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Young Athletes should delay Sport Specialization until 15 or 16-years-old

By American Academy of Pediatrics, 10/16/16, 2:00PM CDT

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Young athletes who focus on a single sport and play it year-round — sometimes on multiple teams — may think they're boosting their odds of playing in college or even professionally.

But they may be hurting their chances instead, according to a new clinical report from the American Academy of Pediatrics authored by a local physician.

Overuse injuries and mental burnout are sidelining too many kids and teenagers, says Dr. Joel S. Brenner, medical director of the sports and adolescent medicine programs at Children's Hospital of the King's Daughters and the report's lead author.

"If they're playing multiple sports, they're learning different skills that will transfer over to their primary sport," Dr. Brenner says. "They're training different muscles and allowing their other muscles time to recover. If they do the same sport with no break, they also can start to feel a lot of stress and anxiety and perhaps not want to remain physically active at all."

About 50 percent of all athletic injuries are related to overuse, and 70 percent of children drop out of organized sports by age 13, according to the report.

The AAP report recommends delaying specialization until age 15 or 16 at the earliest, when physical growth is more complete and a player is better able to decide how much time he or she wants to devote to a sport.

Athletes should take at least three months off from their primary sport during the year, in month-long increments, as well as one to two days off per week. The AAP also advocates a ban on ranking youth athletes nationally or recruiting them for college until late high school.

The report, "Sports Specialization and Intensive Training in Young Athletes", was published in the September issue of the journal Pediatrics. It updates position statements first published in 2000, addressing a youth sports culture that has moved even more toward year-round sports.

Local doctors and physical therapists see a variety of overuse injuries in kids and teenagers, including stress fractures, muscle and tendon damage in joints and abnormalities in the growth plates, or tissue that grows near the end of long bones before adulthood.

The problem isn't just in playing a single sport, but also in playing sports that require similar movements, says Michael Satterley, a physical therapist and clinical director of Tidewater Physical Therapy's Oyster Point Clinic in Newport News. Swimming, baseball, volleyball, tennis and lacrosse, for example, all involve overhead motions that can lead to shoulder injuries, a frequent problem he treats.

"The body is really not designed for that much repetition," Satterley says. "Athletes need to pay attention to pain signals and work in some opposite movements. Those who use a lot of overhead motions, say, would benefit from strengthening their back muscles."

Symptoms of emotional burnout include fatigue, personality changes, little enthusiasm about practice or games and trouble completing usual routines. Athletes who feel a lack of personal control over sports decisions, and who face intense time demands and frequent negative feedback, are at higher risk.

Increasingly, parents, kids and coaches can feel a pressure to specialize that is tough to resist, Brenner concedes. Yet with the exception of sports where peak performance comes before maturation, such as gymnastics or figure skating, many successful athletes actually don't pick a single sport early. In this year's NFL draft, 90 percent of first-round picks played multiple sports in high school, Brenner says.

Sports that seem unrelated can improve the way an athlete plays his or her primary sport, notes Mike Kuebler, owner and head instructor of Colonial Baseball Instruction in Williamsburg and a former college player and high school coach. A baseball player who also plays football, for example, has learned how to fall to the ground without getting hurt.

That skill is rarely practiced on the diamond, on the other hand. "So when something does happen in a baseball game like diving for a ball, evading a tag or getting out of the way of a pitch, you may end up getting injured," Kuebler says.

In his experience with college recruiting, coaches often are happier to see diversification, Kuebler adds: "Many of them would rather have the player that plays multiple sports, so they know they are getting someone that is more athletic and will have a decreased chance of getting injured."

For parent Kelly Ashe of Yorktown, having her sons in multiple sports has helped keep their overall focus on education, family time and friendships. Bobby, 13, does football, basketball, wrestling and baseball; Carson, 10, is involved in football, basketball, track and soccer.

"I have had a few parents and coaches tell me that they might be better if they played just one sport," Ashe says. "I want them to dream big, but I don't want them to base their self-worth on how they do in sports. I am realistic: the chances of 'making it' are very slim. I don't want them to look back on their lives and realize they missed out on all the fun of being a kid."

Brenner, personally, has fond memories of playing street hockey as a boy in Buffalo, N.Y., until his fingers were frozen and it was too dark to see the puck. So he's a big advocate of "deliberate play" – exercise for pure enjoyment, outside of structured practices or competitions.

"We've got to remember what the real benefits of sports will be for most of these kids, in terms of lifelong health," he says. "We need more parents need to speak up and be their advocates."

By the numbers

Youth sports should be mostly about having fun, learning qualities such as sportsmanship and leadership and promoting physical activity for life, a new report argues.

Of high school athletes:

3 to 11 percent continue playing at the college level

1 percent receive any scholarship money

.03-.5 percent go on to play professional sports

About 50 percent of athletic injuries are related to overuse.

Some 70 percent of kids will quit playing organized sports by age 13. Reasons can include injury, mental burnout, time constraints and a lack of playing time.

Source: American Academy of Pediatrics, "Sports Specialization and Intensive Training in Young Athletes", September 2016.