Our Young Athletes – Are we encouraging “overuse injuries?”

The 3 to 5 year old happens to show an advanced skill level in a particular sport. Perhaps he/she happens to have a very mature approach to the golf ball; or a very advanced swing at the pitch; or an extremely gifted control of the soccer ball; or is equally adept at handling/dribbling a basketball with either hand.

At 3 to 5 years of age, what should be the normal suggested path of development, both physically and behaviorally, probably be?

What generally happens today is the arranging of play dates. However, if we see a glimmer of talent on the field (or in the gym), play dates are substituted for managed sports skills sessions or camps. Perhaps we enroll the youngster in some sort of seasonal activity such as soccer or T-ball. Or perhaps it is an early gymnastics class. We also would like to feel that we expose the youngster to proper nutrition because that would be a better basis for good good health. Although the sales of quick snack packages loaded with sugar and preservatives seems to be quite high and stable! We arrange for these "focused” or more dedicated sports enhancements partially because today’s early school years are much more dedicated to academic achievements and partially because we seek a "fast track” to development in a particular sport.

Of course, 50 years ago, the first year in school was almost completely unstructured, although monitored. The time after school was more unstructured than today, allowing the child to play more of a role in selecting what to do and with whom to do it. Between 5 and 10 years of age the child probably had more "free choice” time along with less supervised time outside of the house. Sports were more under the control of the youngsters. The group of kids met, improvised some equipment for whatever they decided to play (e.g. rolled up and taped newspaper for a football, or broomstick and rubber ball for street baseball often referred to as "stickball”) and then proceeded to "choose up sides / teams.” The refereeing or umpiring was left up to those who shouted first and loudest. One did not become over zealous in calling fouls because one knew that if he/she developed the reputation of always making the call, they would either get picked last at the next go-around or perhaps not even invited to participate.

There were occasional injuries; some kids developed into the better athletes. Most good athletes competed in a number of sports, and there were those who, for the level of competition at the time, even made it to the level of professionalism. The high school level schedules were roughly 10 game schedules allowing youngsters to compete in a number of sports. The college schedules were a bit longer, yet still short enough to allow for a greater number of multi sport athletes. At the recreational, school, and collegiate levels, most athletes developed nurtured bonds with their coaches that extended beyond what the youngster contributed to the team by virtue of a skill.

Fast forward 50+ years. Today, as soon as, or if and when, the youngster shows an unusual advanced talent for a sport, out comes the life long plan, even if it means starting at 5 years old (or as is the case with some, as young as 3 years old). It might mean taking out a second mortgage on the house, but nothing will be spared for the cost of the upscale equipment, the "better” training facility, the proper personal trainer or coach, or even the better geographic location for optimum exposure. There is a documented case of a family, with more than one child, selling the family business, virtually sacrificing one child’s needs in order to support (e.g. equipment, registration fees, travel expenses) the other child’s apparent talent in a particular sport.

In today’s atmosphere, there exists a pressure from a variety of perspectives to expose the child to the particular sport all year around, and also to increase and speed up the physical development of the child. In addition to the youngster’s increased intensity to exposure in that one particular sport, usually there is less opportunity for the youngster to experience interacting with other youngsters of comparable age who are not as involved in that one sport. This extreme focus on becoming an elite athlete may even interfere with or slow down social development. So now we have more time being managed by someone other than the youngster. More decisions are being made for him/her, so that he/she remains on schedule for improvement and development for higher and higher competitive exposure. Then of course there is the concern for making sure that the youngster moves from environment to environment that will allow for more and more "proper” exposure. The "right” coaches from the "right” clubs, high schools, colleges or perhaps even professional groups have to see the youngster.

With such intense management throughout the year, including the designed overseeing and probable pampering of the youngster, how difficult are we making it for he/she to learn how to cope and make decisions for themselves. It is interesting to see in sports that involve team play in constant motion (e.g. basketball or soccer) one frequently sees the coach dancing up and down the sideline constantly shouting instructions to just about every player out there…which of course results in the youngster trying to play while at the same time honing in on listening for what to do, instead of learning to recognize and respond for him/herself during the competition, and developing the attentiveness to instruction during practice times or times out during a contest.

It seems as if today’s young athlete has been so insulated via controlled regimentation by the "trio”…the parent, the coach, the trainer…that social skills, money managing skills, personal interacting skills, coping skills, or decision-making skills have been farmed out to the "trio”. During this process what appears to be happening is that there is such emphasis on the development for the particular sport that very specific parts of the body are becoming overworked. Although there are some muscle groups and related bone usage that are more generic, each sport requires some very specific muscle function and bone usage. The result being that there is an increased risk of what is becoming known as "overuse injuries” and "biased development.” This is a phenomenon that we are becoming aware of and tracking only within the last few years. How many consumer products are there that we would prefer to over use, and run the risk of that product breaking down somehow? Wouldn’t we prefer to have two pairs of shoes so that we can alternate and thus increase the life span of each pair; would not we like to turn the fan off periodically, in order to avoid burning out the motor; don’t we consider that we devaluate any commodity the more we use it because we interpret more use with increased wear and tear and potential function breakdown/ loss?

It appears as if we are creating the conditions whereby youngsters today in the 20-30 year old range group have the muscular-skeletal systems of people two and three times their age and are thus subject to greater medical care at younger ages. How prudent is it to encourage a 15 year old to increase his weight (to the degree where his BMI rises well beyond a desired 25) and then counsel him into maxing out muscle strain constantly and getting him to live in a circumstance that would "allow” him to compete just about 12 months out of the year? How healthy could it be if the 15 year old is being counseled into jumping on a relatively hard surface while at the same time banging up against another "hard body” (typical in basketball) for about 20-40 minutes a game, about 3 - 5 games over a weekend during the summer months, and then 2, 3 or 4 games a week during the school year…and at the same time, finding the time to engage in the increasing straining exercises so as to increase the muscle mass? Why are we asking a 15 year old girl to engage in increasing both torque and concussion (typical in soccer) on the knee for about 40 -60 minutes a game, 2 – 3 games a weekend in the summer and then 2 games a week during the school year. In addition they probably are performing maxing out strength resistance exercises on the same muscles, virtually all year around. In many instances, these youngsters are asked to attend off-season, club workouts, camps, and training exercises between school and or summer games.

Sure, the competition is possibly keener today because the athlete is better developed. He/she might have better skills, they certainly use more technologically advanced equipment, and might even have a higher quality of coaching leadership. However, the young athlete of 50 or more years ago, comparatively, while possibly not as skilled as the athlete today and obviously didn’t have the benefits of today’s equipment, nutrition and training routines, nevertheless had comparable opposition and competition relative to his/her time, and needed whatever it took, as today, to compete at the higher collegiate or professional levels….yet the athlete of history was not exposed to the "overuse” drive that exists today. No mater what the sport was that 5, 10, 15 year olds loved and participated in, they certainly had times of diversity and rest. Throughout the year, while engaging in a variety of sports there was a better chance that more areas of the muscular-skeletal system were being developed, utilized and rested.

For many youngsters, competitive sports are a path out of their socio-economic environment; a door opening to higher education; a chance to enhance their identity. However, for too many it is also an opportunity for parents and/or coaches to profit from the athletic success of the child. So for many reasons, not only do youngsters miss out on opportunities to experience making decisions for themselves or develop coping mechanisms, but they are too often miss-guided by parents or coaches into life style regimens that involve excessive physical stress on very specific parts of the body (especially epiphyseal plates, tendon and ligament anchorages, joint structures)…and thus run the risk of "overuse injuries.” This is in addition to the increased risk of making poor decisions with their life styles.

So, are we treating the kids today as property to be researched, developed, packaged, and then marketed? Is this being done at the expense of their health? Is the young athlete today being treated as an economic asset? Could this be why there seems to be more muscular-skeletal disorders as well as socially-economically miss-managed private lives in the athletic community resulting from poor decisions and questionable values due to over managing, over controlling, and questionable motives and advice on the part of adults?


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