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The Dark Side of Kids' Sports


For many of us, reflecting on childhood sports participation conjures up fond memories. Through youth sports we met the different challenges required for healthy development, demonstrated effort and commitment, basked in success, and learned to cope with disappointment. To watch our own children grow while meeting challenges is one of life's great joys. But I'm concerned that such character-building attributes of kids' sports have become overshadowed today by a culture that is more competitive, is less focused on fun, and produces more injuries.

News reports (and maybe your own experiences) highlight some disconcerting trends in youth sports:

  • As pick-up games go the way of the dinosaur in favor of league play, more and more kids are quitting sports. Fully 70% now drop out by age 13.
  • Often-pushy parents pay large sums for equipment, travel, and coaching fees—and they have high expectations for success. This, despite polls showing that 90% of kids would rather play on a losing team than sit on the bench of a winning team.
  • Almost unbelievably, four of five parents in a National Safe Kids Campaign survey said that injury was "part of the game." More than half expressed little concern about the possibility of their child being hurt.
  • More kids are involved in organized sports at younger and younger ages. The American Academy of Pediatrics, however, recommends no organized sports participation until age 6. Instead, it suggests unstructured play.
  • Young athletes are specializing at earlier ages. The three-sport athlete is becoming a thing of the past.

Perhaps because of this heightened emphasis on specialization, overuse injuries have replaced traumatic injuries as the most common reason for physician visits. Children as young as 8 now sustain overuse injuries. According to the National Electronic Injury Surveillance System, each year more than 3.5 million sports-related injuries in US kids under 15 need medical attention (20 million to 30 million participate in youth sports). This large increase in overuse injuries in children has been anecdotally reported by many, including PSM editorial board member Lyle Micheli, MD. Among the factors cited are novices who are expected to achieve at high levels and already accomplished young athletes who are pushing or being pushed even further.

Children today participate in sports camps and year-round athletic competition. They adopt the competitive sports paradigm with uniforms, nameplates, identification with celebrity athletes, and the specter of scholarships or even a professional salary. Sports participation has become a high-stakes endeavor for parents, leagues, and commercially interested parties.

At the same time, the overall fitness of America's youth over the past two decades has declined dramatically. Without the adoption of lifelong interest in regular physical activity—one of the major determinants of overall health—our children risk diseases associated with sedentary living. And having more kids drop out of sports only makes matters worse.

What, then, is our goal for children's health? Is the competitive sports paradigm, developed at elite levels and transposed to young children, our choice? Is our goal truly to whisk our 12-year-old video-game-playing child into the car en route to one of his 300 days of training and competition and have a $6,000/4,500-mile-per-year commitment? Why should we in medicine leave the reporting of this problem to the lay press? And please, let's not talk pedantically about prevention of injury when all such efforts pale in comparison to a paradigm that is fundamentally flawed.

Next month, I offer some practical solutions for restoring some sanity to what should be one of the most enjoyable times in life. Stay tuned.

Gordon O. Matheson, MD, PhD