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Pushing too hard too young

With more kids than ever in organized sports,  experts in sports medicine and youth athletics say they are increasingly concerned about the pressures put on young children to excel at sports.
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Intense training schedules. Pressure to win and be the best. Painful injuries. Given all these factors, it’s not surprising that some athletes simply burn out on their sport. But what is shocking to many in the field are the young ages at which this is increasingly happening -- sometimes as early as 9 or 10.

The scenario often goes something like this: Eager to nurture the next A-Rod or Michelle Kwan, parents enroll their 5- or 6-year-olds in a competitive sports league or program. Over the next few years, training intensifies and expands to the off-season, making practice essentially year-round. Youngsters may join more than one league or a traveling team. They may have to sacrifice other interests and give up most of the down time that allows them to just be kids.

Soon the stakes get higher because many parents and coaches play to win. Winning means recognition and that could lead to lucrative opportunities -– high school championships then college scholarships and perhaps a shot at the pros.

“Kids sports have become much more competitive,” says Dr. Jordan Metzl, medical director of the Sports Medicine Institute for Young Athletes at the Hospital for Special Surgery in New York City.

“And in general, high-level competition for young kids is not a great thing,” says Metzl, co-author of “The Young Athlete: A Sports Doctor’s Complete Guide for Parents.”

With more kids than ever in organized sports, an estimated 30 million of them up through high school, Metzl and other experts in sports medicine and youth athletics say they are increasingly concerned about the pressures put on some children to excel. Not only are these youngsters at risk for emotional burnout, they may also develop injuries that plague them for a lifetime. Some will turn to steroids or other performance-enhancing substances to try to gain an edge. And some may give up on sports -– and exercise -- altogether.

'It's not fun anymore'
Kids with a strong internal drive may thrive on the competition. But the pressure can be too much for others, particularly grade-schoolers who aren't as equipped to deal with the stress as older athletes.

And the goals of sports for young kids can differ dramatically from those of their parents and coaches, says youth fitness researcher Avery Faigenbaum, an associate professor of exercise science at the University of Massachusetts in Boston.

“Most children would rather play on a losing team than sit on the bench of a winning team,” he says.

When Faigenbaum asks kids who've quit why they're no longer interested in sports, their typical response: "It's not fun anymore." They wanted to have a good time, make friends and learn something new, he says. But make the game all about hard-core training and the final score, and many kids will sideline themselves.

“They’re getting turned off of sports at a young age -– and that’s a sad tale,” says Faigenbaum.

There’s ample evidence that sports participation can have important benefits for kids, including improved physical health and emotional well-being. Hopefully, they’ll also learn life lessons in teamwork, discipline, leadership and time management. But kids can't profit from these benefits if they're quitting sports early on.

A new ball game
While parents may have spent much of their early childhoods riding bikes around the neighborhood, playing pick-up games of baseball or basketball with the local kids and maybe joining Little League, today’s youngsters often fall into two disparate groups: those who sit inside playing video games and those who participate in organized competitive sports like soccer, ice hockey and basketball.

A big difference today is that kids involved in sports play harder and younger than ever, says Steve Marshall, an assistant professor of epidemiology and orthopedics at the Injury Prevention Research Center at the University of North Carolina at Chapel Hill. And with dreams of college scholarships and multi-million dollar professional contracts, the competition can get out of hand, he says.

“Youth sports have become about more than kids having fun," says Marshall. "Frankly it’s beginning to get out of control. It’s almost a national obsession.”

Certainly coaches who treat young athletes like military recruits can be a big problem. So can athletes who take the game too seriously and play when they’re injured or, as they enter the teen years, turn to performance-enhancing substances that they hear of their idols in the big leagues using.

Parents the prime culprits
But experts in the field mostly point to parents as the prime culprits in promoting a competition-crazed environment in youth sports.

"Parents tend to think everyone’s going to the Olympics,” says Patrick Mediate, a physical education teacher and coordinator of the strength and conditioning program at Greenwich High School in Greenwich, Conn.

Of course, many parents are a positive force, supporting their children and making sports participation possible by taking the time to drive kids to and from practice and games. But parents who live vicariously through their children can be problematic, experts say. It's one thing for kids to dream of Olympic gold medals or Super Bowl rings and to work toward those goals. But it's another matter if parents are pushing their kids to do something they don't want or pressuring them to succeed in a way that’s hurtful.

Marilyn Enmark, a youth soccer coach in Detroit, says she’s seen her share of overbearing parents.

Recently, one of her players, a 7-year-old boy, hit the boards during an indoor game and was holding his head. His father, a former soccer player himself, went over to the boy but rather than asking him how he was feeling, scolded him for playing poorly. A week later, his mother called him over after a play and she, too, sharply criticized him. “He was sobbing,” Enmark says.

Parents -- and coaches -- who push too hard too young, particularly when they emphasize winning above all else, can easily wipe out a child’s motivation to play, says Dr. Henry Goitz, chief of sports medicine at the Medical College of Ohio in Toledo.

“They may be preventing the next Michael Jordan from coming to be,” says Goitz, a team physician for the Toledo high schools and a former team doctor for the Detroit Lions. “They can take the heart out of a kid.”

But not all pushing is bad, says Michael Bergeron, an assistant professor of pediatrics at the Medical College of Georgia in Augusta. He acknowledges, however, that there's no good answer on where to draw the line.

“You need to know your child,” he says. If kids truly hate a sport, then let them quit. But maybe they just need some encouragement. Some 19- or 20-year-olds may wish their parents had pushed them more to stick with sports when they were younger rather than giving up, he adds.

Injury toll
Aside from the psychological pressures that young athletes may experience from intense training and competition, physical complaints are a growing concern, sports medicine specialists say.

One of the most comprehensive surveys to date, by the Centers for Disease Control and Prevention, found that from 1997 to 1999 sports and recreation-related injuries were more common nationwide than injuries from traffic accidents. Americans ages 5 to 24 were most likely to be treated for sports-related injuries by health professionals. Kids 5 to 14 had the highest injury rates of all -– 59.3 episodes per 1,000 people. That’s slightly higher than the rate for people 15 to 24 (56.4 per 1,000) but substantially greater than the rates for those 25 to 44 (21 per 1,000) and 45 and up (6.2 per 1,000).

A fifth of kids lost one or more school days a year because of their complaints. Strains and sprains accounted for the most injuries overall, followed by fractures. Among kids 5 to 14, bicycling was associated with the most injuries, followed by basketball, football, playground equipment and baseball or softball. In those 15 to 24, basketball and football were linked to the most injuries.

Greater sports participation, particularly among girls in recent decades, is one reason injuries appear to be rising, experts say. A study published last September in the Journal of the American Medical Association showed that over the last 30 years in the area around Rochester, Minn., forearm fractures, many of them resulting from sports and recreation activities, increased 56 percent in girls and 32 percent in boys, mostly among kids in the preteen and early teen years. Also on the rise are knee injuries known as anterior cruciate ligament, or ACL, tears that are more likely to affect girls, often those who play basketball or soccer.

Another factor that contributes to sports injuries is the couch-potato culture where kids lounge around all summer watching TV, for instance, and then jump into a sport in the fall when they’re woefully out of shape. “The musculoskeletal systems of boys and girls may not be prepared for sports,” says Faigenbaum. “They’re an absolute set-up for injury.”

On the flip side, too much training can lead to overuse injuries such as "Little League elbow," which results from repetitive throws, and stress fractures.

Metzl diagnosed a pelvic stress fracture in one 9-year-old girl who had been playing soccer two to three hours a day, five to six days a week. But in kids like her, diet could also be a contributing factor. Too much soda and not enough milk can weaken bones. So he now orders bone density tests on young athletes with curious stress fractures and tracks the kids over time.

Early specialization questioned
A big issue, many experts in the field say, is the push for kids to specialize in a single sport very early in life –- well before puberty.

“This has backfired in our faces,” Faigenbaum says. “It truly doesn’t work.”

Kids may hone certain skills in a particular sport with early, intense specialization, but they can also burn out emotionally and physically. And they may not necessarily be achieving the goal they or their parents hoped for -- becoming the best athlete they can be in that sport, he notes.

“When you play different sports, you use a variety of motor skills -– jumping, running, twisting –- that can transfer to a lot of sports,” Faigenbaum says. But if young kids focus on just one sport, they may not reap these benefits.

“There’s absolutely no evidence that says that if a [child] athlete plays just one sport that will guarantee success as a teen or adult,” he says, adding there’s actually more evidence that if they diversify they’ll play better. Ask most pro athletes what they were doing at age 10, he says, and most will say they were playing two to three sports, not just one.

Focusing on a single activity also puts all of a young athlete's eggs in one basket, says Metzl. If kids don’t try other sports, how do they know whether or not they might like those sports more -- or be better at them?

And even top-notch athletes can tire of their sport because of what it takes to win. At Greenwich High School, the boys' swim team program has been hugely successful, losing only one meet in the last 25 years. But just a handful of the athletes have gone on to swim in college, says Mediate.

“They have double practice sessions -- morning and night –- almost every day for 10 years,” he says. “So it does add up. It’s burnout.”