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Cover Story

Why Kids’ Sports Injuries Are Up

Children are suffering due to early specialization in sports. Here’s how to help prevent the problem.
photo by iStock

There are few things that North Texans love more than sports—and we like to start ’em young. No one blinks an eye when preschoolers start honing their soccer skills on a recreation team and move up to a year-round select team by age 9. Or when second-graders train 20 hours a week on a competitive gymnastics team.

If the kids mostly love it, then what’s the harm? For starters, early specialization in a single sport can take a toll on young, developing bodies. Injuries once found in high schoolers are now common in middle schoolers, and it’s estimated that up to half of injuries seen in pediatric sports medicine are related to overuse.

Local sports medicine doctors say it’s great that kids are getting exercise — 60 minutes a day is recommended — but they caution that too much training without proper recovery time is asking for trouble.

Kade Ashley, 13, started playing flag football at age 4. Since then, the seventh-grader from Lucas has tried every sport out there. He has fine-tuned his repertoire to now include just football and track. Serious about becoming a college and professional football player, Kade wakes at 5:30 a.m. to lift weights, monitors his diet, takes regular ice baths, and stretches every morning and evening.

He trains by the book, with guidance from the Michael Johnson Performance center in McKinney, and has only suffered one injury to date—a strained soleus muscle in his calf.

“He’s an outdoors kid and (his drive) has nothing to do with his parents,” says his dad, Keith Ashley. “He enjoys it 110 percent.”

Kade’s sister, Kyler, is 15 and has been in gymnastics since age 4. She’s a Level 10 gymnast, the highest designation, and trains for 25 hours a week. Although she has had a few injuries, including a broken ankle, her dad says she devotes the time because she loves the sport. Kyler plans to pursue collegiate gymnastics.

“We tried the softball thing, but she’s 5’1” and she really loves gymnastics,” Keith says. “As parents, our first questions are, ‘Did you have fun? Did you enjoy it?’ ”

It’s no accident that North Texas has spawned two Olympic gymnasts, Carly Patterson and Nastia Liukin. The sport is widely popular here and young women are training up to 40 hours a week, putting tremendous demands on their bodies, says Dr. Shane Miller, attending physician and pediatric sports medicine specialist at Children’s Medical Center.

“They are incredible athletes, but you have to balance what the body can handle with being safe,” he says. “If you’re not enjoying it, then no number of hours is appropriate.”

Lofty Ambitions
An estimated 38 million children play organized sports, with basketball, baseball/softball, football, soccer, and cheerleading among the most popular.

Parents often start out with good intentions, but some emphasize winning at an early age because they see college scholarships or professional-level play in their child’s future. The reality is that few will ever reach those aspirations. By age 13, 70 percent of kids drop out of youth sports, according to Safe Kids USA. Many become injured, suffer emotional and psychological issues of burnout or quit before they ever reach that next level.

photography by Justin Clemons
Kids under the age of 10 should play a variety of sports—preferably one at a time—that emphasize different physical skills, hand-eye coordination and social development. Miller says the focus should be on fun, exercise, and teamwork—then, lastly, skills.

That’s counterintuitive to how the game is played in North Texas and across the country. Parents are bombarded with emails for sports camps, batting clinics and soccer skills classes, and often feel pressure from coaches to beef up skills in the off-season. The reason: they fear their child will fall behind.

“The unfortunate part is that parents and coaches are succumbing to the system,” says Lance Walker, performance director at Michael Johnson Performance, a McKinney facility that offers training, assessment and coaching for athletes of all ages. “They think if their child doesn’t play year-round in a summer league he won’t get moved up to club. That leads to an overuse injury at 15 or 16 that could have been avoided if he had multilateral development.”

Insufficient or nonexistent physical education programs in schools also affect kids’ physical abilities, he says. Good curriculums ensure kids are receiving well-rounded training in a variety of sports and physical activities.

Walker says that Oklahoma’s PE programs fare better than those in Texas, but some schools on the East Coast are dumping their PE programs entirely after eighth grade.

Kids also suffer from what Walker calls “highlight syndrome.” They’re not watching sports as often, choosing instead to catch the highlights on ESPN.

“They see LeBron (James) dunking the basketball, but they’re not seeing the behind-the-scenes development that requires that type of athleticism,” he says. “It’s promoting an early specialization problem.”

Where it Hurts
Many young athletes are training like 19- and 20-year-olds, but their bodies are in a different growth and maturization stage.

MJP physical therapist Lorenzo Vite says he sees a higher incidence of injuries in child athletes who play select sports and participate in competitive gymnastics. It’s not uncommon to see 10- and 11-year-olds, who are working out at higher intensities, experiencing adult-like injuries.

Overuse injuries develop over time and are caused by repetitive stress on tendons, muscles, bones or joints and not allotting enough time for the body to heal. Children have wide-open growth plates and are susceptible to shoulder injuries, tendonitis, stress fractures, back pain, and knee pain.

They heal faster than adults, but it’s important to “respect the injury by not loading the injured area,” Vite says.

Dr. Troy Diehl, partner at Performance Orthopaedics & Sports Medicine in Frisco, says parents know their child best and can tell when they’re in pain. Sometimes younger children can’t verbalize where they hurt, so parents should look for symptoms like swelling or a change in gait, such as limping.

“If you find your child is complaining of pain and they normally wouldn’t, then listen to that,” he says.

The best initial treatment for injuries is RICE: rest, ice, compression, and elevation.

Ideally kids will take a break from the sport or the activity that is exacerbating the symptoms and rest. But rest is a subjective term. Most kids think they can still practice at home or shoot baskets with friends even though they have an injury.

If a child has pain, swelling, loss of motion, weakness and an inability to bear weight, consult a pediatric orthopedic specialist for a firm diagnosis. The next step would be physical therapy to learn proper techniques to increase flexibility and strength.

Vite, who performs physical therapy on adolescents ages 11 to 18, says growth plates can heal with the right care.

“Kids have tons of youth juice,” he says.