Give Kids A Break!

Injury Prevention

By Dr. Marc Kowalsky

For many of today’s young athletes, summer break includes a sports camp that provides concentrated training in their specialized sport. But according to ONS Sports Medicine Specialist and Orthopedic Surgeon, Dr. Marc Kowalsky, early sports specialization is the last thing they should be doing with their free time.

“There is an increasing body of evidence indicating that early sports specialization does more harm than good. In fact, it seems as though it actually decreases the potential for success in the sport in the long term,” he said.

Dr. Kowalsky also noted that children who specialize in a single sport before the age of 13 don’t develop the protective neuromuscular patterns that help prevent stress to a single area of the body.  Because young athletes are less likely to perform technical repetitive skills properly, these children are more prone to overuse injuries that can sideline them later in life.

“The risk of injury doubles for children involved in excessive organized play at early ages over children who participate in an appropriate amount of free play,” Dr. Kowalsky said.

Children who undergo early sports specialization also increase their risk for psychological burnout. Overtime it can manifest as mood disturbances, social isolation, and eating disorders. “These kids often drop out of the sport altogether as they get older,” he said.

Despite popular belief, early sports specialization does not guarantee elite performance later in life. A study of elite adult athletes at amateur and pro levels revealed that elite success did not require exclusive participation in a single sport until their high school years. Instead, top players participated in multiple sports in the preceding years, developing important movement patterns that made them stronger over time.

“Sports diversification actually increases overall athleticism, and the chance of a young athlete achieving elite status,” Dr. Kowalsky said.

The trend toward early youth sports specialization is relatively new. Twenty years ago, young athletes typically played a particular sport only during a given season (i.e. football in the fall, baseball in the spring, swimming in the summer), and most kids rested from competitive sports for a season or during the summer.

The surge in throwing injuries, stress fractures, and other overuse injuries in younger athletes reflects the physical pressures affecting today’s young athletic bodies.  A recent study found that high school athletes who had trained in one sport for more than 8 months in a year were more likely to report a history of overuse knee and hip injuries, as opposed to those who played a variety of sports throughout the year or played at less intense levels.

The vast majority of injuries associated with excessive specialization and training are overuse injuries. Overuse injuries develop slowly over time, starting perhaps as a mild twinge before progressing into relentless, often debilitating pain.

Thankfully, these injuries are relatively easy to treat when recognized early, with a period rest and activity modification.  All too often, however, players, their coaches, and their parents, are reluctant to have the athlete sit out a few practices and games.

Left untreated, overuse injuries can lead to more significant structural damage to an affected area. Therefore, it can require lengthier rehabilitation and sometimes surgery.

What’s more, repetitive activities such as throwing or running can lead to changes in the development of growing bones and joints. For example, significant amounts of pitching during adolescence can change the rotation and shape of the shoulder.

“The musculature and bones of the developing thrower are not prepared for the excessive numbers of pitches they throw in a game,” said Dr. Kowalsky. This in part has contributed to an epidemic of young athletes suffering ulnar collateral ligament (UCL) injuries, which sometimes requires the so-called Tommy John Surgery.

The solution is simple, but that does not mean it is easy. Dr. Kowalsky recommends the following practices for children under 13:

  • Make time for unstructured play.
  • Keep the ratio of weekly hours of organized sport to free play below 2:1.
  • Weekly hours of sports participation should not exceed a child’s age, or total of 16 hours in teen players.
  • Athletes of all ages should participate in some sort of supervised strength and conditioning program.

Dr. Kowalsky also recognizes that in today’s competitive environment implementation of these steps can be easier said than done.  Parents and coaches should keep in mind that the ultimate goal is to make sure their children remain free from injury, so they can maximize enjoyment and success in their sport of choice.

About Dr. Marc Kowalsky

Dr. Kowalsky is an orthopedic surgeon and sports medicine specialist at Orthopaedic & Neurosurgery Specialists (ONS). He has expertise in the surgical and nonsurgical management of shoulder, elbow, and knee sports injuries. To schedule an appointment, please call (203) 869-1145 or click Schedule Appointment today.