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zpted zpeds sports injury Personal Health - The Breaking Point for Children in Sports -

 On the problems of overuse , and overzealousness for kids sports. 

Personal Health - The Breaking Point for Children in Sports -

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The New York Times
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May 24, 2010

For Children in Sports, a Breaking Point


I'd be the last person to discourage children from playing sports. Indeed, I wish many more would move away from their computers, put down their iPods and cellphones and devote more time and energy to physical activities.

But for many children and adolescents, the problem is the opposite of being sedentary. Encouraged by parents and coaches, many with visions of glory and scholarships, too many young athletes are being pushed — or are pushing themselves — to the point of breaking down, physically and sometimes emotionally.

The statistics cited by Mark Hyman in his book "Until It Hurts: America's Obsession with Youth Sports and How It Harms Our Kids" (new in paperback from Beacon Press), are sobering indeed: "Every year more than 3.5 million children under 15 require medical treatment for sports injuries, nearly half of which are the result of simple overuse."

Injuries are only part of the problem, Mr. Hyman wrote. As adults become more and more involved, he noted, "with each passing season youth sports seem to stray further and further from its core mission of providing healthy, safe and character-building recreation for children."

Mr. Hyman, a sports journalist, was prompted to tackle this subject in part by his own misguided behavior as the father of an athletically talented son. At 13, Ben Hyman was a prized pitcher for a local team when his shoulder began to hurt — and hurt enough for him to complain — just before the start of league playoffs.

Despite a professional assessment that Ben's problem was caused by throwing too many baseballs and a recommendation to rest his arm up to a month, his father put him in the game, and again three days later, urging him to "blaze a trail to the championship." When the injured boy began "lamely lobbing balls at home plate," Mr. Hyman realized his foolish shortsightedness in putting winning ahead of his son's well-being.

The Dangers of Overdoing It

The problem was put into focus three years ago by the American Academy of Pediatrics' Council on Sports Medicine and Fitness. In a report in the academy's journal, Pediatrics, Dr. Joel S. Brenner wrote, "Overuse injuries, overtraining and burnout among child and adolescent athletes are a growing problem in the United States."

The goal of youth participation in sports, the council said, "should be to promote lifelong physical activity, recreation and skills of healthy competition."

"Unfortunately," it went on, "too often the goal is skewed toward adult (parent/coach) goals either implicitly or explicitly. As more young athletes are becoming professionals at a younger age, there is more pressure to grab a piece of the 'professional pie,' to obtain a college scholarship or to make the Olympic team."

(If you doubt the role of adults, I suggest you take in a Little League game between teams striving for a championship. But instead of watching the players, watch — and listen to — the parents and coaches screaming at them, and not just words of encouragement.)

But most young athletes and their parents fail to realize that depending on the sport, only a tiny few — 2 to 5 out of 1,000 high school athletes — ever achieve professional status.

Clearly we've gone too far when the emphasis on athletic participation and performance becomes all-consuming and causes injuries that can sometimes compromise a child's future.

The sports surgeon Dr. James R. Andrews said that he now sees four times as many overuse injuries in youth sports as he did just five years ago and that more children today are having to undergo surgery for chronic sports injuries.

Though far more common today, the problem is not new. In 1952, the National Education Association took aim at the "high-pressure elements" and "highly organized competition" in youth sports that gave youngsters "an exaggerated idea of the importance of sports and may even be harmful to them."

In 1988 in The Archives of Disease in Childhood, two London-based physicians, N. Maffulli and P. Helms, concluded, "Young athletes are not just smaller athletes, and they should not become sacrificial lambs to a coach's or parent's ego."

They cited an analysis of training regimens finding that "at least 60 percent of all injuries sustained were in direct relation to training and could be avoided by appropriate changes in training programs." They explained that young athletes are more prone to certain injuries, especially stress fractures; tendinitis; a degenerative condition called osteochondrosis; and damage to the growth plates of bones that can stunt them for life.

Whitney Phelps, the older sister of the Olympics wunderkind Michael Phelps, was the swimmer to watch in the 1990s, until she burned out her body. Motivated by her mother, her coach and her own dreams of the Olympics, she recalls, she swam through pain in her back for years, pain sometimes so severe she could hardly stand up. At 14, Mr. Hyman recounts in his book, her arms would go numb when she turned her head, and she was found to have two bulging spinal discs, a herniated disc and two stress fractures.

Playing It Safe

A major factor in the rising injury rate is the current emphasis on playing one sport all year long, which leaves no time for muscles and joints to recover from the inevitable microtrauma that occurs during practice and play. With increased specialization, there is also no cross-training that would enable other muscles to strengthen and lighten the load.

Even when a sport is done seasonally, daily practice can result in problems. The pediatrics council recommends that young athletes "have at least one to two days off per week from competitive athletics, sport-specific training and competitive practice (scrimmage) to allow them to recover both physically and psychologically." The group also recommends that children and adolescents play on only one team a season and take a vacation of two or three months from a specific sport each year.

Whatever an athlete's age, playing through pain is a bad idea. Pain is the body's signal that something is awry. Ignore it and it is likely to get worse and worse, and the injury could become permanent. Get a professional diagnosis and follow the therapeutic advice. After a prescribed period of rest, return gradually to the sport, increasing training time, repetitions or distance by no more than 10 percent each week.

The Pediatrics authors also suggest that it is a sign of possible burnout when an athlete "complains of nonspecific muscle or joint problems, fatigue or poor academic performance." That's when a child's motivation to continue in the sport should be reassessed.

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Personal Web site for John C Kim: KIDDOC.ORG

I am a pediatrician specializing in General Pediatrics, International Adoption Medicine, and in the diagnosis and coaching of families pursuing joy.