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Summer Flowers In This Section

Play Ball! Not Too Hard & Not Too Often

August 13, 2014
Lebanon, NH

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Lately, the term “organized youth sports” has begun to imply “athletes in training.” Due to this exaggerated interpretation, says the director of the Children’s Hospital at Dartmouth-Hitchcock (CHaD), children are training beyond the limitations of their still developing bodies, leading to a dramatic increase in repetitive stress injuries.

“Because of an unbridled emphasis on sports participation, children are increasingly sustaining overuse injuries at younger ages that previously were only seen in adults,” explains Keith Loud, MD, MSc, sports medicine pediatrician at CHaD.

Along with the rising increase in organized sports participation, younger children are training at higher levels intensity. Often they are involved not only in school and travel leagues, but sports camps, competitions and individualized training. Many of these are money-making ventures for the organizations and time-consuming endeavors for the families—resulting in what Loud calls “the professionalization of youth sports.”

It may also be harming your child.

Growing spurts or sprains?

Until a child reaches puberty—which happens at different ages depending on the child—they are “skeletally immature.” Loud explains: “Their bones are still developing at the growth plates and therefore more susceptible to irritation. These areas of soft cartilage are unique to young athletes.” Chronological age does not determine skeletal maturity.

In his practice, Loud sees a variety of injuries due to overuse. “With baseball we have ‘Little League’ elbow or shoulder in the growth plates of the throwing arm.” Soccer players may present with Sever’s Disease, a heel growth plate injury. Other frequent conditions include jumper’s knee or runner’s knee, while dancers and gymnasts may have stress fractures to the spine or lower back. Also, Loud adds, injuries around the hips are on the rise.

“We’ve taken the fun out of sports,” Loud says. “Through these overuse injuries we are potentially derailing the activities of kids who otherwise would remain active.”  

Letting kids be kids

As a pediatrician, Loud understands the “ironic twist” of advocating for less activity when there is an obesity epidemic among children. Yet, he explains, it is not a situation of either or neither. “Both of these at-risk populations – from overuse injuries and poor fitness – could benefit from an increased ability to participate in free play: play that occurs in backyards, playgrounds, or parks. Children are freely enjoying participation, which may develop into games and sports, but primarily this is led by the kids themselves, not stringently structured or organized. In free play, children will generally self-regulate. If they feel sore or tired they will stop or pull back.”

There are other important benefits children learn from free play that go beyond the physical, Loud says, including socialization and cognitive development.

A healthy middle ground

Too much of a good thing can be detrimental. According to Loud, children should have at least one season of the year free from any competitive athletic pursuits, while still maintaining fitness through free play. The other seasons they can participate in different sports – one per season. “The ideal would be the old fashion kid who plays soccer in the fall, basketball in the winter, and maybe track or baseball in the spring, then has the summer off for free play or going to camp—not a sports camp.”

A diversity of sports will train and strengthen different parts of the body, supporting a higher level of overall fitness and helping to prevent injury. “Ultimately this leads to better athletic performance,” says Loud. “Children should never participate in only one sport for the entire year.” Early specialization—when a child focuses on one particular sport repetitively—is one of the main causes of overuse injuries. “But,” he emphasizes, “no matter the season, kids should have at least one day off a week for rest.”

Loud – a 30 year member of the National Athletic Trainers’ Association, and a parent whose children are actively involved in sports, organized and otherwise – is not anti-organized sports. As a parent, he says, it simply comes down to the sheer volume of activity in which kids are participating. First and foremost, he emphasizes, “Children should only be participating in activities they enjoy.”

Who’s minding the kids?

One of the best things that organized youth sporting activities can do is retaining the services of a certified athletic trainer,” Loud says. These are professionals trained in the prevention, recognition, assessment and treatment of athletic injuries. They are also proficient at identifying clues or habits that may indicate a child is burned out or trying to end their participation. “Too often these certified athletic trainers are lumped in with personal and fitness trainers or coaches who might focus more on the game instead of the child. Good trainers overall are trying to provide a level of fitness that will prevent injury.”

Still, the primary responsibility falls to the parent who needs to respect and be aware of a child’s indications of pain, or if there is swelling or redness in a joint. Most importantly, “Parents should listen to their children,” Loud says.

Final inning

Children should be active, but they should also have fun and be safe. A lot of children enjoy sports, and parents enjoy watching them play, but, filled with only good intentions, there’s always the temptation to add the extra sessions, camps or teams, so a child is not bored or left behind. And … what if a teammate gets the big trophy or the million dollar contract instead of the child who took the summer off? Consider that according to the National Collegiate Athletic Association less than one percent of children who are still injury-free enough to become high school athletes will actually make it into professional sports.

“With the rise of organized sports,” Loud says, “there is a concurrent rise in programs and disciplines like pediatric sports medicine, which I specialize in. But I shouldn’t be able to do that – because there shouldn’t be enough injuries for me to be able to see them every day of the week.”

Sometimes, until children are at least 14 or 15 years old, it’s OK for kids to just be kids—and not athletes in training.

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