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Participating in sports and physical activities is enjoyable and beneficial for our health. However, the risk of injuries comes with the fun and excitement of sports. Sports-related injuries, including sprains, traumatic brain injuries and broken bones, are more common than we realize and can land you in the emergency room. Dr. Scott Shepherd, Emergency Medicine Physician, provides a wealth of information. Traumatic Brain Injuries: The Invisible Threat Traumatic brain injuries come in many forms. From “mild” brain injuries, concussions, to major brain injuries and bleeds. Sometimes it is very difficult to tell the difference between a major injury and a minor injury because many of the symptoms are the same. Concussions Concussions are a type of “mild” traumatic brain injury resulting from a blow to the head or a violent shaking of the body that causes a transient alteration in mental function. They are particularly prevalent in contact sports such as football, soccer and boxing. A concussion can affect memory, judgment, reflexes, speech, balance and muscle coordination. Typically, concussions are not life threatening and usually short lived. However, multiple concussions can lead to permanent disabilities. So, remember there is nothing “mild” about injuring your brain. Contusions The more serious brain injuries from brain contusions (actual bleeding in the brain material) and bleeding that presses on the brain are life threatening. These injuries are caused by the same blow to the head as a concussion and the symptoms are the same from memory deficits, loss of coordination to coma. Because of this, anyone who has a blow to the head and is not acting normal should be evaluated by a medical professional. Anyone suspected of having a severe head injury should seek immediate medical attention and follow a strict protocol for rest and a gradual return to play. It is important to note a person may not lose consciousness if they suffer a concussion; however, major consequences can occur if not properly managed. If you suspect you have an emergency that needs immediate medical attention, please call 911 or visit an emergency room near you. While it is impossible to prevent traumatic brain injuries altogether, the severity of the injury can be mitigated through proper helmet usage and knowing your skill level when participating in high-risk activities. The guidelines for picking a helmet for summer activities such as mountain biking, dirt biking and riding off highway vehicles are similar to those of picking a helmet for winter sports. Learn more about choosing the right helmet. Any blow to your head, neck or upper body can result in a major head injury Signs to watch for include the following: Headache Dizziness Blurred vision Difficulty with thinking, attention or memory Sensitivity to noise or light Ringing in the ears Changes in hearing Double vision Changes in behavior Balance issues Nausea/vomiting   Sprains: The Annoying Twist One of the most common sports injuries is a sprain, which occurs when ligaments that connect bones are stretched or torn. Sprains typically occur in joints, such as the ankle, knee or wrist, and are often caused by sudden twists or impacts. Symptoms may include: Pain Swelling Bruising Limited range of motion Rest, ice, compression and elevation (RICE) are the initial recommended treatment, followed by physical therapy to regain strength and mobility.

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As an avid soccer player, Sarah saw her fair share of doctors growing up. However, it wasn’t until she was diagnosed with celiac disease, an autoimmune disease affecting how the body ingests gluten, that she became passionate about healthcare. “I couldn’t figure out what was going on,” Sarah said. “I was getting sick, and my symptoms were getting worse.” Thankfully, after seeing a handful of doctors, she was on the path to recovery.  “I remember being so relieved, and still am! Now I can focus on getting better,” said Sarah. The most important change people make after being diagnosed with celiac disease is the shift to a gluten-free diet. For many, Sarah included, living gluten-free is a lifestyle change. Thankfully, Sarah sees significant improvements in her health after adjusting her diet. “No one should just accept their symptoms as part of life,” said Sarah. Her increased awareness of health and nutrition motivated Sarah to study biology at the University of Nevada, Reno (UNR). “I want to be a pediatrician so I can help patients, especially kids, figure out treatment plans.” said Sarah who credits her experience living with celiac disease as her inspiration. Dancing for Kids’ Health Currently a senior at UNR, Sarah is a member of Phi Delta Epsilon, a co-ed international medical fraternity. Together with her classmates, she is bringing new energy and ideas to philanthropy. Sarah and the members of Phi Delta Epsilon are doing things differently and in many ways redefining what it means to give. This year, they are on a mission to raise funds for kids’ health at Renown Children’s Hospital. And they are doing this by dancing. The UNR Dance Marathon is part of the Miracle Network Dance Marathon, a student-led, year-round philanthropic movement that unites students across the United States and Canada. Collectively, they raise critical funds for Children's Miracle Network Hospitals. And Renown Children’s Hospital is our northern Nevada CMN partner hospital. Since 1991, over 400 college campuses and thousands of students have raised $300 million for kids. Sarah is the executive director of UNR’s chapter. “So far this year we’ve already raised $10,000 for Renown," said Sarah. Most of the fundraising happens on the day of the dance marathon. But throughout the school year, students hold mini fundraisers on campus and in the community. One hundred percent of the funds raised stay local, impacting Renown’s youngest patients. For every dollar donated, 18% helps provide charitable care, 15% goes to life-saving equipment, 12% supports medical research and 55% provides education, patient services and advancement services. “It's inspiring that we banded together to help kids in our community,” said Sarah. Last year they raised over $18,000. They are hoping to exceed that number at this year’s dance marathon in April.

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Renown Health Foundation and local community members raised over $1,000,000 at a charity concert with The Beach Boys and special guest NFL legend Steve Young, on Sunday, June 5, at Montreux Golf and Country Club. The event benefits the construction of Sophie’s Place, a new dedicated music therapy room coming to Renown Children’s Hospital. Over 500 donors attended the inaugural event hosted by radio personality Wink Martindale. The Beach Boys front man Mike Love, a Nevada resident, generously auctioned off two once-in-a-lifetime, private concerts bringing in $300,000. Steve Young auctioned off a Monday Night Football package and ZLINE Kitchen and Bath auctioned off a kitchen remodel. The proceeds raised will be transformative for Sophie’s Place and will impact children in our community for years to come. “I’m thankful to Renown and other children’s hospitals that are dedicating space, precious space, for Sophie’s Place,” says Steve Young, founder of Forever Young Foundation and co-founder of Sophie’s Place. View photos from the event here.   What is Sophie’s Place? Sophie’s Place is a dedicated music therapy room in children’s hospitals across the country. Founded by the Forever Young Foundation and former San Francisco 49'ers quarterback, Steve Young, they provide a comprehensive music and healing arts program. Established in loving memory of musician Sophie Barton, the first Sophie’s Place opened in 2013 at Primary Children’s Hospital in Salt Lake City, Utah. Additional locations include Sutter Children’s Center in Sacramento, CA., Cardon Children’s Medical Center in Mesa, AZ., Lucille Packard Children’s Hospital in Palo Alto, CA., and Brenner Children's Hospital in Winston-Salem, NC. Renown Children’s Hospital will be the next location to break ground and will provide our youngest patients with a state-of-the-art music room. It will be the first of its kind in our community. “Sophie’s Place is a wonderful addition to what a hospital has to offer,” says Dr. Max Coppes, Pediatrics Chair, UNRSOM. Where will Sophie’s Place be Located? Sophie’s Place at Renown Children’s Hospital will be located on the ground floor of the Sierra Tower, next to The John & Sue Dermody Children’s Healing Garden. The family-centered space is designed for children to enjoy the healing aspects of music and encourage creativity and expression during their stay. “We really wanted kids to feel like they’re not in the hospital. It’s a place where they can escape,” says Barb Young, Founder of Forever Young Foundation and Co-founder of Sophie’s Place. The room includes a performance space, recording studio, musical instruments, editing software and an art and play area. “When you walk into a Sophie’s Place, you really feel like you’ve left the hospital and walked into a cool coffee shop,” says Sterling Tanner, President, Executive Director, Forever Young Foundation. How You Can Help Make a Difference Renown Health is focused on being the destination for all your family’s health and healthcare needs. As a not-for-profit health system, Renown relies heavily on community funding. If you are interested in supporting Sophie’s Place at Renown Children’s Hospital, please consider giving to Renown Health Foundation. Make a gift at renown.org/give Call Renown Health Foundation at 775-982-5545 Mail a check to Renown Health Foundation, 1155 Mill St., 02, Reno, NV 89502

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Posture is important, but for those children diagnosed with scoliosis (spinal curvature) it can be a difficult issue. The Washoe County School District Student Health Services Department screens 7th grade students for scoliosis as growth spurts often reveal the condition and, if diagnosed early, scoliosis can stop progressing. We asked Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis to answer some frequently asked questions about scoliosis. What is scoliosis? There are many types of scoliosis: early onset (occurs before age 10), congenital scoliosis is when the bones of the spine do not form correctly, neuromuscular scoliosis which is due to children’s neurologic and muscle disease, and the most common is Adolescent Idiopathic Scoliosis. The term “idiopathic “ means the exact cause is unknown, although we do know it runs in families. This type of scoliosis occurs in 2-3 percent of adolescents and is mainly seen during their growth spurt. This is why middle school screenings are recommended. Both genders get scoliosis but girls are 8 times more likely to have their curves progress and become larger. What are the signs that my child may have scoliosis? A few signs for parents to watch for are: One shoulder might be higher than the other. One leg may seem longer. A hip may be higher or look more prominent. The waist may not look the same from side to side (asymmetry). The trunk or rib cage may be more prominent on one side or shifted. When they bend forward they may have a bump on their back. How is scoliosis diagnosed? It can be noticed by a pediatrician at a physical, school screening nurse, PE teacher or parents. Once the curve is suspected the child is usually referred to a pediatric orthopedic surgeon scoliosis expertise. At the initial visit the doctor will perform a thorough physical including a complete neurologic exam to assess the amount of curvature. Once the exam is completed the physician will determine if a spinal x-ray is needed. The curve on the x-ray is measured utilizing the cobb angle (a measurement in degrees) which helps guide the treatment. What are common treatments for scoliosis? The treatment depends on the size of the spinal curve and the amount of growth the child has remaining. An x-ray of the child’s hand is used to determine the amount of growth remaining. This allows the determination of the child’s bone age, and based on the hands growth plates it can determined if the child is in their rapid phase of growth. Treatments include: Observation - For curves less than 20-25 degrees. This entails visits every 6-9 months with a repeat scoliosis x-ray. Since scoliosis curves increase only 1-2 degrees per month, and variations in measurements can be 3-5 degrees, an x-ray is not recommended before 6 months. If the curve remains less than 25 degrees the child is followed until their growth is completed (usually age 16-18). Progressing Curve - If growth is finished and the curve is less than 40 degrees, the risk of more curvature into adulthood is small. If growth is completed and the curve is over 45 degrees, the child is followed for several years as these curves can progress into adulthood. If the patient is still growing and the curve has progressed greater than 25 degrees but still in the non-operative range (less than 45-50 degrees) bracing is used to stop the progression of the curve. Bracing - Indicated for curves over 25 degrees but less than 45 degrees. If a brace is required you will be referred to an orthotist (bracing specialist). The orthotist assesses your child, reviews the x-ray and then fits the brace. (Having a brace made usually takes 2-3 weeks.) Once the brace is fit, your child will visit the scoliosis specialist for an x-ray in the brace to ensure it fits correctly. The primary goal of bracing is to halt progression of the curve and prevent the need for surgery. The brace must be worn for about 16 hours per day to be effective. In a recent bracing study 72% of the patients who wore their braces as prescribed prevented the need for surgery compared to the group who did not wear their brace. Surgery: When a curve reaches 45-50 degrees, and a child is still growing, surgery is usually recommended because the curve is likely to continue progress. If a curve is over 50 degrees and the child is done growing surgery also may be recommended. This is because when curves are over 50 degrees they tend to increase 1-2 degrees per year for the rest of your life. As curves get larger the amount of lung function tends to decrease which could cause breathing problems later in life. The goals of surgery are to stop the progression of the curve and safely correct any misalignment. This is accomplished by attaching implants (rods, screws, hooks and bands) to the spine. Bone graft is then placed around the implants to encourage the spine to fuse (grow together). This then forms a solid column of bone with metal rods in place, preventing the curve from changing. Most patients are back to their regular sports and activities six months post surgery.

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