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Oregon Family Magazine

Are Kids Overdoing It in Sports?

10/01/2018 ● By Sandy Kauten
Every year, thousands of kids suffer injuries from intense sport specialization and overuse.  Having sustained multiple overuse injuries, myself as a young athlete, I understand how this feels.  As a teenager I started to notice pain in my knee when running and jumping… accompanied by a sharp bone protruding from just below my kneecap.  I kept this to myself (a little afraid); but my mom noticed me in a moment of pain, and immediately scheduled an appointment.  The diagnosis was Osgood Schlatter’s Disease; a painful overuse condition occurring during adolescent growth spurts, and more frequently in people who participate in running and jumping sports.  The prescript was rest, ice, and NSAIDS, which helped with pain, and while they aren’t bothersome, the protruding bones on both knees remain.

This was clearly an overuse condition; but sports were a big part of my life and continuing was very important to me both personally and collegiately, so I made a transition from multiple sports to specializing in one sport – an all too common phenomenon now.  As it turns out, this may have resulted in more problems from overuse…not less. 

Frequently youth athletes, parents, and coaches believe specialization is the best way to become an elite athlete.  A ‘more is better’ approach has been adopted, leading athletes to play basketball, soccer, gymnastics, baseball, or volleyball year-round, with hopes of a college scholarship, or rarely a future in professional sports.  The outcome can (in some cases) result in overuse injuries from common stressors for which the immature skeleton is not prepared to endure. 

Injuries from specializing in a single sport at a young age have been discussed and reviewed at length in sports medicine journals. In September 1989, the American Journal of Sports Medicine published an article entitled “The Accident-Prone and Overuse-Prone Profiles of the Young Athlete.” The authors found muscle and ligament issues among college freshmen who specialized in a single sport as a child. “The overuse-prone profile is mainly based on physical traits: A combination of muscle weakness, ligamentous laxity, and muscle tightness predisposes [such athletes] to stress injuries.”  Furthermore, several studies reject many of specialization’s purported benefits.  Specialization has been shown to lead to overuse injuries and emotional burnout; often without generating the desired competitive advantage thought to be present over multi-sport athletes.  In fact, research has found a direct correlation with overuse injuries and the degree of specialization.

Specialization may not be as beneficial as many believe.  It stifles motor-skill development in preadolescents, leading to increased risk of injury. A recent study found high school athletes who played only one sport for more than eight months in a year were nearly three times as likely to suffer from overuse knee injuries. Continually performing the same type of activity does not lead to increased strength and stamina, but instead more often to overuse.  The best way to mitigate overuse injuries in youth athletes is to not specialize at an early age.  The much quoted 10,000 hour rule for mastery of an activity (from the book Outliers) may not, in fact, be the best way to become an elite athlete. 

“Sport samplers, who have had the opportunity to develop essential fundamental motor skills, will have many different sports available to them across their life span,” the researchers wrote in Kinesiology Review last year. “Sport sampling in the formative youth years is clearly superior to early sport specialization.” In fact, the American Academy of Pediatrics, the American Medical Society for Sports Medicine and the National Strength and Conditioning Association recommend against early sports specialization.  These groups recommend ‘free play’ as a healthy alternative to develop athleticism in young athletes.  “During free play, when a child gets cold, tired, hungry, bored, or sore, she or he will typically stop,” researchers wrote last year in the American Journal of Sports Medicine, of children ages 7 to 18. “But when being supervised by an adult or when participating in organized competition, the child may feel an expectation to continue, and therefore be more likely to push through pain or soreness.”

Today, I encourage youth athletes to not push through the pain, and to see a doctor if they develop pain.  To rest if they are tired or sore, and to not specialize in one sport; rather, to participate in as many sports as possible.  Most importantly, to HAVE FUN, and enjoy free play in an environment free from parents and coaches. 

By Gregory Phillips.  As a former college athlete, the father of three very active children, flag football coach, and Interventional Spine and Sports Medicine Physician, Gregory Phillips knows all too well the risks associated with intense sport specialization and overuse.