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Avoiding Sports Specialization to Preserve our Young Athletes’ Health

Nicholas, Harbaugh, PTA

Sports Specialization has led to a trend over the past couple of years involving our young athletes: the increase in cases of injuries ranging from simple overuse to breaks and/or sprains. This increase in rate and number of injuries seen in young athletes, according to multiple studies, can be linked to the increase of sport specialization in children.  Sport specialization is defined as “year-round intensive training in a single sport at the exclusion of other sports.”

Sport specialization has been associated with high volume training that can result is psychological and physiological stress in an athlete. This stress has been linked to an increased rate of burnout in athletes, as well as recurring and overuse injuries in multiple studies. Overuse injuries otherwise known as cumulative trauma disorders, are described as tissue damage that is a result from repetitive demand over the course of time. The term refers to a vast array of diagnoses: occupational, recreational, and habitual activities. Along with these studies the American Academy of Pediatrics (AAP) have released statements on their position against sport specialization to prevent these problems from arising.

sports specialization

Children were not always encouraged to specialize in a sport. A factor that may have contributed to this cultural change may be in part due to the increased pressure that coaches and parents place on their children to perform at a higher level to attain a collegiate scholarship or professional contract. In 1993, Ericsson and colleagues proposed a statement that in order for a musician to achieve mastery/expertise in that area you must practice for 10,000 hours. Parents and coaches have adopted this rule and applied it to sports to justify year-round intensive training. Many have adopted and applied this rule to athletes without realizing this was made primarily for musicians. These are high, sometimes costly, expectations for an athlete who performs repetitive, rigorous, sometimes high velocity movements and techniques year round without adequate rest time.

Some people ask “But doesn’t focusing on a sport make our youth excel at that particular sport?” Studies have shown that is not necessarily the case. Some studies have even shown that most multisport athletes (participating in 2-3 sports) show more promise to excel in a sport than a specialized athlete due to an increased overall athleticism and better gross motor function. Many professional and collegiate athletes were multisport athletes.

Examine the Ohio State varsity recruitment habits of coach Urban Myers as they depict a preference for the

young athlete

There have been statements from multiple coaches, along with Urban Meyer’s graph, pertaining to their preference of multisport athletes for example

multisport athlete.  According to Pete Carroll former USC and current Seattle Seahawks coach: “The first questions I’ll ask kids are; “What other sports does he play? Does he play ball? All of those things are important to me. I hate that kids don’t play 3 sports in high school…. I really don’t favor kids having to specialize in one sport.” Dan Starsia University of Virginia men’s lacrosse coach and Tim Corbin of Vanderbilt Baseball both concur with Carroll.

 

If this is the thought process of elite coaches, why, as parents, is ours so different? If the athletes goal is to play in college or to try and make it to a professional level, they need to have an all-around athleticism as most elite athletes do.

Examples of multisport athletes are:

  • Michael Jordan- Basketball and Baseball
  • Abby Wambach- Soccer and Basketball
  • Terry Bradshaw- Football and Baseball
  • Amy Rodriguez- Soccer, Swim, Softball, and Track
  • Tom Brady- Football and Baseball
  • Lauren Holiday- Soccer, Track, and Basketball
  • Babe Zaharias- Track and Field, Golf, Basketball, Tennis, Swimming and Volleyball
  • Wilt Chamberlain- basketball, volleyball and track

With many elite athletes being multisport, we need to get away from the thought process that sport specialization will make our children elite. In fact, sport specialization may be the reason a child does not get to that elite level. With burnout and overuse, reoccurring, and surgery required injuries, specializing in one specific sport may actually do more harm.

Year round training through a child’s growth spurt period places an increased work load on lengthening muscles and developing joints. During a growth spurt, performing consistent intensive training throughout the year will increase the stress that is placed on muscle attachments and the coinciding joints. This increased work load causes an increased risk of joint and ligamentous damage and injury. The more repetitive the motion…the more risk for overuse injuries.

Common overuse injuries associated with sport specialization are as follows with patellofemoral (knee) pain being the most prominent:

  • Osgood-schlatter disease
  • Sever’s disease
  • Medial epicondyle apophysitis
  • Distal radial physeal stress syndrome
  • Proximal humeral physiolysis
  • Stress fracture (e.g. spondylolysis)

A common overuse injury seen in pitchers, for example, is ulnar collateral ligament damage which can lead to having Tommy John surgery. This is the reason why we have pitch counts to limit the amount of stress placed on the elbow joint and the associated ligaments.

To allow proper rest time for the young athlete in organized sports, the AAP recommends

  • that children play multiple sports (2-3)
  • play no more than 8 months a year
  • play no more hours per week than the child’s age (13 year old =13 hours) with a maximum of 16 hours per week total.

You may ask: “What do I if my child is specializing in a sport or gets injured in that sport?” The first thing to do if a child is injured is to get them examined by an orthopedist or physician. Depending on the findings, the next step would be starting a physical therapy plan to address the injury and to examine the mechanics of the athlete and their sport. The physical therapist will help evaluate each athlete’s situation on an individual basis and help to prevent any further injury or re-injury.

If an athlete does not suffer from an injury requiring immediate attention, it is recommended that he or she see a physical therapist to examine their movement patterns and form as well to prevent an injury from occurring and needing any further treatment. Before an athlete gets to that point though, the change must start at home with parents and coaches encouraging children to participate in multiple sports as well as decreasing the amount of pressure to play. After all, the main purpose of participating in sports is for overall physical activity and health and most importantly, fun, and enjoyment!

Talk to your children about their goals and encourage them to participate in more than one sport. Once you know their goals, you will know what they want to achieve! Encouraging diversity in sports can help to decrease the occurrence of overuse injuries.

Nicholas Harbaugh is a Physical Therapist Assistant at FMH Rehabilitation Aspen Ridge Outpatient Clinic.  Nick is experienced in treating orthopedic and sports-related injuries with  traditional land therapy techniques as well as aquatic therapy.


Aquatic Therapy Can Help Get You Back to…

There is no worse feeling than the aching pain that won’t go away, prevents you from accomplishing everyday tasks, and keeps you from doing the activities you love. If you have recently been injured or identified with having a debilitating diagnosis, aquatic therapy may be your answer to a pain-free lifestyle and get back to the activities you enjoy.

Diagnoses for Patients who benefit from Aquatic Rehabilitationaquatic therapy

Spinal Issues: Thoracic, Cervical, and Lumbar Spine Issues, Posture Issues, Spine Compression Fractures, Herniated Discs, and Spinal Stenosis

Imagine you are floating vertically in the pool using a floatation device. Since you are not touching the bottom, the water decreases the effect of gravity on the spine and creates traction. This process removes the pain you are feeling so you can now focus on learning the therapist’s exercises and doing them appropriately. Core stabilization will be the focal point of your exercises as it permits increased trunk/back movement with less pain due to the warmth, buoyancy, and pressure of the water.

Lymphedema Issues

If you have lymphedema issues, you may be experiencing swelling in your extremities. When you find yourself in the SwimEx Pool, you will notice a decrease in the swelling due to the hydrostatic pressure, making it easier and less painful to do strength exercises. This decrease in swelling will also make walking much easier.

Foot and Ankle Issues: Achilles Tendon Repairs or Tears and Toe, Foot, or Ankle Fractures

Typically, your doctor will give you weight bearing restrictions and you will most likely need a device to assist you while you walk and/or a boot. However, due to the anti-gravity properties of the water, you would not have to adhere to the restrictions. Other positive effects would be a decrease in swelling and less painful side effects. The pool helps you recover much faster because it allows you to work on balance in the early stages of recovery. Normally, patients have a hard time working on this if they are not in the pool due to the stress and pain of their foot or ankle.

Knee or Hip Replacements: ACL Repairs, Arthroscopic Repairs of Hip/Knee, and Patellar Tendon Repairs

The water provides a good environment to work on range of motion, stretching, and strengthen of these tender areas. An important distinction between aquatic and land therapy is the level of soreness associated with each, with aquatic causing much less soreness. Also, aquatic therapy allows you to perform most exercises sooner than on land with much less pain, getting you back to normal in much less time.

Fibromyalgia and Chronic Pain patients

Normally physical therapy is the last straw for this type of diagnosis. However, physical therapy in the pool should be one of the first choices since it will help you build stamina, endurance, and strength and manage your pain.

There are many more diagnoses that can be treated utilizing aquatic therapy. If you are not able to tolerate the pain associated with land therapy, aquatic therapy is an excellent alternative due to the anti-gravity environment. You will feel less pain and pressure in the pool and be able to make progress sooner than typical land therapy.

Get the therapy you need so that you can get back to your day-to-day routine and the actives you love. The goal of any rehabilitation team is to get you back to doing the activities you enjoy. Swinging a tennis racket. Walking through the woods. Peddling a bike around town. Pushing a cart down the grocery aisle. Even folding laundry! No matter the activity, enjoy life!

The ultimate goal of any therapy program is to get you back to _______ .   What is your blank?

Contributors: Morgan Thompson, Amelia Iams, DPT, Cynthia Brendle, PTA