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March 10th, 2010
07:00 AM ET
A 'silent epidemic' for teenage sports injuries
By Madison Park Teenage athletes who play in multiple leagues and participate in sports year-round tend to overuse the same muscles and joints. The overuse could lead to serious injuries such as dislocated shoulders, torn anterior cruciate ligaments and ligaments usually seen more often in adults, said Dr. Thomas DeBerardino, an associate professor of orthopaedics at the University of Connecticut Health Center. DeBerardino will moderate a session at the American Academy of Orthopaedic Surgeons conference in New Orleans, Louisiana, this week about adolescent sports injuries. Calling the wave of injuries a “silent epidemic,” he said he sees three major areas of injuries- head, neck and knees. Some young players play on year-round schedules and with several teams. “If you’re on multiple teams, that is detrimental to the overall health of their kids’ shoulders and knees,” he said. “It comes down to being overscheduled. Along with being overscheduled, they’re overexposed and potentially injured. “They never have a break. This increases risk of overuse and the adult-type injuries like stress and ligament injuries.” One example DeBerardino cited is youth baseball. Young pitchers could end up racking high pitch counts in each of their various leagues and increase their risk for elbow and shoulder injuries. His advice to teen athletes is simple: Learn to listen to your body. “Each kid and body is different,” he said. “Everyone has a different thresh point. You get an injury if you’re over-fatigued, you’re doing too much and you don’t have enough of a recovery period. Each parent and person responsible for the kid needs to pay attention. You don’t have to examine the kid. Ask them if they feel overwhelmed, over-challenged. When you need a break, you need a break.” And the reality is not every kid is going to be a Zack Greinke. Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.
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I grew up swimming, and I had to quit at the age of 12 due to overuse resulting in multi directional instability. It has been over ten years since then, but I've had 3 surgeries as a result, and I am facing the possibility of a 4th. I think it is important for parents and coaches to be aware of potential injuries.
While I'm not sure I'd call it a 'silent epidemic', I don't think my parents ever even considered my injuries as a possibility. I was just doing something I enjoyed and was good at. A lot of the injury could have been prevented with proper stretching and strengthening, which my coaches should have provided and my parents would have loved to have been educated on.
Texas 13 shows us exactly what is wrong with Texas football with this quote:
"Tell a cyclist to come put on a football uniform and see how long he lasts and well see how it compares to a real sport"
When Texas13 says "see how long he lasts" he means how long before he suffers a catastrophic injury. Texas13 is equating catastrophic injuries with "real sport". That's messed up.
A good friend of mine, former linebacker from Nebraska U., tells me that a Dallas high school football coach once tried to institute a rule that boys couldn't go for a sport unless they also tried out for football. Fortunately this was shot down, but the fact that it was even attempted speaks volumes to the callous attitude Texas football has towards their children's health. BTW my friend blew out his knee while at Nebraska thus ending his football career.
I'm a healthcare provider that takes care of teens and sports med is a big part of it. This is a significant problem. I think team sports or individual activities are great for people. The problem is idiot parents or coaches who pretend they are in Major Leagues. Professional athletes of all kinds take breaks, they don't plan MLB all year round; why should 11 yo's do that? Curveballs/sliders? Until you are in late high school– 16-17yo, maybe?? you don't need to throw curveballs or sliders. In little league learning to throw accurate fastballs, or even change ups, are more appropriate and better for them if you are looking to have success at higher levels later on.
Most people re reasonable and understand this, but there is still a group of "macho" morons who think they are managing MLB teams in little league
I am responding to Michael Wong. He stats that he does not feel that team sports are even healthy. My god with some many children over weight in this country. More kids need to get up a play a team sport. Instead od sitting in fron tof the television or computer. I do understand parents putting children in too my sports at the same time but there are not enough kids getiing outside and playing sports anymore.
I have 5 kids, 2 in sports right now. We do little league in the spring – summer, football in the summer – fall, and basketball in the winter. I wasn't happy with some of the things I saw over the years, pushing the kids too hard, it being more about winning than fun, etc. I also saw the good things, my kids have formed friendships that have lasted longer than friendships they have made at school. I've seen single parent kids get some form of structure that seemed to help them out. Better confidence and self-esteem in the kids that participated. To me the positives have outweighed the negatives.
This past year, I've decided that if I didn't like what I saw, I should push to make changes rather than walk away. I've gotten involved as a coach for baseball, and on the board of directors. My primary goals are to make it fun for the kids, and keep them safe. If they learn something about baseball or football along the way, even better.
Michael Wong, I would just note that you cite skiing as an alternative to team sports. Skiing is very injurious, just look at the statistics. Did you notice how many olympic skiers/skijumpers were "coming off of a torn ACL in 2007" ect?
Another point is that this a great discussion that needs to be had, but don't fall into the fools bargain of choosing sports over no sports. I sit with both swim team and swim lessons parents while our kids are in the pool together. The swim lesson parents talk about the swim team kids like they are missing out on their childhood. That's extreme, and I wonder if they are not just mad because my kids have become internally motivated competitors, while theirs keep looking up to see if mom noticed they could swim without floaties. Sports and life need to be kept in balance, but being on a competitive team is better than being on the high school pot-smoking team, which is a place that non-competitive slackers are more likely to end up. (Yeah, I know, insert Michael Phelps joke here.)
I have to strongly disagree that team sports builds some skills such as leadership ... Some coaches are able to make it happen, most don't. Some sports just build the idea that the player is the most important thing at school (unjustified self-importance). Their is value in sports, no doubt, but it's not the only game in town.
Try character building orgainizations such as scouts.
And Devin, anyone that calls someone an idiot should look in the mirror.
I've been doing competitive sports non-stop for 25 years. Injuries are not caused by year-round play. They are caused by trying to do a movement that you have not properly conditioned yourself for. Physical conditioning specific to the sport being played is necessary to avoid injury. If you've got weak shoulders, but you try to throw a baseball like a major league pro, you're going to tear something. You have to build yourself up to play like that. The "epidemic" of injuries among our youth is most likely due to the fact that our youth are so grossly out of shape! Even at the age of 40, I can still out-run, out-lift, out-maneuver, and out-last any teenage girl in this country. That's sad really. They should be running circles round me.
I have personal experience with this topic. I had a long baseball practice on a cold day in 9th grade, and my arm began hurting afterwards. I was out for about a month due to pain in my elbow, and eventually quit playing my favorite sport due to my injury. I am now 28 years old, and I can no longer throw a ball with more than about a 60 % effort. When my son is of age to toss a ball around, I'm not even convinced that I'll be able to always take part in it. I was always a little hearbroken that I could not play the sport that I loved, but I was just pushing myself too hard. I think this is common, and parents should pay more attention to it.
My son played soccer, baseball, and basketball and that kept him motivated and on track until he was 14. Feeding your child a diet high in omega-3 and green vegetables won't hurt either.
Most young athletes hurt their arms by pitching too much. Everyone has heard about little league elbow. Some boys play 150 baseball games a year and that's about 50 too many. Children should be limited to 200 pitches a week.
But that's impossible to do – so you get injuries. And a child will always want to do what he's best at – if that's pitching instead of hitting or fielding then the arm wears out.
I saw a comment regarding individual sport and I disagree. I played tennis for 8 years through high school and college and never had an injury and I played my heart out. It just depends on the situation and the person playing the sport. The repitition injury you refer to can be seen in pitchers, basketball, soccer, hockey, volleyball and plenty of other team sports too.
Some programs are overboard. In my area, there are kids that play soccer/lacrosse/basketball year round. meaning the seasons never end. They may get a few weeks of a break in maybe June when school gets out, but other than that, there is a tournament every weekend, practice during the week and even conditioning practices and skills practices along with scrimmage practice. Ridiculous. Some of these coaches encourage the kids to not play high school balls but stay with the club teams to get exposure to college scouts. I think they are over exposed. What ever happened to soccer in the fall, lacrosse in the spring and basketball in the winter with summers to do a few camps and be a kid instead of having collegiate level of practices and training. Get real people. While its good, what percentage of these kids are going to play in college? 10%?
I played football for 10 years and luckily I had no injuries, partly due to how much I focused on strength and conditioning. While I think that football is a great sport for kids to play it's pretty obvious that it results in a ton of injuries. On my college team we would sometimes have as many as 20 guys out from practice for some reason or another.
The main problem with sports like football is it's something that ends after high school for most, and college for almost everyone else. Very few people go on to the NFL or other adult football leagues, it's simply too hard on the body for most to play into adulthood. I think it's important that kids pick up activities that they can do for the rest of their life, so that they don't turn into the fat guys sitting at the bar watching sports after their high school or college career is over.
I severely damaged both of my shoulders in middle school pursuing a wrestling career that at the time I had hoped might one day go to the Olympic level- I competed and co-ed state tournaments, girls only state and national events... now I can't lift more than "40 lbs" with my doctor getting fussy with me because I wasn't encouraged to do my physical therapy. Ten years later, I still have inflammation and pain if I overuse my arms... which doesn't take as much effort as it did when I was younger. And quite obviously, I'm not competing anymore, much less an Olympic level.
Point being... any sport can be overloaded and not only do parents need to change what they are doing with their kids, but doctors need to push to have things treated fully. If I had had a doctor who was vigilant about my rehab, I'd have a lot more use of my upper arms than I do. Instead I am seeing a physical therapist twice a month.
A good warning of the silent dangers of exerting pressure on the same joints. Team sports are the worst because injuries can come also from contact with others or falling down. Non-team sports can be also dangerous when overdoing it. Swimming too much causes damage mainly in the shoulders, running too much in the knees, and so on. And this is not only for teenagers but for everybody. Alternating sports helps a lot.
I am currently a young athlete who plays soccer competitively (my team travels 3-4hrs. away for games, not tournaments, games) 11 months of the year, and that month of a break is only because the club soccer season doesn't start until a month after the high-school season ends. I agree 100% with this article's statement that "year round sports increase the chance of injury." I am the perfect example of that. I have gotten a fracture in the growth plate of my pinkie finger and in the fracture plate of my wrist as a result of soccer. I also had a strained MCL in my knee as a result of soccer. But it doesn't only increase the risk of injury, it increases the risk of illness too, for when your body is tired, your immune system is weakened, and I am the perfect example of that too. In the eighth grade, my last year I played organized basketball. I had mononucleosis from the start of tryouts through all but one or two games at the end of the season, but didn't realize it until I had also gotten strep throat while still unknowingly battling mono. I learned I had mono when strep test found me to have both mono and strep, but i received no medicine to help me fight the mono because I was already well on my way towards recovering from it. In both the injuries and illnesses though, I do not regret my decisions to play year round sports, sometimes consisting of more than one sport at a time, all because I had what is currently in my mind "the time of my life" while playing, and still do have the "time of my life" while playing year round soccer. While this article is correct that year round sports increases the risk for injury, if it doesn't inform you of all the risks increased by playing year round sports, and doesn't take into consideration the enjoyment kids get from playing those sports, then it should not be taken into too serious of consideration. All in all, common sense is the greatest way to fight injuries and illnesses (I probably sound like all those annoying coaches and doctors that lecture you on moderation, but I am dead serious), and if you take one to two days off from playing sports every week, then you will be just fine as long as you eat right, get enough sleep, and know that if you lose games it is not the end of the world (even if it is the end of the season).
Your honest young athlete,
Nick
As a physical therapist, I've seen a tremendous increase in the number of cases of overuse injuries in young athletes over the last ten years. Most of these injuries can be attributed to "year round" participation in club sports and select organizations.
In the old days, athletes participated in various sports that had specific seasons with a definitive beginning and end. Each sport places a different emphasis on various muscles and joints. Having seasons in sports allows athletes to rest the part of the body predominately used by a particular sport by transitioning into a different sport that emphasizes use of a different part of the body. Thereby, the risk of overuse injuries is minimized. Of course, tramatic injuries such as ACL/MCL ligament tears will inevitably occur with any sports participation. But, risk of overuse injuries like tendonitis, patellofemoral conditions, sprains/strains is dramatically increased with "year long" participation in a single activity that places stress on the same area of the body over a prolonged period of time without any rest.
Another contributing factor to "overuse injuries" in sports is parents who do not use common sense and allow their injured athlete to rest from a sport. After an injury, at least two weeks of complete rest is necessary to facilitate the healing process. I can't tell you the number of parents who will not comply with a request to allow their young athlete to rest because there is "an important game" or "big tournament" coming up that they refuse to let their child miss.
From talking to parents who place their young athletes in these situations, the predominate reasoning for participation in select/club sports is to obtain a college scholarship. However, if you count all the club fees, tournament fees, travel expenses, private coaching expenses, equipment, uniforms, time off work, etc. paid over several years, conventional wisdom would tell you that the parent could have paid for their child's college education by just saving their money and letting their child play seasonal sports in their local school district.
Lastly, too many coaches/parents forget that emphasizing flexibility, strengthening, conditioning, etc. pre/post athletic participation is extremely important to avoid injury. I tell young athletes on a daily basis that if they don't do the preparatory work to play a particular sport, they should not be involved in the sport at all due to high risk of injury.
I think it's all about balance in a child's life. I know too many kids whose parents schedule them for year-round sports and use the practices after school as a babysitter.. So many kids have no "down time" at all, between sports and homework and any other activity they are in. They have lost the ability to just stay home and hang out with their families. I know a 15 year old who tore her ACL in Gymnastics and had surgery and was told to sit out for 9 months. She started back in 6 months and tore her other ACL and just had surgery. Many kids are being told in every kind of sport and club that they will get scholarships to pay for college and the parents push it because let's face it, college prices are skyrocketing. The reality of it is that very few of them will get scholarships for sports. I think we need well-rounded kids who try a number of activities, whether it's sports, music, scouts, etc. There are scholarships for lots of activities out there if you look. I am not knocking sports, just saying keep it balanced for your child and put yourself in your child's position once and see if you would like it.
I unknowingly fractured a vertebrae in freshman track doing the high jump. I kept complaining to my coach that my back hurt but he insisted I just must not be stretched out enough. By the time I had an x-ray of my spine the fracture had healed over with scar tissue instead of bone. I think coaches in high school really need to take complaints seriously. I can understand pushing players in college and the pros, but we need to chill out a little bit with pushing high schoolers to take as much as the absolutely can.
The American Association of Pediatrics is of little help. For example, they once put out a position paper saying that kids shouldn't lift weights because at the time nobody in the AAP could say for sure whether or not lifting weights caused injuries to growth plates of bone. [Turns out it doesn't.]
Meanwhile, the AAP ALREADY knew of several children's activities and sports that WERE definitively linked to growth plate injuries. But because these sports were popular with their patients and lucrative for a pediatrician's practice (unlike the sport of weightlifting) there were no position statements against those activities. To this day you will not find a postition statement from the AAP stating that 10-year old kids should not play football.
Danielle,
That's another irony. School sports coaching requires much less training and certification than personal trainers yet school sports have a much higher injury rate than gym activities. School sports have less legal liability too, thanks to support from the legislation such as New Jersey's "Little League Law" that is not afforded to personal trainers. So we have a situtation where the risk-to-benefit ratio is significantly higher in school sports than for fitness instruction but the safety training requirements and legal liabilites are actually much lower.
as im reading this i believe a sport that is most dangerous is cheerleading. i have been a cheerleader for over 10 years and a gymnast for 6. cheerleaders sustain very serious injuries from head, neck, back and many other injuries. i have personally have had 4 surgeries 2 on my wrist due to breaking it from cheerleading and 2 surgeries on each elbow due to a displaced nerve. Each states need to take in consideration on how these young children are getting injured when everything is completely preventable
actually, teen sports are a verry vigorous hardworking activity. Injuries can be costly in many areas. Just because you didnt play high school sports doesnt mean they arn't important because trust me, they are. so basiclt, everyone that thinks teen sport injuries are un-important, shut your mouth. thanks!
I have seen more injuries in foot ball at all levels. JV,PW, Midje ts ,Bantums. High School. How many times is the Thanksgiving games made to be far more important than i twas? Many or our children carrying injuries for the rest of their lives.
I agree year round sports activities can contribute to the increase of injuries, but sometimes we overlook simple solutions. As a nurse and busy mom, I've observed parents who plan for balanced nutrition for their kids have children with far less injuries than those who don't. Their bodies need the necessary nutrients for tissure growth and repair.
I know some kids don't want to eat "healthy" because they think it doesn't taste good. Been there, done that with my kids.
I have a health briefing this Saturday at 2 pm EST with pediatrician, Dr. Christine Wood. She wrote the book "How to Get Kids to Eat Great and Love It!"
Come and learn more! http://www.myhealthbriefing.com/invite.php?inviteCode=3847620
I agree with this article and other opinios as well. I'm 15 and i am overweight but I'm not over weightt because I don't play sports. Ii was on the rec. basketball league last year and it did teach me group work but I didn't have that much fun because 1. We weren't winning
2. Our coach would get mad at us for losing when we obviously have no skill at the game
3. I didn't really have any benefits with being on the team that much.
I'm not good at sports at all but I like watching them. But i doo everyonec in a while enjoy just running (for as long as I can) BUt yes being on a team is stressful because of homework, social stauts and other sorts of things and I always felt a lot of pressure when playing the games. But you shouldn't push your child to the extent that their knees were hurting all the time (mine hurt a lot and hurt every once in a while). I just think the classic gym games are enough.
Lance is right about children carrying injuries for the rest of their lives. I injured the ligaments in my shoulder over a year ago because I over-trained. Even after six months of physical therapy, I still have trouble with it. In fact, my orthopedist told me that the chances of my shoulder ever going back to normal are slim. The whole "no pain no gain" mentality is dangerous; it's the same mentality that got me hurt. I love sports and I continue to play, but I'm a lot more careful now about monitering how much training I do and how I'm feeling.
More than 3.5 million kids under age 14 receive medical treatment for sports injuries each year.
Here is a helpful website to keep kids in the game for life – http://www.STOPSportsInjuries.org
I was a gymnast for 13 years, from ages 4-17. Dealing with pain was such a part of the experience. When I started pole vaulting at age 16, my pv coach had to completely rework my pain scale. I was training 20 hours a week for gymnastics while doing about 15-17hrs/wk for track during the same time frame, often working out 6+ hours a day. My pv coach would ask how I was-I would say good, because to a gymnast good means that you're hurting, but you took pain killers and now you're ok. She would ask questions like "How did you feel when you woke up?" and "How much excedrin have you had today?" to help me learn what good, bad, great, ok really meant. In gymnastics, you could say something was really bothering you, and your coach would tell you to do at least half the workout and see how it went. Shortly after quitting gymnastics, I sprained my ankle vaulting. When it was still swollen after two weeks, I saw a doctor who informed me of 6 healing stress fractures in my foot/ankle that I had been ignoring, still from gymnastics. Now I'm in college and running cross country and track. I feel so good because my coaches listen to me when I talk about pains and allow me to cross train when I'm not 100%. They don't pressure me to compete or train through pain. For years I listened to my body and then shoved out its complaints. I've finally reached a point where listening to my body means following what it's saying, not just ignoring it.
Goal setting is very important if you want something to be done in a short period of time.~".
sometimes i am having some problems when setting goals.:`
Great article. Sports injuries havbeen an increasing among young athletes. Theyneed a better understanding of how to avoid injuries during athletic activity.
For more information on how to optimize athletic performance and avoid sports injuries, parents and their children should read "Surviving a Season: Essential advice for young athletes, coaches, and parents on staying healthy and avoiding sports injuries." It's a great resource
This is excellent information that parents have to be aware of that their child could be at risk now and well into the future. I have
seen many former high school athletes whose current physical state is related to injuries sustained while growing up.
I have seen many former athletes whose current problems relate back to injuries suffered as students in high school and earlier.
Excellent information that many parents miss.
goal setting is very important in life an also in business""
goal setting is very important in business setting and also in any career that you choose-..
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Foster is a tremendous back, running behind a superb offensive line. Opening the playoffs with a 19-13 victory over the Cincinnati Bengals, Foster rushed for 140 yards and a touchdown on 32 carries. It was an impressive performance. The Bengals (10-7) are no cream puffs on defense, and defensive tackle Geno Atkins is one of the best in the business. But the Texans’ offensive line still opened holes for Foster, and he ran with power and passion.
Dallas Cowboys owner Jerry Jones pointed to early season losses to the Seattle Seahawks and Chicago Bears when he explained the decision to fire defensive coordinator Rob Ryan.
"I didn't like the way we were playing in a lot of cases," Jones said in a taped interview that KTVT-TV aired Wednesday, via ESPNDallas.com. "I thought we could play better before the injuries, and so I factored that in. It wasn't like we had a lot of injuries out here when we played Chicago. It wasn't like we had a lot of injuries when we played Seattle. I didn't like the way we played there.
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Where in the world is Todd Haley? With the Arizona Cardinals looking for their next head coach, we have conflicting reports on the Pittsburgh Steelers offensive coordinator's whereabouts.
A source close to Haley first told NFL.com's Ian Rapoport the coach won't meet with the Cardinals after the team requested permission for an interview.