This and prior studies have found that not only are athletes who specialize early at risk for injury, they also end up with overall poorer muscle balance, coordination and visual motor skills than their peers that play multiple sports. Soccer players, for example, can have strong skills when it comes to foot control, but might be lacking in overall general coordination. Add basketball into the mix, and the basketball’s need for more eye-hand coordination can also lead to enhanced skills for soccer. “Our biggest concerns, initially, are chronic overuse injuries,” notes Dr. Guenther. “Doing the same motions repeatedly can produce an imbalance of musculature, and put undue strain on specific muscle groups and bone.” For some, running leads to Sever’s disease, where micro cracks form in the growth plate of the heel bone. Osgood-Schlatter disease is discomfort just below the knee where the patellar tendon attaches to the tibia. While both are commonly referred to as diseases, they are really overuse injuries. Both result in pain, and can lead to increased deposits of calcium and bone in the area of irritation. Kids who spend a lot of time in cleats or on the basketball court can have increased risk for both of these problems. Soccer players can experience hip flexor strains from kicking too big a ball. Swimmers experience shoulder strains and rotator cuff injuries. Volleyball players can develop upper body imbalances and shoulder strains. Baseball players can develop “little league elbow” from throwing too much. Dr. Guenther is particularly concerned about seeing younger and younger kids experiencing injuries that used to show up primarily in older athletes. “We’re seeing ACL tears in 8- and 9-year-olds.” Muscular imbalances that develop from playing one sport too much can put young athletes in a position where they can torque a knee and suffer a significant injury. As puberty arrives, and girls develop wider hips, they also develop a greater risk of knee injury because of the changing geometry of their bodies and their center of gravity. Ligaments also become slightly more flexible and softer, and more at risk for tears. Dr. Guenther notes that some excellent research has been done by the University of Cincinnati focused on how female athletes land from a stride or jump. Exercises and jump training can help balance their musculature and train them to land safely and decrease the incidence of knee injuries. Several local physical therapy
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clinics offer this type of training. Some injuries can lead to problems later in life, as well. While coaches might limit the number of pitches a baseball player throws in practice, kids often go home and throw on their own. The chronic pain and inflammation that can result can force a player to stop pitching, and even restrict time spent in the outfield where long throws must be made. Enough inflammation, and a player simply can’t throw the ball, and in some cases must stop playing. “For ACL injuries, the knee is never really the same,” notes Dr. Guenther. “And ACL injuries are generally linked to a significant risk of arthritis within the next 20 years. So for someone injured at 10, that means the possibility of getting arthritis in their 30s, which means limiting activity for a big part of the prime of their life.” For athletes that specialize in a sport early, there’s the risk that their physical tools may or may not develop to support their continued growth and success in a particular sport. In some cases, a young athlete may blossom later than their peers, and find “late” success at a sport. Focusing exclusively on one sport can deny a player the opportunity to try something new and different, and perhaps thrive in that environment. Michael Jordan was famously cut from his high school basketball team as a freshman before becoming one of the best players ever. Conversely, a dominant center on the basketball court may tower over peers in middle school and junior high, but later be just average height. Any number of soccer goalkeepers have seen early success, then struggled later when they end up smaller statured than they’d like. Too much time in goal can also leave them behind when it comes to the skills a field player needs. In Fort Collins, as interest in and opportunities to learn rugby grew over the years for young women, local players picking up the sport in their high school years found success locally, regionally and beyond. Local products Amanda Kehmeier and Sadie Anderson, who both played soccer primarily prior to high school, found success playing rugby in high school and college, and Anderson now represents the U.S. in international play. For boys, lacrosse has grown quickly in Northern Colorado, and provided local athletes a new sport to learn, compete and succeed in. Dr. Guenther notes that for years, the AAP has made recommendations that kids not play just one sport, and that they take breaks between seasons. That has been controversial in some
circles, given that baseball, soccer, basketball and swimming are all sports that athletes can do year-round. “As pediatricians, we have attached that discussion to all the visits we have with patients and their parents, and that is something relatively new in my 25 years of treating patients,” he says. “We encourage them to try different sports, different activities and to take a break – rest those joints, muscles and growth plates.” The worst risk increases seen, over years and multiple studies, is for those who play one sport year round. In addition, higher risk of burnout is seen by those participating in higher levels of competition. That can result in less enjoyment and poorer performance in any given sport. Those who compete on mid-level teams are not as likely to burn out, and are more likely to play other sports, and not do the same sport year round. They also tend to stick with and enjoy a given sport for a longer period of time. To reduce the chance of injury and burnout, and help ensure that your child enjoys organized sports for the long term, Dr. Guenther offers these suggestions: •
Make sure your child engages in regular, unstructured play.
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Delay specialization in a single sport for as long as possible.
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Take time off regularly from training and competing.
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Add in another sport or activity to vary what your child is doing.
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Ensure that strength and fitness training focuses on whole-body cross training.
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Regularly explore new activities as your child grows and matures.
Future American Academy of Pediatrics research will focus on whether educating parents and kids on the two-to-one ratio of organized sports to free play, and providing specific guidelines, will reduce overuse injuries in youth sports.
Brad Shannon is a freelance writer based in Loveland.
Lydia’s STYLE Magazine