Skip Navigation
MUSC mobile menu

MUSC Health Blog


Guest Post by:
Lindsey Clarke, MS, ATC, CMT
Athletic Trainer;  Massage Therapist Charleston Battery
MUSC Sports Medicine


You’ve been to camp. Family vacation was great.  The summer has flown by, and the beginning of the school year is looming.  While it’s the time to relax and have fun, summer is also the perfect time for athletes to start getting their bodies ready for their upcoming fall sports. By maintaining and following good nutrition and hydration practices in the off-season, leading up to and throughout pre-season, you’ll be able to work out, train and compete at your best.

While off-season is the time to address any changes you’d like to make as far as body weight or composition, your main focus during pre-season should include making sure you are consuming adequate calories, staying properly hydrated to match sweat loss, as well as recovery nutrition.  While it may seem at times all you’re doing is going to practice, eating constantly, and running to the bathroom, adolescents/younger athletes need to account for the fact they are not only playing a sport, but growing and developing as well…both of which require a large amount of energy. According to the National Academy of Sciences’ Food and Nutrition Board of the Institute of Medicine, Estimated Energy Requirements (EER) for very active 14-18 year old athletes range between 3283 calories to 3804 calories per day.  Leaner athletes, or those who tend to burn more calories or those who need to gain weight, may require an additional 500-1000 calories.  Consuming that many calories can be a challenge for athletes, but being mindful of your hydration practice, as well as consumption of healthy foods and adequate calories will ensure your success in meeting these demands.

A common mistake made by athletes is over-consuming protein. Protein is most definitely important for building muscle and repair, but excess intake can be detrimental to your diet.  Hyper-focusing on protein consumption can negatively affect the balance of carbohydrates, protein, and dietary fat.  Athletes’ energy(glucose) stores can be greatly affected when protein displaces needed carbohydrates.  Excessive protein can also lead you to consume fewer fruits, vegetables, and whole grains that have necessary nutrients for performance.  These nutrients aid in processing the energy needed for physical activity.  Gaining your energy and nutrient requirements from whole foods is best, as it is more bio-available.  Unless you are dealing with an allergy, intolerance or deficiency, more often than not you should be able to gain all your nutrition through a well balanced diet including lean/vegetable protein, carbohydrates, and healthy fats with limited, if any, supplements.

Hydration plays a very large role in your performance.  Pre-season typically demands multiple practices a day, often outside in the elements(heat, humidity, etc).  Even the smallest amount of dehydration can negatively affect performance.  Athletes should consume at least 64-80 ounces of fluid a day-more so if you sweat heavily, wear padding (as in football), or it is hot/humid. Maintaining a balanced state of hydration throughout the day is important, as it prevents entering a practice or training session in a dehydrated state.  It is near impossible to properly rehydrate during activity.  About two hours before exercise, start consuming about 20 ounces of fluid. About 30 minutes before, drink another 8 ounces and then drink 4-8 ounces every 15-20 minutes during activity. Any water weight lost during exercise should be recovered by 20-24 ounces of fluid for each pound of water weight lost. The goal with proper hydration, however, is to lose minimal water weight during exercise.  This helps ensure an adequate level of hydration for future practices or training sessions.

Adequate fuel before, during, and after training during pre-season, is paramount in maintaining the weight and muscle gains achieved in the off-season.  Without proper hydration and nutrition, recovery from hard pre-season training will be insufficient causing the body to be weak heading into the regular season.  This can then lead to decreased performance and injury. Preparation starts before you even step foot on the court or field.  Commit to become more involved in your dietary practices.  Getting enough calories with the right balance of nutrients is key for the maintenance of a healthy, and well-primed body during your season.

Guest Post by:

Stephanie Davey, ATC
Certified Athletic Trainer
MUSC Sports Medicine

It’s that time of year again……High School Football season!  July 31st marks the first day of high school football pre season training in South Carolina.  Hopefully, our student athletes have had a fun and safe summer, but now that the summer is over we find out how prepared they are for the upcoming season.Football players on field

All high school football programs have a different policy for summer training.  Some make it mandatory to participate in a strength and conditioning program run by the coaches.  Some trust their student athletes to train on their own.  When the football players report to the first day of practice, some will be in the best shape of their lives, some will not.  It’s likely to be very hot and very humid.  In order to protect the athletes, coaching and sports medicine staffs have to account for the varying levels of fitness and prepare for the worst.  One way to do that is by setting a practice schedule that allows all players to acclimatize to the heat.

Allowing athletes to acclimatize to the heat, prepares their bodies to physical exertion in high heat and humidity.  This helps protect them from the varying stages of  heat illness.  Acclimatizing is a gradual increase of time and exertion in the heat.  Practices start with the football players wearing helmets, shirts, and shorts only.  Gradually, they add equipment until they are in full pads.  They also increase the time spent in the heat gradually.

Currently, there are only a handful of states that have mandates requiring heat acclimatization.    Some states do have guidelines and some states high school governing bodies have rules.  In South Carolina, teams follow a 14 practice schedule.  On practice day 1, they are limited to 3 hours in helmets, shirts, and shorts.  They gradually increase to full gear on day 14.

While we all want our student athletes to be able to relax and have fun over the summer, reporting to fall practice out of shape can be dangerous.  Not only does proper fitness increase their performance, but it also decreases an athlete’s chances of suffering a heat illness episode.  So encourage all your student athletes to have fun and stay in shape over the summer!

Water Safety

Did you know drownings are the leading cause of injury death for young children ages 1 to 4? Three children die every day as a result of drowning. To keep children safe:

  • Always supervise children when in or around water. A responsible adult should constantly watch young children.
  • Teach kids to swim. Formal swimming lessons can protect young children from drowning.
  • Learn cardiopulmonary resuscitation (CPR). Your CPR skills could save someone’s life.
  • Install a four-sided fence around home pools.

The Charleston area offers many opportunities to get out on the water and recreational boating can be a wonderful way to spend time with family and friends. Make boating safety a priority when taking children out on the water.

  • Wear a properly fitted life jacket every time you and your loved ones are on the water.

Heat and Sun Safety

While many of us love the long hot summers here, they can be hazardous to children's health. Heat-related illness happens when the body’s temperature control system is overloaded. Infants and children up to 4 years of age are at greatest risk. Even young and healthy people can get sick from the heat if they participate in strenuous physical activities during hot weather. For heat-related illness, the best defense is prevention.

  • Never leave infants, children, or pets in a parked car, even if the windows are cracked open.
  • Dress infants and children in loose, lightweight, light-colored clothing.
  • Schedule outdoor activities carefully, for morning and evening hours.
  • Stay cool with cool showers or baths.
  • Seek medical care immediate if your child has symptoms of heat-related illness.

Just a few serious sunburns can increase you and your child's risk of skin cancer later in life. Their skin needs protection from the sun's harmful ultraviolet (UV) rays whenever they're outdoors.

  • Cover up. Clothing that covers your and your child's skin helps protect against UV rays.
  • Use sunscreen with at least SPF (sun protection factor) 15 and UVA (ultraviolet A) and UVB (ultraviolet B) protection every time you and your child go outside.

Enjoy our great outdoors but follow these tips to keep you and the family safe this summer!

For more information and tips visit

Guest Post by:

Shane K. Woolf, M.D.
Chief, Sports Medicine Service
Medical University of South Carolina

Summer has arrived and folks of all ages are spending time outdoors pursuing their favorite active pastimes.  Tennis and golf are two of the more popular activities with about 12 and 30 million participants each year, respectively, in the United States.1  As our population ages, many participants fall (reluctantly) into the category of ‘mature’ recreational athlete. For these folks, staying healthy and avoiding injury is paramount to enjoyment of their favorite sport. The positive health benefits of athletic activity are quickly lost when injury occurs. Fortunately, some simple preparation and training tips can help to reduce your risk of injury in either sport!tennis player

Stay Flexible

Keeping a regular flexibility routine either through yoga or simple ‘sitting-on-the-floor-in-the-living-room’ stretches can help keep your joints, tendons and muscles ready for action in both tennis and golf. The shoulders and upper limbs as well as the trunk/back are under significant stress during the swing of a club or racquet.  Torque exerted during rotation of the torso or shoulder in order to make contact with the ball, can be among the highest stresses the human body might experience. It is a little like wringing out, or even whipping, a damp towel, if you think about it. Limber ligaments, tendons and muscles are more forgiving, allowing the necessary rotation to achieve motion and also to tolerate these stresses without resulting in a strained muscle or sprained ligament.

Maintain CORE strength

So what exactly is the ‘core’ that I keep hearing about, you ask? Think of it as the central framework and support structure for your whole body. The core is centered about your spine, abdominal musculature and pelvis. It is important for correct posture, balance, coordination, and is the key to many athletic moves. Consider a core routine as your Central Orthopedic Rehabilitative Exercise program. This would include abdominal strengthening, lumbar spine strengthening, hip strengthening, and balance training. Yoga and Pilates can be useful to achieve this. The web is also a fine resource for DIY core stability exercises such as planks, bird-dog/airplane, side-bridges, exercise ball activities and balance exercises. A fitness instructor at your local gym or wellness center can also help get you started in the right direction.

Keep the Arms and Shoulders Strong

Repetitive power gripping and the swing of a club or racquet can cause microtrauma to the rotator cuff tendons, biceps, and the extensors or flexors of the forearm (ie tennis elbow – lateral epicondylitis, and golfers elbow – medial epicondylitis). The backhand tennis swing coupled with wrist weakness has been linked to development of elbow pain. The soft tissues in older athletes are more likely to be degenerative and also more likely to be damaged with both repetitive use as well as improper mechanics. Similarly, the medial, or inside edge, of the elbow is under stress when forearm flexors are engaged during a golf swing.

Some keys to avoiding injury are flexibility of the forearm muscles, balanced strength from shoulder to wrist, and gradual increase in play. As anyone who has had a sudden increase in the number of sets or holes played will attest, these muscles are usually not happy for a few days afterward. 

Stay Hydrated

The hot days of summer can be especially dehydrating after even a short period of activity. Realize that the heat index will effectively make a hot day much hotter physiologically due to the effect of humid air on the body’s cooling mechanism. In dry climates, evaporative fluid loses can happen with little notice, thus resulting in dehydration without much warning. Dehydration can impair the cardiac, renal, and neurologic systems. Performance is diminished at best, and serious health risks can happen with deeper levels of fluid losses. Take regular water breaks or indulge in a sports drink, but be careful with the caffeinated beverages and avoid that adult beverage until AFTER your round in the hot sun. Alcohol and caffeine can worsen the effects of dehydration.

Consider a Medical Consultation Prior to Starting a New Activity

For mature athletes, especially those with existing conditions like diabetes, heart disease, lung disease, asthma, obesity, among others, it is advisable to consult with your primary care provider before engaging in a new or more strenuous activity (eg joining a competitive tennis league after a year of inactivity). Medical issues are not necessarily going to keep you off the court or course, but having your health optimized can make for a safer and more enjoyable experience. Primary care sports medicine physicians are especially in tune with your athletic passions and how to address the ailments that need to be considered. Similarly, existing bone and joint problems may be manageable in ways that allow sports participation, even without surgery. A visit with an orthopaedic sports medicine specialist to discuss your injury may help you find a way to get back into the action!

Don't forget to like us on Facebook or follow us on Twitter!


Know someone who’s interested in becoming a doctor? The Medical University of South Carolina College of Medicine (COM) has an exciting opportunity for anyone considering, or in-process of, applying to medical school.

Our COM admissions department will be hosting a live Twitter chat on Wednesday, June 17 from 12:00 p.m. - 1:00 p.m. This don't-miss event will allow students to have their med school admissions questions answered and provide valuable advice on how med school applicants can really make themselves stand out among the competition.

Anyone who would like to follow the chat or take part in it, can do so by using the hashtag #muscapps or by visiting on the day and time of the event. Our Twitter handle is @MUSC_COM if students would like to become followers of the COM.

We look forward to chatting with all you future doctors out there and getting lots of questions answered!


Share Your Story

Subscribe to the Blog



Request Appointment

Launch MUSC MyChart

Contact Us