Did you have a childhood hero? If so, you likely aspired to emulate them and their achievements.  

Nowadays, your kids may see their favorite athlete or influencer using pre-workout supplements, whether on social media or in stores, to enhance their performance in the gym or on the field.

What are pre-workout supplements?

Pre-workout supplements come in various names, flavors, and sizes. Some popular options are creatine and branched-chain amino acids (BCAA). While creatine and the main ingredient in most pre-workout supplements is caffeine, most BCAAs don’t contain caffeine.

These supplements are taken before a workout or athletic match with the goals of increasing endurance, muscle mass, and reducing recovery time. But the question is should middle- or high school-aged kids use these supplements? The answer: Probably not.

What are the risks of pre-workout supplements?

“These can cause increased heart rate or heart burn. You’re also taking a lot of supplements that are going straight to your gut. You can see some nausea, vomiting, diarrhea or constipation. They’re also not well-monitored, the U.S. Food & Drug Administration (FDA) isn’t regulating these very closely,” says Erica Dawkins, a dietetic intern with OSF HealthCare.

Taking it further, kids with heart defects need to steer clear of these supplements.  

“A lot of times we see defects or heart irregularities that somebody isn’t even aware of. They don’t know that until they take something like this and have an adverse event,” Dawkins says. “So, if you already know, avoid these because we don’t want to throw that heart into an abnormal rhythm it might not be able to come back from.”

What are the benefits of pre-workout supplements?

“A lot of them will already have beta-alanine or branched-chain amino acids which help improve recovery time and reduce fatigue,” Dawkins says. “We also see some nitrates used that help improve blood flow to the muscles.”

Most pre-workouts are intended for healthy adults in moderation. Pregnant and nursing women are generally advised to avoid them due to the high caffeine content.

Alternatives for improving athletic performance in kids

“Focus first on making sure you’re having quality workouts, then introduce healthy nutrition,” Dawkins says. “We want to make sure we’re getting that nutrition throughout the day. Especially if we’re working out multiple times throughout the day. If you’re working out within two to four hours, make sure you’re getting a snack. We see a lot of benefits for pre-workout snacks or snacks during half-time. We also want to make sure we’re staying adequately hydrated.”

Dawkins says leafy and root vegetables like spinach, lettuce and beets are a great, natural option.

“Those have the natural nitrate in it. So, we’re getting the same effects we would from a pre-workout supplement, just in our regular diet,” Dawkins adds.

Having a conversation with your child’s pediatrician or sports medicine physician is extremely important if you are wondering what supplements should or should not be added into their routine.

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Whether you’re a competitive athlete or a casual runner, repetitive use of your legs (especially long distances like a 1600 meter run at a track event) can bring pain, swelling, tenderness or soreness along the shin bone (the tibia). The medical term is medial tibial stress syndrome.

“It’s usually because they’re increasing the frequency or intensity of their workouts,” Delaney says. Changing surfaces can also play a role. Delaney says she’s seen shin splints in football players who run on soft grass transitioning to basketball season and a hard court.

Diagnosis and treatment

Delaney says health care providers might take an X-ray or a CT scan to determine the extent of your injury. From there, the advice is typically to rest and ease back into competition.

“If you’re in a high impact sport, alternate days and do low impact work like pool workouts or getting on a stationary bike,” Delaney suggests.

Icing the leg can also help. A trick, Delaney says, is to freeze some water in a paper cup and tear away some of the cup so you have exposed ice. Then, massage your leg with the ice block.

“It gets a lot deeper into the soft tissue as opposed to just putting a cold pack on the leg,” Delaney says.

Delaney says rushing back into competition could cause the shin splint to progress to a stress fracture, or a tiny crack in the bone. That could mean an extended time on the sideline.

Prevention

Talk to any orthopedic provider, and you’ll be told the right footwear goes a long way to prevent injuries. Delaney agrees. She says to talk to an expert, like an athletic trainer, to find the right shoe for you. Flashy and expensive isn’t always best.

“Foot mechanics play a role,” Delaney adds. “Do you have flat feet? People with no arch support in their feet typically get shin splints. It’s a hard impact as opposed to having an arch to absorb the shock.” If this is the case, you might need a shoe insert (also called an orthotic or insole).

Get on a workout plan to strengthen your midsection and legs, and stretch before and after running. Delaney also says you can try leg compression sleeves. These can help prevent swelling and muscle fatigue and increase blood flow.

Learn more

Read more about how to keep your body in top shape on the OSF HealthCare website.

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‘It shouldn’t be a barrier to play'

In the sports world, victory can be just inches or seconds away.

Think about ‘The Longest Yard’ in Super Bowl 34 between the Tennessee Titans and St. Louis Rams. In the final play of the game, one yard was all that stood between the Titans and the Vince Lombardi Trophy.

Or look at the 2024 Summer Olympics! Noah Lyles earned the United States a gold medal after winning by just five thousandths of a second in the 100-meter final.

Athletes look for game changers to help propel themselves ahead of the competition, and creatine has entered the chat.

Who does creatine work for?

“Creatine, when used appropriately, can improve your max power. It can help with muscle growth in certain individuals, it typically does not have as significant of an impact when you're doing more endurance-based sports," says Karan Rai, MD, a sports medicine physician with OSF HealthCare. "If you're a weekend warrior or CrossFit athlete trying to get a little extra boost, while practicing appropriate hydration and dietary intake, I think creatine has benefits.” 

Dr. Rai adds that in the realm of supplements, creatine has been “decently studied over the years.” He says football players, power lifters and track sprinters could benefit from the supplement. However, if you’re training for an upcoming Ironman or triathlon, it’s really not necessary.

Hydrate, hydrate, hydrate!

It’s no surprise that extreme exercise increases the amount we sweat. With or without creatine, that’s reason enough to up your water intake. But Dr. Rai says with creatine, there’s an added reason to why water is so important.

“Commonly I'll find someone who is new to using a supplement and they'll come see me and talk about muscle cramps or excessive fatigue after their workouts,” Dr. Rai says. Oftentimes it's because of an imbalance in their intake, whether that's food intake or hydration."

If you already cramp constantly or are not as experienced in weight training, Dr. Rai would recommend caution in using creatine. He says to talk to your primary care physician or a sports medicine physician to see if creatine is a beneficial option for you.

Best times to use creatine

Before and/or after your workouts are times Dr. Rai recommends taking creatine. He says like most dietary changes, don’t rush it.

"When someone is using creatine, I recommend they start slowly. Typically, utilizing it before the workout and making sure your workout is power based vs. endurance-based matters," Dr. Rai says. “Just starting off, depending on the serving size, use one to two scoops.”

Careful with the caffeine!

Avoid a ton of caffeine consumption if you're using creatine. Caffeine can elevate the heart rate and creatine can cause cramping, so combining those things could lead to "adverse outcomes," Dr. Rai says. 

"Supplements are meant for augmentation," Dr. Rai adds. “A healthy diet, hydrating appropriately while cultivating your goals, whether you're a power or endurance athlete, gives the max benefit. Really we should be looking at creatine or sports drinks as a way to augment and get that extra 5-10% we are pushing for, based off our goals.”

If you’re looking to add creatine to your lifestyle, Dr. Rai recommends creating an individualized plan with your doctor or sports medicine team.

Due to limited data, the American Academy of Pediatrics does not recommend creatine for kids under 18.

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Con la vuelta a la escuela, los consultorios médicos se llenan de niños que necesitan chequeos, vacunas y, en algunos casos, chequeos cardíacos.  

Esto se da especialmente en el caso de los deportistas, según el Dr. Frank Han, pediatra cardiólogo de OSF HealthCare.  

"Cada vez que los estudiantes regresan a la escuela, es necesario realizar chequeos cardíacos para ayudar a detectar problemas cardíacos en los niños", afirma el Dr. Han.   

Los Institutos Nacionales de la Salud (NIH) efectuaron una evaluación de 10 años sobre la muerte súbita durante actividades deportivas.  El objetivo era caracterizar los datos demográficos y las causas de la muerte súbita cardíaca durante la práctica deportiva en Australia.  Se realizaron casi 20 000 autopsias entre 2006 y 2015.  La mayoría de las muertes fueron de adultos.  

Los resultados mostraron que la reducida cifra de niños que murieron por afecciones cardíacas eran arritmogénicos o presuntamente arritmogénicos, es decir, que producían o eran propensos a producir arritmia cardíaca.  O bien los niños padecían cardiomiopatías hereditarias, una enfermedad adquirida o hereditaria del músculo cardíaco.  

Por eso, el Dr. Han recomienda a los padres que hablen con los pediatras de sus hijos para asegurarse de que están al tanto de si sus hijos padecen alguna cardiopatía.  Si el pediatra intuye que el niño quizá tenga un problema, le recomendará que lo examine un cardiólogo para una evaluación más exhaustiva.  

"La evaluación general para empezar es un electrocardiograma en el consultorio de atención primaria.  Después de eso, junto con una revisión de los antecedentes familiares, se puede recomendar un ecocardiograma o una prueba de esfuerzo para determinar si hay algún problema en las válvulas cardíacas o si el músculo cardíaco es demasiado grueso", explica el Dr. Han.  "Uno de los principales fines de la prueba de esfuerzo es intentar simular el ejercicio más intenso que podría hacer esa persona.  Posteriormente, reuniremos toda la información en nuestra visita para averiguar si hay algún problema."   

Aunque puede ser difícil, sobre todo para los niños más pequeños, conocer los signos de una afección cardíaca, es importante prestar atención si creen que algo no es normal.   

"Pueden decir cosas como que les 'pita el pecho' o que les 'late con fuerza el pecho'. En el caso de los niños mayores, pueden dar descripciones muy variadas; por ejemplo, que les cuesta hacer ejercicio. Esto puede manifestarse como dolor de pecho, dificultad para respirar o fuertes palpitaciones, sobre todo al hacer ejercicio", explica el Dr. Han.  

El Dr. Han señala que no todas las cardiopatías se detectan cuando la persona es joven.   

"Algunas cardiopatías congénitas no se manifiestan de niño, como las cardiopatías genéticas, que pueden aparecer a una edad más avanzada", afirma.  "El electrocardiograma y la ecografía del corazón están diseñados para detectarlas si aparecen a una edad más avanzada".  

El Dr. Han agrega que es muy importante conocer los antecedentes médicos de la familia.  Si en su familia hay antecedentes de afecciones cardíacas, él recomienda hablar con su médico de cabecera y, en caso necesario, someterse a un chequeo cardiológico. 

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There’s good news for both “weekend warriors” and “marathon maniacs” who prioritize running.

Researchers from Northwestern University surveyed more than 3,800 Chicago Marathon runners about how many years they’d been running, their pace, and if they had any family history of arthritis. The results, which were presented at the American Academy of Orthopaedic Surgeons (AAOS) annual meeting, showed no connection between their running habits and an increased risk of knee or hip arthritis.

Karan Rai, MD, an OSF HealthCare physician who specializes in sports medicine, says the benefits of running far outweigh the risks.

“The common myth or misnomer out there is that running can cause arthritis or that it’s a big risk factor for arthritis,” says Dr. Rai. “What we’ve found over time is that it helps the joints. There’s a little bit of that ‘use it or lost it’ where the little bit of stress that running can do, when performed safely, can actually help the joint health.”

Dr. Rai works on running plans with patients who have arthritis. He says if you love running, you can still personalize your plan to make it work for you.

“For people who already have arthritis, you may want to modify how you run. Choose surfaces that are more even, maybe go for shorter periods of time,” Dr. Rai says. “Usually, when I’m having that discussion with my patients regarding running and arthritis, I first get a basic understanding of what their physical activity level is before suggesting how to introduce running into their exercise regimens.”

If you’re looking to get into running, Dr. Rai says running on an indoor surface is a good place to start.

“Outdoor running can be a little more problematic for people with arthritis. Another thing I discuss with my patients is your mileage. Studies have shown as we get up to more than 15-20 miles a week, your risk for injury rises significantly,” explains Dr. Rai. “Impact matters. Footwear helps cushion that impact. If you’re a regular runner I strongly recommend switching your shoes out every six months or so. Or every 300-500 miles.”

But if arthritis becomes more severe, Dr. Rai says running won’t be recommended.

“If someone is exhibiting signs of moderate to severe arthritis, it can hasten the progression of arthritis,” Dr. Rai says. “But that needs to be individualized. Because I always prioritize, from the medical side, a person’s goals and desires when it comes to activities and hobbies like running. Because there is a great mental health benefit to that, too.”

Dr. Rai recommends new runners start slow, listen to your body and focus on how you feel while you run. He adds that some muscle soreness is normal, but if you have persistent pain multiple days after running, you may be running in a way that is detrimental to yourself.

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