Estimated read time: 6-7 minutes
The official start to fall is days away, but the competitive sports season for young athletes is already here. On playing fields and in gyms, kids are developing their athletic skills, meeting and working with teammates, and engaging in activities before and after school.
"These kids get a lot of self-esteem and leadership skills out of playing sports," said Aaron Provance, CAQSM, FAAP, MD, a pediatric sports medicine doctor with University of Utah Health. "They learn how to work as a team and as a group, which will help them succeed in their work life and careers in the future."
Provance has been treating youth sports injuries for the past 17 years, and he has seen a lot of changes that have resulted in an increasing number of overuse injuries and burnout. These evolving challenges are often based on the trend to get kids into sports specialization at an earlier age.
"When we talk about early sports specialization, the child stops playing all other sports to focus on just one sport, and they typically play more than eight to nine months of the year, often year-round," Provance said. "This leads to excessive and repetitive stress on various areas of the body where you can have a growth plate injury, and these kids don't have enough recovery time."
About 50% of the youth sports injuries that Provance and his pediatric sports physician colleagues would normally treat result from overuse due to children's unique growth patterns and skeletal systems. The other 50% of the injuries are acute or traumatic in nature: ACL tears, knee injuries, ankle sprains, and fractures.
With the trend toward early sports specialization, Provance is now observing a spike in some of those traumatic injuries in his younger patients. At the pediatric sports clinic where he is a director, Provance has treated three 8-year-olds with complete ACL tears and one 6-year-old.
These are injuries I did not see in the younger population when I was just starting my practice. We are finding some of these bigger injuries trickling down into younger populations.
–Aaron Provance, pediatric sports medicine doctor with University of Utah Health.
"These are injuries I did not see in the younger population when I was just starting my practice," he said. "We are finding some of these bigger injuries trickling down into younger populations."
Sports medicine professionals like Provance are not the only ones worried about these traumatic injuries, along with the physical and mental burnout young athletes are experiencing. So are the kids who feel over programmed and overwhelmed by excessive training and non-stop competition.
A report by the American Academy of Pediatrics (AAP), published in the journal Pediatrics earlier this year, estimates that as many as 7 in 10 kids quit sports by age 13. And those numbers play a role in statistics that show 75% of U.S. teens do not meet healthy guidelines for physical activity.
In response to these disturbing developments in youth sports, the AAP and its members have published a set of guidelines designed to keep kids in the game.
"The AAP suggests that specializing in one sport before the age of 12 can lead to overuse injuries," Provance said. "It is recommended that kids only play or train in their sport for the number of hours which reflect their age. If they are 12-year-olds, that would mean that they are only training or competing 12 hours a week in their sport."
Other AAP recommendations Provance encourages his patients to follow include taking one to two days off from training and competition per week and two to three months a year away from one specific sport. It is all about rest, recovery, and refueling.
"Sleep and nutrition are huge factors in the recovery process, even for the youngest athletes," Provance said. "Now we know that young athletes need at least eight to nine hours of sleep per night if not more. Young athletes need to make sure they are eating enough: three healthy, good-sized-portion meals per day, and refueling before, during, and after training sessions with healthy snacks."
What experts like to call the professionalization of youth sports is also creating stress levels in kids that are well beyond their ability to navigate and treat. "There is a growing concern about how these young athletes are doing from a psychological perspective with overuse injuries and stress," Provance said.
Parents, coaches, and even kids often put pressure on themselves to train and perform well beyond their age and abilities. It is an issue Provance and his colleagues often talk about with their patients and parents.
"I think a lot of these young athletes feel like if they are not on top of their game, if they are not winning, then someone else is winning and they're not continuing down that path to success," Provance said. "That puts a ton of pressure on them—internal pressure, coaches' pressure and parent pressure that can really take a toll on their psyche."
Provance believes that making education and information available to parents and coaches is an important way to ensure kids enjoy sports and continue to participate in them into adulthood. It is about giving kids choices and the ability to have fun while staying active.
"Keeping it all in perspective, it is important to have these young kids exposed to a variety of sports so they can see what they are passionate about or what they like to do," Provance said. "But also keeping in mind that they are playing for fun and not just competing to win all the time because that is probably not their goal."
It is possible to measure success around effort and participation with a focus on fun, sportsmanship, and other life skills. That is a message Provance and his colleagues across the country hope to spread more effectively and efficiently.
"These young athletes are learning how to be physically active for life, which can decrease depression, anxiety, obesity, and heart disease," Provance said. "They will be much more productive adults if they have activities in their life."
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