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Competitive Kids Are Specializing in One Sport at Early Ages, Raising Injury Risks

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Competitive student athletes are increasingly opting to focus on one sport at earlier ages, increasing their risks of injuries from overuse of the same joints and muscles, doctors say. 

Rather than playing a variety of sports or taking an off season, younger and younger kids are zeroing in on one athletic activity, training in focused areas throughout the year, physicians with the American Academy of Orthopaedic Surgeons and American Orthopaedic Society for Sports Medicine said. 

Resulting injuries to students' still-developing bodies can have lifetime effects and may eventually drive them to quit competing in the sports they love, those physicians said in a recent webinar hosted by the organizations.

"As more athletes under the age of 12 focus on just one sport and year-round training, coaches, parents, and athletes need to encourage youth to think about participating in a variety of activities to prevent injuries," said Charles Bush-Joseph, a professor at Rush University Medical Center in Chicago. "While sports participation has many benefits, including the development of strong bones and muscles, children who do specialize are often more likely to develop overuse injuries because of their repetitive movements, are stressed, and may even consider quitting a sport and losing the benefits."

Even when controlling for factors like age and amount of practice time, focusing on a single sport for three or more seasons out of the year increases a child's risk of injury, the organizations say. That's because developing joints and muscles aren't given proper time to heal when they are repeatedly stressed. The doctors cited trends like high rates of elbow pain for youth baseball players and soft tissue injuries for competitive gymnasts. A 2017 study of youth athletes ages 5 to 14 found that 28 percent of football players, 22 percent of soccer players, and 25 percent of baseball players had overuse injuries.

And some athletes may be at greater risk.

"High socioeconomic status athletes reported more serious overuse injuries than low SES athletes, potentially due to higher rates of sports specialization, more weekly hours in organized sports, less frequent opportunities for free play, and greater participation in individual sports," said Neeru Jayanthi, associate professor of orthopedics and family medicine at the Emory University School of Medicine in Atlanta. "We think it is possible that injury risk happens not just from how much you play, but rather how you spend that time. Unorganized free play may potentially be protective of overuse injury. We believe that this allows an environment where the child can be self-directed."

So what else can schools and coaches do to help students stay safe if they choose to specialize in a single sport? The organizations have resources for students, parents, and coaches. Among their recommendations:

  • Identify possible risk areas for overuse injuries at pre-season physical exams.
  • Incorporate stretching and strength exercises into training.
  • Encourage student athletes to take at least one season off and to alternate sports and positions.
  • Identify possible overuse injuries by communicating with athletes frequently about areas of concern. Some children might not recognize there is a problem until they are in severe pain, the organizations say.

Photo: Getty Images.

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