Sports Medicine

Contact our Sports Medicine Team

Sports Medicine

The Punahou Sports Medicine Team provides first aid and health care to all Punahou students, specifically those participating in interscholastic athletics. Our team will also assist with emergency care and treatment of non-athletes who sustain an injury at school. Our goal is to provide the best medical coverage for our athletes and students while maintaining a safe and healthy environment.

List of 3 items.

  • Services

    We offer our services via telehealth or in person. To make an appointment, please visit our scheduler.
    Emergency Care
    • Activate our Emergency Action Plan
    • Provide immediate care and treatment
    • Monitor the athlete or student
    First Aid
    • Assist with minor injuries and illnesses
    • Direct the athlete to an appropriate health care provider for their injury or illness
    • Provide in house appointments with a physician
    Injury Prevention
    • Monitor injury trends via collection and analysis of Punahou athletic injury data and recommend appropriate changes in team training to reduce injury risk
    • Select, apply and modify prophylactic and protective equipment and other custom devices for patients/clients to minimize the risk of injury or re-injury.
    Injury Evaluation
    • Evaluate minor or major injuries sustained in practice or competition
    • Identify and diagnose an injury or illness by examining symptoms and orthopedic findings
    • Design and implement therapeutic exercise program
    • Utilize therapeutic modalities in treatment plan
    • Choose the best possible treatment specific to the injury and athlete
    • Provide treatment options depending on the severeness and stage of the injury
    Practice and Competition Coverage
    • Oversee practices and competitions
    • Provide accessible medical coverage at all times
  • Standard of Care

    The health and welfare of student athletes is Punahou’s first concern. The Punahou Sports Medicine Team adheres to the NATA Code of Ethics and the Athletic Training Educational Competencies as established by the NATA.
  • Objectives

    The Sports Medicine Team are committed to:

    • Providing health care in a safe and healthy environment
    • Enabling injured athletes to return safely to competition
    • Reducing the risk of athletic injury for our student-athletes
    • Educating student-athletes about athletic injuries so they are empowered to lead healthier, injury-free lives
    • Coordinating with the strength and conditioning program, the coaches, the athletic support staff, school administration, physicians, and other healthcare providers to provide the best possible healing environment for our student athletes
    • Providing efficient and timely care of athletic injuries that are incurred by Punahou athletes during their season
    • Facilitating a safe return to school and sport for student athletes after a concussion by coordinating care between teachers, school administration, counselors, the health center, parents, coaches, and the student athlete

Knowledge Base

List of 8 items.

  • Concussions

    Punahou School’s Concussion Management Program (CMP) ensures student athletes return to athletic participation safely. CMP aligns Punahou School with the National Athletic Trainers’ Association Position Statement: Management of Sport Concussion, 2014; the Consensus Statement on Concussion in Sport: the 6th International Conference on Concussion in sport held in Amsterdam, October 2022; the National Federation of State High School Association (NFHS) Concussion Guidelines 2009 and New Rules Release March 2010. The National Athletic Trainers’ Association Position Statement and the NFHS Association Concussion Guidelines were developed by physicians, a neuropsychologist and athletic trainers trained in concussion management. The NFHS Association established a new rule in the fall of 2010, “any player who shows signs, symptoms or behaviors associated with a concussion must be removed from the game and shall not return to play until cleared by an appropriate health-care professional.”

    Read the Full Concussion Management Policy
  • Daily Nutrition for Performance and Training

    Optimal nutrition is important for each athlete’s performance. Taking in the proper foods, fluid intake, and supplements will allow an athlete to compete at their full potential. With the  right information, an athlete can start to change their way of living in order to fuel their body for the best output. Proper nutrition not only helps with performance but contributes to endurance, fitness level, mental health, and overall wellness.

    Carbohydrates increase endurance and high intensity training. Intermittent sport athletes should consume more carbs during training and competition. To help with fatigue it is suggested to consume carbohydrates before, during, and after exercise. Athletes should intake about three to twelve grams of carbohydrate per kilogram of body weight.

    To calculate the exact amount of carbohydrates and athletes should consume daily use this formula:
    • Weight (kg) X Carbs (g) = Carb Intake (g)

    Protein helps to build and maintain muscles. It is important that athletes do not consume more protein than the body can use. Depending on the sport, the amount of protein needed can vary. Endurance training should have 1.2-1.4g, strength training can vary between 1.6-2.0g, and weight restricted should stay between 1.8-2.0g.

    To find the daily protein intake use this formula:
    • Weight (kg) X Protein (g) = Daily Protein Intake

    Good sources of fat are great for fueling an athletes’ body for endurance exercises and short bursts of energy. This increases the body's metabolic efficiency which can help an athlete exercise with a lower intensity while maintaining the same speed. Consuming 20-30% of calories that are from fat is recommended for athletes.
  • Ergonomics

    Ergonomics plays a huge role in injury prevention when working  from home. The use of proper body mechanics, technique, posture, and desk set up are all contributed to the practice of safe work practices. There are specific stretches and exercises that will benefit a student-athlete and faculty by preventing injuries from occurring. Two of the most common complaints are neck and back pain. In order to prevent injury or discomfort, you should incorporate regular stretching and strengthening of muscles during breaks. The ergonomics handout below gives tips on how a proper workplace should be set up and information on how to prevent common injuries.
  • Fluid Intake

    Hydration is key for an athlete to reach their peak performance. Body weight is made up of 60% of water. During exercise fluids are lost and the fluids need to be replenished, if not, it can lead to dehydration.

    One way to monitor hydration, an athlete can weigh themselves before and after exercise. For every pound of body weight loss drink approximately three cups of water.

    Another way to monitor hydration is checking urine color. Urine similar to lemonade is a sign of hydration, rather than a dark yellow color indicating dehydration. Do not rely on thirst as an indicator of dehydration. Athletes typically get thirsty after they have already lost enough fluid to make them dehydrated.

    Fluid replacement drinks that contain 6 – 8% of carbohydrates can provide energy and fuel to an athlete during intense training or long workouts. Fluids that contain sodium and electrolytes help absorb and replace sweat loss. An athlete should also consume fluids 15-30 minutes before exercise and every 15 – 20 minutes during competition. Do not drink carbonated or caffeinated drinks or drinks that contain those ingredients as it will cause GI distress and decrease fluid consumption.
  • Heat Related Illness

    Exercising and competing in high temperatures can be dangerous. Heat illness occurs when the body’s core temperature reaches an unsafe level. Sweating is the process our body uses to cool itself, but with high humidity and hot temperatures, athletes' bodies can have trouble maintaining a safe body temperature. This may lead to heat-related illnesses. Athletes who are not acclimated to hotter temperatures, unconditioned, or getting over illnesses are more likely to experience heat-related illnesses. 

    It is important that an athlete takes precaution to lower the incidence of heat-related illness. Precautions include replenishing any fluids and electrolytes that are lost during exercise, maintaining a healthy diet, and monitoring hydration levels. 

    Athletes and coaches should learn the warning signs and symptoms of heat illnesses in order to act quickly and give the appropriate care. Below explains the signs, symptoms, and the proper care for heat related illnesses.

    Heatstroke is the most severe form of heat illness. This illness usually occurs when there is poor ventilation on a hot and humid day. This can lead to shock, brain damage, or death if not treated immediately.  Signs and symptoms:
    • Fever
    • Red skin
    • Small pupils
    • Rapid shallow breathing
    • Weak rapid pulse
    • Decreased sweating
    Proper care:
    • Seek emergency medical care immediately
    • Move the athlete to a shaded or cool area
    • Elevate the legs
    • Remove or loosen clothing
    • Wrap the athlete in a wet cloth
    • Apply cold compress to the neck, armpits, and groin
    • Give the athlete an electrolyte drink or add one teaspoon of salt to a quart of water
    Heat exhaustion is the moderate form of heat illness. Heat exhaustion can lead to heat stroke if there is no immediate action. 

    Signs and Symptoms:
    • Nausea
    • Light-headed
    • Thirst 
    • Irrational Actions
    • Weak, slow pulse 
    • Dilated Pupils
    • Heavy Sweating 
    • Cool and clammy skin
    Proper Care:
    • Rest in a shaded area
    • Loosen or remove clothing 
    • Replenish the loss of electrolytes
    • Pour water over the athlete unless there is signs of being disoriented
    • Wrap a wet cloth around the athlete and position a fan toward him/her
    • Apply a cold compress (neck, armpits, or groin)
    • Continue to check the athlete temperature every few minutes until the body’s temperature is 100° F. Once it reaches 100° F, continue to check every 30 minutes for 3-4 hours to ensure that the temperature is stable.
    Heat cramps are the earliest sign of heat illness. Painful muscle spasms are due to the loss of salt in the body through perspiring.

    Signs and Symptoms:
    • Painful muscle cramps (legs, arms, abdomen, back)
    • Heavy perspiration
    • Weakness 
    • Lightheaded
    Proper Care:
    • Rest in a shaded area
    • Replenish the loss of electrolytes
    • Pour water over the athlete unless there is signs of being disoriented
    • Wrap a wet cloth around the athlete and position a fan toward him/her
    • Apply a cold compress (neck, armpits, or groin)
    • Gently massage the cramped muscles
  • Mental Health Considerations

    Mental Health is an important issue that needs to be addressed on a regular basis. It is normal for an athlete to have their mental health affected. Depression and anxiety are the most common mental health diagnosis. Athletics can both increase and decrease unique stressors. Eating disorders are also a common health issue in sports. An athlete should seek self-help by speaking to their parents, an Athletic Trainer, or school counselor. It is important that Coaches ask athletes how they are doing, talk about mental health issues and normalizing them, provide education materials, and share resources. 

    Please visit SWELL in person or online for any concerns, questions, or support. 

    One helpful tool that can be used to keep track of an athletes mood is by creating a mood chart. This will not only bring awareness to daily mental health, but it will allow an athlete to focus on their mental health on a daily basis. Below lists symptoms of these specific mood disorders. Keep in mind that an athlete does not have to show all symptoms to have a mood disorder.

    Depression symptoms:
    • Decreased interest or pleasure
    • Decreased motivation
    • Feeling heavy or down
    • Fatigue
    • Lack of concentration
    • Decreased sleep
    • Decreased appetite
    • Feelings of worthlessness
    • Thoughts of self-harm
    Anxiety symptoms:
    • Lack of concentration
    • Agitation
    • Irritable
    • Physical distress
    • Decreased sleep
    • Decreased appetite
    • Panic attacks
    • Increased fear
    • Constant worry

    At times, an athlete will partake in a sport that emphasizes a certain weight and size. For example, football values weight as it shows strength and wrestling uses weight classifications to divide competitors. These values can alter an athletes mind and encourage unhealthy behaviors. Revealing uniforms can increase consciousness and body dissatisfaction as well as the focus on lowering body fat for better performance negatively changes the athletes perception of themselves. Weight loss, excessive dieting, and excessive training play a part in eating disorders. Below shows the difference between healthy eating and disordered eating.

    Healthy Eating:
    • Healthy eating habits
    • Appropriate food amount
    • Body acceptance
    • Eating is pleasurable
    • Eats intently
    • Positive body image
    • Does not feel guilt after eating
    • Does not regulate emotions through food
    Disordered Eating:
    • Weight and shape dissatisfaction
    • Excessive exercising
    • Striving for perfection
    • Compulsive overeating or undereating
    • Eats to regulate emotions
    • Restricting
    • Fasting
    • Steroid or laxative use
  • Pre-Event and Post-Event Meals

    Pre-game meals should be eaten 3-4 hours before an event. Carbohydrates should be limited if an athlete eats within one to two hours before the event. Protein is a good source of food to regulate energy levels by slowing down carbohydrate absorption. Events in hot and humid climates should have an electrolyte replacement such as pretzels or sport drinks that contain sodium.

    Depending on the time an athlete eats before the event can determine what kind of meal is recommended. For example, an athlete who eats an hour or less before an event can eat granola bars, bananas, pretzels, or dried mango. A meal two to three hours before an event might be oatmeal, fruit, bagel with peanut butter, or yogurt.

    Four hours before an event is the recommended time to eat a meal. At this time, an athlete could eat grilled chicken with rice and fruit, chicken pasta with vegetables, or turkey sandwich with carrots.

    A post-game snack or meal should include carbohydrates to allow the body to replenish glycogen. This meal should be consumed within four to six hours after the event. Choose higher carbohydrate foods such as fruit and yogurt, pita and hummus, or a banana and peanut butter. Added protein can help with muscle growth and recovery.
  • Sleep Considerations

    Sleep is important to an athletes overall health, recovery, mental health, and performance. It allows the body to repair and restructure DNA, improves memories, regulate weight and metabolism, boost immune function, and decrease blood pressure. It is recommended that an athlete gets 7 to 10 hours of sleep for optimal performance and adequate recovery from training and injury.

    Sleep can be related to the risk of injury and illnesses. A decrease in sleep has shown an increase in poor performance which can lead to injury. The body immune system can be suppressed and make it more likely to be at risk of an upper respiratory infection.

    Endurance athletes are able to run a farther distance when they have a full night‘s sleep compared to when they are sleep deprived. Sprinters have shown improvement with their speed when they get the proper amount of sleep. It only takes one night‘s sleep to affect a time-trial performance. The reaction time, accuracy, and decision making needed in sports can be decreased when an athlete is deprived of sleep. By increasing sleep time by two hours, this will allow the body to fully recover and recharge in order to complete at peak performance.

    Follow these tips to better your sleep routine:
    • Make the room cool and dark
    • Turn off TVs and phones to heighten melatonin levels
    • Workout during the day and avoid any exercise at night
    • Avoid caffeinated drinks
    • Make a sleep schedule allowing 7 – 10 hours of sleep
    • Take a 30 minute nap earlier in the day if recovery is needed from the previous night

Injury Knowledge Base

List of 1 items.

  • Osgood Schlatter’s

    This is typically a sports-related complaint due to repetitive microtrauma resulting in traction to the apophysis at the tibial tuberosity and the distal patella tendon. Osgood Schlatter‘s is more commonly seen in males during their growth spurt from ages 12 – 15 and for girls in their growth spurt from ages 8 – 12.

    • Knee pain
    • Tenderness
    • Swelling at the anterior tibial tubercle
    • Ice the knee for 20 minutes pre and post-activity
    • Add heel cushioning to shoes or change to shoes with more heel padding for the majority of the practices. Save cleated shoes for games.
    • Limit running during practice regardless of shoes worn.
    • Give periodic rest during activity to allow knees to rest.
    • A patella strap, placed between the patella and the tibial tuberosity may give some relief. The strap changes the primary tension and moves it from the tibial tuberosity to the strap sight.
    • Pain will not go away until the athlete can rest the knee for several weeks.
    • Modify cardiovascular activity – bike or swim when possible to reduce repetitive trauma to the knees.
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