In the US alone, 60 million children participate in organized sports. There is immense pressure to be one of the few to attend college on an athletic scholarship, be drafted to play professionally or compete in the Olympics. This shift has led to a rise in early sports specialization and, with it, a rise in injuries. It is important for parents and coaches to understand injury prevention, common treatments and when to seek medical care for their young athletes.

Early sports specialization is a training method adopted by youth athletes before adolescence. It consists of intense year-round training in one sport at the exclusion of all others. Upwards of 41% of young athletes have adopted this method in recent years, which has led to both an increase in overuse injuries and early psychological burnout.

Studies have demonstrated a poor knowledge base in both parents and youth coaches regarding injury prevention. As youth athletes are still growing and developing, it is important to maintain a well-balanced diet with sufficient vitamin D and calcium for bone support. Maintaining consistent follow-ups with a child’s pediatrician will allow parents to know when their child is at risk of injury. Poor development, missed menstrual periods and prior injuries are risks for future injuries. Growth spurts, when there are expected changes in bone and soft tissues, are a prime time for developing overuse injuries; improving flexibility and biomechanics may protect youth athletes from these injuries.

Equally important in injury prevention is addressing external factors. Moderating training volumes, participating in preseason conditioning, strength training, using proper equipment and openly communicating with coaches may reduce injuries. It is recommended by the American Academy of Pediatrics that children limit sports participation to the number of hours of their given age per week with at least one to two days off per week and with scheduled rest of at least three months out of the year in one-month increments.

Parents are encouraged to seek medical attention for their youth athletes when there is a visible deformity, persistent pain, swelling, bruising and tenderness that are not improving or when they are unable to bear weight on the extremity. The most common injuries are overuse injuries and stress fractures. Treatment is largely dependent on both the location and severity of the injury, which is generally evaluated with imaging starting with an X-ray. For lower-risk injuries, rest, rehabilitation and graded return to exercise are followed. Higher-risk injuries, or those with poor healing, may require surgical intervention with greater time out of play.

Early sports sampling, which promotes movement diversity through involvement in multiple sports, protects against injury and is recommended over early sports specialization. In general, athletes are able to specialize in one sport in late adolescence, according to multiple medical associations, including the American Medical Society for Sports Medicine; an athlete is better able to optimize their physical, psychological and social skills during this time. Together, parents, coaches and physicians should prioritize safe involvement in athletics for children.

Dr. Taylor is a first-year resident at Halifax Health – Family Medicine Residency Program and Sports Medicine Fellowship.

Dr. Hinman is the Sports Medicine Fellowship Program Director at Halifax Health.

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