Kely Kuhn PT
5 Tips to Help Prevent Youth Sports Injuries.
I can honestly say playing sports as a kid was one of the best experiences of my life and helped shaped me into who I am. The benefits of sports can be far reaching. Fortune magazine discussed the benefits of sports for women in a recent article listed here.
However, 70% of kids are dropping out of sports by age 13 and 10% fewer kids are playing team sports since 2009. (2) As a mom with two kids just entering the sports world, I'm already feeling the pressures of starting them young and specializing early. I understand how parents can struggle to find the right balance between keeping them healthy and keeping up with the team, so I wanted to share some tips that I have learned from working with athletes that may help keep more kids healthy and engaged in sports for a lifetime. Last week was National Youth Sports Specialization Awareness Week , so I hope this post helps to shed some light on this topic.
1. Give your kids good bone health.
Some of the most debilitating injuries for athletes are bone stress injuries (stress fractures) which may require significant time away from sports. But having good bone health can help, and the best window to develop it is childhood.
Playing sports that require jumping, cutting, and changing direction create axial load which help to build bone. Adding in a variety of different sports with different movement patterns also helps with this process. This is especially important for kids interested in more endurance activities such as running, swimming and cycling that do not axially load the bone and may not help develop the best bone health. Crossing over during off seasons to " ball" sports may be key for endurance athletes to develop bone strength to support a lifetime of healthy activity. I'll touch on this more later, but free play that includes climbing and jumping is also crucial to help build bone in the early years and should not be sacrificed in the name of early organized sport. As kids get older and find less time for free play, adding in resistance training and plyometric training can be a way to help build bone. Plyometrics should only be introduced by a coach or trainer who understands the technique and demands of plyometrics to get maximal benefit without causing injury. If you want to learn more about bone stress injuries I suggest listening to the Runner's Zone podcast Episode 5.
2. Play multiple sports.
I know it feels like if your child doesn't play on the team year round they will miss out and not keep up with other kids. I also know the "politics" of sports are hard to navigate. But youth sports specialization is doing so much harm to kids and sports in general. This Vancouver Sun article highlights the damages of youth sports specialization including seeing more and more children with injuries that were previously only seen in pro athletes.
In addition to the injuries, sports specialization is making us less athletic. When athletes play multiple
sports they develop different skills and movement patterns that may help in their primary sport but are not necessarily developed in that sport. For example every single one of the 2015 U.S. Women's world cup winning team were multi-sport athletes in high school and many attribute the skills they learned in other sports to their success on the soccer field. (5) Also, we know that some of the best golfers played basketball during their youth. Jumping develops skills that correlate to a good long shot. There are so many examples of this crossover effect that often get pushed aside in the name of specialization.
A current evidence based review published in Sports Health concludes:
" Children should be encouraged to take part in a variety of sports and interests to best attain the physical, psychological and social benefits of sport. Children who specialize early (prior to maturation) in a single sport execute less age-appropriate sports skills especially when they do not participate in as much unstructured free play."
Playing multiple sports gives kids the ability to stay healthy and active year round and not become deconditioned in the "off" season. The variety of movements in different sports allow different areas of the body to be stressed or loaded, with no one area takeing too much stress, thus preventing overuse injuries. It's a win-win.
3. Watch overall Health
Preventing sports injuries is not just about on the field management. Overall health can play a huge part in injury prevention and recovery. If an athlete is not sleeping well, is stressed or has poor diet, their nervous system will be in more of a fight or flight response and more vulnerable to pain and injury. With increasing amounts of school work, practice time and social stresses, athletes may be more primed for injuries than ever before. Keeping good sleep hygiene should be a priority but often gets pushed aside for one more practice or a little more homework. This Washington Post
Article highlights the increased pressure on kids during sports that is causing them to drop out. This same pressure can also contribute to injuries. Add in the pressures of school work, limited time for proper sleep and diet and we have created a pressure cooker for injuries. Allow kids time to be kids. Just getting outside for free time can do wonders for health. (8) Keeping consistent sleep and wake times and healthy diet are imperative for injury reduction. Travel and more competitive sports have a place, but all athletes should be able to have times where they just play rec or even "pick up" games without all the pressures that come from competitive sports. Keep sports fun!
4. Have Off Seasons
This ties right into sports specialization. Having an off season to any one particular sport is crucial to managing our growing injury rate. The NBA recently highlighted year round youth basketball as one of its biggest problems for the league as a whole. Players are so worn down and lack the overall good movement skill to be resilient to injury. The league is riddled with injuries and believes the culture of sports that these current pro-athletes were brought up in may be a large contributing factor. (9) The National Athletic Trainers Association recently put out guidelines for parents to help navigate sports, which include not playing any one single sport year round.
NATA Guidlines (10):
1. Delay specializing in a single sport for as long as possible. Sport specialization is often described as participating and/or training for a single sport year-round. Adolescent and young athletes should strive to participate, or sample, a variety of sports. This recommendation supports general physical fitness, athleticism and reduces injury risk in athletes.
2. One team at a time: Adolescent and young athletes should participate in one organized sport per season. Many adolescent and young athletes participate or train year-round in a single sport, while competing in other organized sports simultaneously. Total volume of organized sport participation per season is an important risk factor for injury.
3. Less than eight months per year: Adolescent and young athletes should not play a single sport more than eight months per year.
4. No more hours/week than age in years: Adolescent and young athletes should not participate in organized sport and/or activity more hours per week than their age (i.e., a 12-year-old athlete should not participate in more than 12 hours per week of organized sport).
5. Two days of rest per week: Adolescent and young athletes should have a minimum of two days off per week from organized training and competition. Athletes should not participate in other organized team sports, competitions and/or training on rest and recovery days.
6. Rest and recovery time from organized sport participation: Adolescent and young athletes should spend time away from organized sport and/or activity at the end of each competitive season. This allows for both physical and mental recovery, promotes health and well-being and minimizes injury risk and burnout/dropout.
I believe this may be one of the biggest factors in growing injuries. Every animal species has a period of youth that is filled with play (humans have the longest period) because play is essential to development. Babies spend most of their first year of life developing their base movement patterns; rolling, crawling, kneeling, and squatting - all before walking. They practice these patterns
all day long and build the base for all movement skill to develop. Kids continue this movement exploration with free play. It is their brain's way of fine-tuning movement. When we sacrifice free play in the name of organized sport, we can lose that base movement and develop kids who may be incredibly skilled at one sport but cannot perform basic movement skills such as standing on one leg or squatting. Climbing, spinning, rolling, hanging upside down and swinging - all things that are now considered "dangerous" - may actually be crucial parts to our vestibular development. (11) Even spending time sitting on the floor can be beneficial (12). Todd Hargrove wrote one of my favorite books "Playing with Movement" that highlights the need for play in both kids and also adults. He states:
"Play is not about doing things that are immature, frivolous, or trivial. It is about getting absorbed in an activity that is intrinsically motivating."
Play fosters good movement, which is crucial to sport success and reducing injury. It is an essential part of brain development which can also factor into injury resilience. It is intrinsically motivating and fun, which means it's not stressful. Allowing time for free play can help drastically reduce injuries later in life. As athletes get older and play becomes less frequent, strength training and plyometrics may help fill the gap but they are most successful when a good base of movement has been solidified in childhood.
Adams, J. J. (1970, January 1). Fear, Greed, Broken Dreams: How Early Sports Specialization Is Eroding Youth Sports. Vancouver Sun. Retrieved October 28, 2019, from https://vancouversun.com/news/local-news/fear-greed-broken-dreams-how-early-sports-specialization-is-eroding-youth-sports
Berg, A. (2019, October 1). NATA releases guidelines on Youth Sports Specialization. Athletic Business. Retrieved October 28, 2019, from https://www.athleticbusiness.com/athlete-safety/nata-releases-guidelines-on-youth-sport-specialization.html
Brooke-Marciniak, B. (2016, February 4). Here’s Why Women Who Play Sports Are More Successful. Fortune. Retrieved October 28, 2019, from https://fortune.com/2016/02/04/women-sports-successful/
Carlson, N. (2019, February 1). 5: Bone Health and Staying Healthy. Retrieved October 28, 2019, from https://itunes.apple.com/podcast/id1447184160
Douillard, J. (2019, October 28). 70% Of Kids Quit This By Age 13 - Dr. Douillard’s LifeSpa. John Douillard’s LifeSpa . Retrieved October 28, 2019, from https://lifespa.com/70-of-kids-quit-sports-by-age-13/
Hanscom, A. (n.d.). The Case For Recess - Why We Need To Bring Back Free Play - TimberNook. TimberNook. Retrieved October 28, 2019, from https://www.timbernook.com/the-case-for-recess-why-we-need-to-bring-back-free-play/
Hargrove, T. (2019). Playing with Movement.
Holmes, B. (2019, January 11). ‘These Kids Are Ticking Time Bombs’: The Threat Of Youth Basketball. ESPN.com. Retrieved October 28, 2019, from https://www.espn.com/nba/story/_/id/27125793/these-kids-ticking-bombs-threat-youth-basketball
Miner, J. (2016, June 1). Why 70 percent of kids quit sports by age 13. Washington Post. Retrieved October 28, 2019, from https://www.washingtonpost.com/news/parenting/wp/2016/06/01/why-70-percent-of-kids-quit-sports-by-age-13/
Myer, G. D., Jayanthi, N., DiFiori, J. P., Faigenbaum, A. D., Kiefer, A. W., Logerstedt, D., & Micheli, L. J. (2016). Sports Specialization, Part II. Sports Health, 8(1), 65–73. Retrieved October 28, 2019, from 10.1177/1941738115614811
Rogers, M. (n.d.). U.S. Women Were Multi-sport Athletes Before Focusing On Soccer. USA TODAY. Retrieved October 28, 2019, from https://www.usatoday.com/story/sports/soccer/2015/07/03/abby-wambach-morgan-brian-lauren-holiday/29665797/
Schlanger, Z. (2018, April 22). Just Being Outside Can Improve Your Psychological Health. Quartz. Retrieved October 28, 2019, from https://qz.com/1258538/just-being-outside-can-improve-your-psychological-health-and-maybe-your-physical-health-too/
Starrett, K. (2019, September 18). Ground Game: Why Sitting More On The Ground Can Transform Your Life - The Ready State. The Ready State. Retrieved October 28, 2019, from https://thereadystate.com/why-sitting-more-on-the-ground-can-transform-your-life/