It’s no secret that young athletes get injured more these days than their parents did playing sports as youths. And it should be no real surprise why. One of the biggest differences between children’s sporting experiences nowadays and their parents’ play at a young age is the prevalence of single-sport specialization.
Parents today are under significant pressure for their child to specialize early in a single sport, to participate season after season, and to move through the developmental pipeline and up the competitive ladder.
If kids don’t select their specialty sport early, they won’t excel in it — and they won’t have that extra edge. The fear, as it were, is that the child athlete won’t qualify for the elite travel or high school team, and definitely won’t be able to play a sport in college.
At the same time, Safe Kids Worldwide reports that 1.24 million kids were seen in emergency rooms for sports injuries in 2013, and kids aged 13-15 years old accounted for 37 percent of those injuries.
Over the course of my almost 20 years working at Capitol Rehab of Arlington, the number of adolescent children we see with overuse injuries and ACL tears has increased significantly.
So what is the reason young athletes get injured so much these days, and what is the relationship between increased overuse injuries and participation in only one sport?
Repetition is one explanation.
Children naturally go through adolescent growth spurts, but unlike athletes who participate in multiple sports, single-sport specialization from a young age subjects student athletes’ bodies to repetitive forces for pretty much the entire year, making them uniquely vulnerable to injury.
Two reasons explain this vulnerability. First, during adolescent growth spurts, the long bones grow quickly, but the associated tissues that are in and around those bones, including tendons, ligaments, and cartilage are weaker initially, and their ability to accept repetitive high loads isn’t as developed as when they have fully matured tissue. This repetitive micro-trauma to the tissues can lead to problems such as Osgood Schlatter’s, which is inflammation below the knee that occurs during growth spurts; Severs Disease, a common heel injury in young people; growth-plate injuries; shin splints; and an ongoing list of growth-related problems.
Second, the adolescent body shoots up quickly, changing its size and center of gravity, and unfortunately the brain can’t keep up and recalibrate quickly enough. Boys grow fastest between 14 and 15 years old, and sometimes can grow up to 4 inches in a year. Girls’ fastest growth usually occurs between 12 and 13 years of age, and they can grow as much as 2½ inches in a year. During these ages, children often will experience a temporary decrease in overall skill, speed, and coordination, and their movement patterns change, making them more susceptible to injury.
Evaluation and assessment of movement patterns, and movement-based strength in foundational movements required in sports such as running, squatting, jumping, lunging, pivoting and rotating is essential to injury prevention.
Although it is impossible to prevent all injuries, at Capitol Rehab of Arlington we focus on being proactive, not reactive. Assessing if a young athlete is executing the proper mechanics needed during training is crucial to avoid unnecessarily subjecting tissues to excessive forces.
Once deficiencies are identified, movement training becomes the focus to make these foundational movements rhythmic and natural by recruiting correct movement patterns through repetition — and building confidence in these movements.
It is encouraging to see children participate in sports, and to take physical activity seriously. But with organized sports, travel, and select teams becoming more prevalent, it is important that parents and coaches do not sit back and assume adolescent injuries are unavoidable. They can be prevented, and repairing deficiencies and concentrating on strengthening alternative muscles used in sports is a good way to reduce the risk of injury.