One of my patients was in for evaluation of running-related knee pain. During the visit, I inquired about his family, and he mentioned his son that still was playing ice hockey - year-round now. If he did not play in the summers, he would be relegated to the lowest competition level for the coming season, effectively making it unlikely he would be in the running for future upper-level community youth teams and eventually the high school team. His son is 11 yr old. It made me think back to my days in the youth leagues: the season ended when the ice melted in the spring. This natural break allowed (or forced?) kids to move to another pursuit until the weather grew cold enough to freeze outdoor ice rinks the next fall.
In this issue of Current Sports Medicine Reports we tackle some of the issues surrounding youth sports, including burnout, overuse injury, and early specialization, and we contrast those with the "underuse" that contributes to childhood obesity. On one hand, we have 11-yr-olds and younger children playing a single sport year-round; on the other hand, we have children who do not participate in any physical activity at all. Some do not participate for financial reasons, others for lack of adult role modeling and encouragement, some due to restrictions of the "built environment" and others for lack of confidence or fear of ridicule from adverse experiences in gym class (the late bloomers who would do fine with additional time for physical growth and motor-planning maturation).
Children should flourish within the five domains of life - physical/physiologic, psychological, cognitive/academic, social, and spiritual - as a part of and as a requisite for participating in sports. As Stovitz (1) outlines in the pyramid of sports medicine and child health (Fig.), it takes a community of dedicated individuals and organizations to advance youth sports from a global health perspective. Embedded within the pyramid are the parameters that contribute to overall child health as it relates to youth sports. A simple example of things that go wrong with youth sports is the post-game treats for younger players, which often have considerably more calories than the youngsters expended during the game or practice.
Although youth sports seem at times dominated by parents pushing their kids in the pursuit of scholarships and coaches bent on developing winning teams and professional-level players, most adults are out there to give kids the opportunity to participate in an activity. Sometimes basic education is missing to make the experience healthy, like knowing the calorie load of a snack. Sometimes not acknowledging when it is too hot to practice football in full gear turns to tragedy. Sometimes the adult motivation moves the activity away from having fun, and it becomes a chore for a child tied up in a sport promoted by a parent.
As a parent and a physician, I encourage children and adolescents to become involved in sports to keep them active, to learn to work individually and in groups toward a common goal, and to develop healthy lifelong activity habits. Some kids take to sports, and others require more encouragement to participate. Most kids just want to have fun, but an occasional child sets and achieves lofty goals like making the Olympic team or running a marathon. Part of the conflict arises when child athletes with wide and varied interests are funneled by adults into a single sport at an early age. There was a time when most Division I athletes were three sport- athletes in high school. Maybe it has become a parochial notion that children and adolescents should learn and play multiple sports, but it seems a healthier approach to physical activity. The end goal in youth sports should promote fun, fitness, and health across the entire population.
1. Stovitz SD. The pyramid of sports medicine and child health. Br. J. Sports Med
. 2010; 44(1):4-7.