#YouthSportSafety: Early Sports Specialization in Youth Athletes

My colleague and Athletic Trainer Julie Young,
pool side and talking about injury prevention
in young swimmers

I’ve been thinking a lot about youth sports specialization lately.

It’s likely the nexus of the Olympics, my reading of the book The Sports Gene, and our own journal’s publication of the AMSSM Position Statement on Youth Sports Specialization and Overuse that has prompted this.

Readers of this blog will recall that I recently profiled the AMSSM Position Statement and interviewed the lead author, Dr. John DiFiori. Likewise, I  recently reviewed the excellent book The Sports Gene, which looks into, among many other things, the application of the ’10 000 hour rule’ to athletes’ pursuit of elite sport excellence.  What does it take to make an Olympian?  Many would argue that part of the answer lies in identifying excellence early, and starting to groom that talent at a young age:  it takes about 10 years to fit in those 10 000 hours of dedicated practice.   These forces are at least part of what drive the growing phenomenon of youth sports specialization.

I have a professional bias toward this line of thinking, of course:  I practice clinical pediatric sports medicine, and most of my research interests lie in keeping kids safe and active.

For instance, Nationwide Children’s Hospital (NCH) and the YMCA of Central Ohio recently paired up to release a couple of educational videos on the Education and Prevention of Overuse Injuries in Youth Swimmers and the Risks for Early Specialization in Youth Swimmers.  The task combined my interests in youth sports and swimming (I am a member of the USA Swimming Sports Medicine Task Force).  It was a lot of fun working with folks like Julie Young, a swimmer and athletic trainer at NCH with whom I work and do research.  Click on the links to those videos and let me know what you think.

CJSM has made quite an effort over the years to profile high quality research that looks at the phenomena that impact youth sports.  For instance, my good friend Dr. Anthony Luke, at the University of California, San Francisco, was the lead author of a 2011 CJSM study, ‘Sports-related injuries in youth athletes:  is overscheduling a risk factor?’ which I highly recommend.  And another good friend, Dr. Pierre d’Hemecourt from Children’s Hospital Boston published  as lead author an evaluation of a novel back outcomes measure designed to address pain and disability in pediatric and adolescent patients with back pathology; this came out in the May 2012 CJSM.  This brief litany represents just a smattering of the research we publish on youth sports.

Most recently, of course, there was the AMSSM consensus statement and study, just published in the January 2014 CJSM.  In addition to the study itself, I must commend to you the associated editorial by William O. Roberts, M.D., M.S.  It is very well done.

The single line that most resonated with me after reading Dr. Roberts’ piece is this: “Children left to themselves in spontaneous and unstructured sport and recreational activity are generally free of overuse injury; when adults step into the picture that ‘injury free’ status seems to change.”

In America, it certainly is true that adults have stepped into the picture of youth sports in a big way.  At times, this adult presence can be a positive, beneficial presence.  For instance, Avery Faigenbaum, who has been on these blog pages on several occasions, emphasizes the health benefits and safety of youth resistance training, but always emphasizes the importance of adult supervision:  about the only time kids injure themselves weight lifting occur when unattended.  At other times, and most of us in the clinical sports medicine world can attest to this, coaches or parents can drive their charges in a manner more in keeping with, well, an Olympian.  Overuse injuries are more likely than gold medals in that scenario.

There is a LOT of buzz in the sports medicine world surrounding these issues.  Stakeholders are aware of the twin perils:  the rise of pediatric inactivity and obesity, and the the risks inherent in youth sports (ranging from ACL injuries to concussions, both of which appear to have increased in incidence).  The Aspen Institute Sports and Society Program has begun its #ProjectPlay Initiative:  “Reimagining Youth Sports in America.”  Just this past weekend, the project had a big televised event on ESPN with such luminaries as Bill Clinton and Kobe Bryant in attendance.   Dr. David Satcher, the former U.S. Surgeon General, has assembled a National Council on Youth Sport Safety which has just begun its work; it can be followed on twitter @ythsportsafety.  And as I write, a wide-ranging field of experts–from sports psychiatrists to exercise physiologists to public health practitioners–are assembling in Orlando for the “Developing the Healthy Youth Athlete” conference taking place there.

Outdoor free play for kids:
the antidote to overscheduling,
overuse, overspecialization.

And  before I forget to mention it, for those readers who are interested in learning more about unsupervised, outdoor free play in kids, I heartily recommend getting to know the Leave No Child Inside movement.

We’ll be continuing to publish research on #YouthSportsSafety in the pages of the CJSM journal, and on these blog pages.  I’ve got plans to blog about “Leave No Child Inside”  and interview soon a leader in that field.  I already have in the works an upcoming “5 questions with CJSM” post  with Robert Zayas, the Executive Director of the New York Public High School Athletic Association. I’m looking forward to hearing what he has to say about a host of issues, including the rise of club (non-school-based) sports  in the United States. And it’s a mere two weeks until the March CJSM hits the stands!

Daylight savings time and Spring here in the States is not far behind as well……

That’s a lot to look forward to!