Not 'Small Adults'
Injuries on the Rise
An estimated 60 million youth aged 6–18 are involved in some form of organized sports. Of those, 44 million are active in more than 1 sport. Of those 60 million, 27 million participate in team sports. While the prevalence of overuse injuries varies depending on the particular sport—for example, 37% in skiing, compared with 68% in running—overall estimates range from 45.9% to 54%.1
More children also are specializing in 1 particular sport early in life, as opposed to sampling—playing various sports during different seasons throughout the year. "They're performing that certain skillset over and over and over again, and as a result they develop overuse injuries," says Granger.
But not only focused athletes are at risk. She says that more sedentary children—whose schools may offer less physical education because of funding cuts—become injured because they haven't learned to train properly. Nutrition is another factor: Injuries may occur if kids aren't eating enough or aren't getting the best type of nutrition to either prevent injuries or heal from them.
"Youth need to diversify. High school athletes used to play 3 or 4 different sports throughout the year," observes Teresa Schuemann, PT, DPT, ATC, who focuses on injury prevention in younger players. "When athletes use different techniques, they use different parts of the body."
"Today," Schuemann continues, "the sports industry wants kids to get hooked on a certain sport early." Schuemann is director and owner of private practice TPT Inc in Loveland, Colorado. She's also program director of a sports physical therapy residency program for postgraduate and continuing education provider Evidence in Motion. "This includes coaches. They see talent and want to develop it." Schuemann is a board-certified clinical specialist in sports physical therapy.
While it's often recommended that, at most, children's sports participation match their age—for example, that 12-year-old girls play no more than 12 hours of sports per week2—Corey Kunzer, PT, DPT, notes that, unfortunately, the best athletes tend not to stop there. "They'll play a lot more minutes than other athletes," he says. "They also may play in multiple leagues, and typically are starting and playing the whole game." "It's increased intensity, volume, and exposure for injury." Kunzer, a board-certified specialist in sports physical therapy, is the supervisor and coordinator of sports residency physical therapy at the Mayo Clinic in Minnesota.
That's not to say that youth shouldn't be active. "There are great benefits to participation in youth sports, including development of self-esteem, socialization, and overall general fitness," Kovacs says. But what's needed is balance.
She explains that when kids play on various types of teams—school, league, travel, club—it eventually catches up with them, as they're also attending school and doing homework. Overuse injuries can come, too, from time spent traveling for these teams. Youth aren't getting enough sleep, and they're exhausted. Research suggests that youth are well-advised to play any single sport only 8 months of the year, as opposed to year-round.2
Young athletes sometimes play so much, says Kovacs, because of the "professionalization" of sports—meaning that their parents believe they can become good enough to receive college scholarships or go pro. The reality, though, is that only about 2% of high school athletes receive college scholarships, according to the National Collegiate Athletic Association.3
Granger notes that in addition to kids being pressured by their parents in some cases, they also may be pushed by peers, coaches, school systems, and even other parents who want to see the teams win. And sometimes athletes put pressure on themselves to keep playing—even when hurt.