SPORTS

Youth Sports: How much is too much?

 

Charlotte Moriarty, MD, PhD, CAQSM

Youth sports participation has been growing exponentially in recent years, with an estimated 30 million children and adolescents playing organized sports in the United States alone. On one hand, this is great news for a nation facing an obesity and exercise-insufficiency epidemic. On the other hand, it is putting our youth at high risk for sports-related injury. As a parent and a sports physician, I aim to prevent sports-related injury in our young athletes.

There are more than 2.6 million sports injuries in patients aged 24 years and younger each year. At least half of these injuries are overuse in nature. An overuse injury is any type of muscle, tendon, or joint injury (e.g. tendinitis, stress fracture) that is caused by repetitive microtrauma. These injuries often develop gradually and cannot be linked to a specific cause or incident. Insufficient rest and recovery is frequently implicated in the development of these injuries. Sports-related injuries range from mild to severe in nature, but all affect the young athlete in his or her ability to participate, enjoyment of sport, emotional well-being, and social interactions.

One factor contributing to the rise of overuse injuries in youth athletes is early sports specialization. Multiple national physician organizations, including the American Academy of Pediatrics (AAP), the American Orthopaedic Society for Sports Medicine (AOSSM), and the American Medical Society for Sports Medicine (AMSSM), have firmly advised against specializing in a single sport during early adolescence. AOSSM has defined early sports specialization as the combination of playing and training in a single sport for greater than 8 months per year, playing a single sport “to the exclusion of participation in other sports,” and starting this commitment prior to age 12 years.

Multiple investigations in the medical literature have demonstrated the detrimental sequelae of early specialization, including burnout, overuse injury, and decreased enjoyment of playing sports. Specifically, early sports specialization has been correlated with serious overuse injuries (including injuries to ligaments and growth plates), anterior knee pain, and hip pain.

In a recent survey of 235 young athletes aged 7-18 years, 60% played their respective favorite sport at least 9 months per year. Of the 235 athletes, 70% expressed an interest in playing collegiate or professional sports. Approximately 30% had been advised by a coach not to play other sports, while 22% had been told by their parents not to play other sports. Half of surveyed athletes believed their academics suffered as a result of their sports participation, and more than 70% felt their social lives were interrupted by sports participation.

As many young athletes aspire to play collegiate and/or professional sports, the balanced athleticism attained with multi-sport participation should be emphasized. By engaging in a diverse array of sports and physical activity, the year-round participation that increases overuse injury risk can often be avoided. In addition, the athletic dexterity gained from multi-sport participation has also been shown to increase longevity in sports involvement. What parent doesn’t want that for their child? Furthermore, among current professional athletes, 97% stated that multi-sport participation contributed to their success in their chosen sport.

Aside from playing multiple sports, here are a few additional recommendations to keep our young athletes healthy and on the playing field:
• No more than 5 days per week playing a given organized sport (e.g. soccer)
• At least one complete rest day from organized sport per week
• At least 2-3 months rest from organized sport per year

Finally, if your young athlete is complaining of pain during or after activity, have them evaluated by a health professional at the earliest opportunity. Early evaluation can prevent more serious injury and delay time away from sport.
For more information about youth sports injuries, click here.

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