less than 10 percent of their body weight.
2. Put heavier items closer to the child’s body in the backpack, so that it does not pull the backpack away from their spine.
3. Parents should pick up their child’s backpack on a regular basis to feel its weight.
4. Backpacks should be worn with one strap on each shoulder, not hanging off one shoulder.  Use the abdominal strap if one is provided.
5. The backpack’s straps should be fitted snuggly over the child’s shoulders.
6. Make sure the backpack is positioned literally on the back - between the shoulders - and not resting on the child’s lower back or hips.
7. Have the appropriate size backpack. If the straps are tight and the back pack hangs down past the hips, the back pack is too big for this child.  It should rest above the hip line.
8. If your child has pain in their shoulders, neck or back- there are options with back packs with wheels.You might also ask the school to provide one set of books for school and one set for home.  These modifications sometimes require a physician note for the school.
9. If your child has more to carry than is recommended for the backpack, they can carry some items in their hands to balance the weight on the body. Make sure that they are not carrying more than 10 percent of their body weight.
10. If your child is complaining of pain after the backpack is removed and does not go away, seek a physician consult.

Please check out the below links to assist you with keeping your child happy and healthy this upcoming school year!

Dana S. Harrison, PT, MPT, Cook Children’s SPORTS Program/Rehab Manager

Related links:

• Cook Children's Sports Performance Orthopedic Rehab Team Specialists (SPORTS)
• Backpack safety for pre-grammar school
• Backpack safety for elementary school
• Backpack safety for teenagers

About the author

Dana Harrison, PT, MPT is Cook Children’s SPORTS program/Rehab manager. Our physicians, therapists, nurses and technologists work exclusively with kids and understand the unique needs of a growing athlete's bones, muscles, body and mind.

Unfortunately, it’s also a troubling trend among today’s high school athletes.

Cook Children’s pediatrician David H. Goff, M.D., FAAP, calls overstressed, busy children a huge problem – both in the classroom and on the playing field. In his Denton office, Dr. Goff sees patients who suffer from a variety of symptoms like chronic abdominal pain, anxiety and depression.

“I see this over and over. I look in the child’s eyes. They are exhausted. I say to the parents, ‘You need to cut back,’” Dr. Goff said. “And it is amazing to me. They say, ‘We can’t. No way. We have a tournament this weekend.’ For any successes we have, we have 100 more burnouts.”

The American Academy of Pediatrics agrees with Dr. Goff. A group of eight organizations, including the AAP, released a consensus statement regarding their concern with today’s high school athlete.

The AAP states, “Student athletes report higher rates of sleep disturbances, loss of appetite, mood disturbances, short tempers and inability to concentrate than non-athletes.”

The recommendations focused on the importance of educating students, parents and coaches on mental disorders in student-athletes; the stress involved with today’s athletes and ways to monitor their behavior.

Concerns of the AAP included the injuries and stress related to student athletes training year round, which doesn’t give them time to rest and recover.

The AAP said these athletes also face stress from poor performance on the playing field, injuries, concerns about getting cut from the team and trouble keeping up with school work, along with their extracurricular activities.

Because of the stress involved, student-athletes may suffer from “a pattern of lack of sleep and under-recovery” and chronic fatigue that puts him or her at risk for anxiety and depression. Other issues include:

• Physical (Physical conditioning, injuries, environmental conditions)
• Mental (Game strategy, meeting coaches’ expectations, attention from media and fellow students, time spent in sport, community-service requirements, and less personal and family time)
• Academic (classes, study time, projects, papers, examinations, attaining and maintaining the required grade point average to remain on the team, and earning and maintaining a collegiate or academic scholarship).

David Gray, M.D., medical director of Cook Children’s Orthopedics and SPORTS, agrees with Dr. Goff that too much activity can simply be harmful to a young person.

With the advent of select sports and recreational leagues, Dr. Gray said children now play the same sport year round without getting a break from those activities. He wants young athletes to have variation in their activities. If not, the repetitive nature of the same sport creates stress and strain especially on growing bones.

Dr. Gray and his colleagues see children who never have a break during the year sometimes playing on two or three different teams during the same season. He said it’s too much stress on their growing skeleton, causing muscle aches, strains and pain.

Both Dr. Gray and Dr. Goff stress children, especially before they reach high school, should focus on participating in several different sports to prevent using the same muscles year round. They say it also helps the child avoid getting burned out on that specific sport.

“For kids, sports are great and you learn a lot from them, but they should be fun,” Dr. Gray said. “Kids need to enjoy them too. You don’t really want a 12 or 13 year old performing to the point where they are having injuries that could actually impact them as an adult.”

Dr. Goff admits this subject quickly places him on his soapbox. But it’s because he sees so many of his patients facing stress and are simply not happy.

He sees them come in with dark circles under their eyes and behind closed doors and just one-on-one with him, they admit to a different story than what they have been telling to their parents.

Far too often, Dr. Goff hears the regrets of parents, but only when it’s too late. The child has gone off to college and the parent wishes they had taken a trip to the Grand Canyon with their family, instead of racing off to another game.

“I ask the parents to leave the room so I can talk to the child,” Dr. Goff said. “I ask, ‘Do you really want to do this?” They say, ‘No I’m tired.”

The scary part of this story is that far too often the parents are trying to do what’s best for their child, but in reality they are doing harm.

Dr. Gray said he is beginning to see injuries in children as young as 8 years old with ACL injuries. Injuries that were once thought not to happen until children were much older.

“Another problem is that the really good, young kids are getting left behind,” Dr. Gray said. “They are burned out because they are pegged to be the superstar and they get over worked, over trained and over pushed. Some get burned out and pushed to the wayside and other kids, who were not as big, catch up by the time they are in middle school. They have more passion and they are not burned out. And they pass them by.”

Both Dr. Gray and Dr. Goff also see phantom injuries – muscle aches or headaches. Anatomically there seems to be nothing wrong with the child. In reality it’s the child hinting he or she needs a break.

So what should a parent do? Here’s a start:

• During the year give the child down time and a chance to recuperate. This is the case physically for sports and mentally for school.

• Vary the child’s routine to avoid burnout

• Give your children an opportunity to tell you if they are enjoying themselves.

“It’s easy to succumb to parental peer pressure,” Dr. Gray said. “Parents are afraid if they don’t do something their child will be left behind. What’s most important is that your children enjoy sports, or enjoy their activities and has a good mental outlook on life. It’s hard for parents to not live vicariously through their children. It’s a hard lesson for parents. You want the best for your child and want your child to be successful. But sometimes less is more.”

Why is it important for my child to be treated for a finger injury?

Just because your child’s finger may not look like it is broken, it is still important to have it looked at by a professional. The bones of the hand are quite small, and fragile. But, the bones aren’t the only thing in the hand that can be injured. There are also several ligaments and tendons in the hand that are at risk for injury. A ligament connects bones to other bones and their job is to support the bones and joints, and in some cases, prevent certain movements. If a ligament is injured and not allowed to heal, it can cause the bones to be unstable which can lead to further injury.

When should I get help for my child that has injured their hand or finger?

• If your child’s finger looks like it is out of place.
• If there is any bruising, swelling, or pain that lasts more than a couple of days.
• If your child is unable to bend or straighten the finger.
• If your child is favoring that hand or finger and doesn’t want to use it in everyday activities.

If your child injures their finger and it looks to be out of place, you should seek immediate attention from a medical professional. Do not try to put the finger back into place on your own. You could cause further damage.

Oosthuizen said he was closing the bathroom door Tuesday morning at the place his family is staying for this week's Crowne Plaza Invitational at Colonial. Sophia was on the other side.

"Her finger was on the side of the hinges," Oosthuizen said. "It nearly cut off the finger completely."

Oosthuizen rushed his daughter to the emergency room at Cook Children's, which is located in Fort Worth and is the primary charity for the Crowne Plaza Invitational.

At the hospital, they met with Dr. Pamela Sherman, an orthopedic surgeon and hand specialist. She explained that it was important to repair the nail bed on Sophia's finger and give the new nail a chance to grow in order to save the finger. Dr. Sherman then performed the surgery.

"It was a scary moment," Oosthuizen said. "It was Sophia's first time under anesthesia. You never know what's going to happen.

"Dr. Sherman was great. ... She told us it's important to have the proper people doing it, and they have some of the best there."

Sophia will go to Cook Children's on Sunday for a check-up before the Oosthuizens return home.

Louis Oosthuizen is grateful for the attention his daughter received at Cook Children's.

"If I'm in doubt ever to have any surgery or something for my kids, I'll fly in to see them," Oosthuizen said. "The way they handled it, the way they spoke to us and treated the kids -- it was amazing to us.

"I didn't even know there were hospitals like that."