The Young And The Hurt

Organized sports put the pressure on children to specialize early, but at what cost?

September 03, 2000|By Elizabeth Large | Elizabeth Large,Sun Staff

Take your pick. Either your child is an overweight couch potato who watches TV all day, or you have a stressed-out athlete with back problems, shin splints and chronic tendinitis.

Today's parents must sometimes feel those are the only options. Kids don't seem to simply go outside and play anymore. Instead, they compete.

In the past decade sports camps, leagues and travel teams have been added to school athletics. Sports like soccer and baseball now have more than one season. The result is that some pre-teens are dealing with the training regimen and game schedules of elite athletes.

"More and more kids are starting to specialize in one sport, and with that specialization come injuries," says Marty Sataloff, head athletic trainer at McDonogh School, who's been working with young athletes since the mid-'70s. "Kids don't play in their back yards anymore. They go from sports camps to school teams. It becomes a bigger and bigger deal younger and younger."

The injuries are often overuse injuries, such as tendinitis, stress fractures, shin splints and rotator cuff problems. They may start small as a twinge or soreness. The athlete doesn't mention the relatively minor pain to a coach or parent but simply plays through it. He or she applies a little ice, takes a few ibuprofen.

No pain, no gain, right?

As the athlete continues to play through the "minor" injury, repetitive stress on the same body part -- hitting another 100 forehands, practicing the same pitch again and again, running a few more miles -- may eventually lead to debilitating pain, doctors' visits and enforced time off.

Seventeen-year-old Rachael Baitch started gymnastics at age 4. After 11 years she gave it up because she was tired of dealing with chronic back problems.

"If I had to do it over again," she says, "I would try more variety of sports."

Last year Rachael ran track for Bel Air High School. She had to stop when she suffered a stress fracture (a hairline break often caused by repetitive stress) running hurdles. She still hopes to compete in college.

"I'm running occasionally and doing sit-ups and push-ups," she says. "But right now I'm pretty much laying low."

Doctors have been worried for years about the effects of intensive training on the developing bones, ligaments and tendons of gymnasts and ballet dancers, who start early and often specialize. But in the last few years young soccer, basketball and lacrosse players, swimmers and runners have been filing into sports medicine clinics and pediatricians' offices with overuse injuries.

It's been a disturbing enough change that the American Academy of Pediatrics this summer issued a policy statement on the subject, recommending that young athletes be encouraged not to concentrate on one sport until adolescence.

The recommendation is controversial. For one thing, the authors of the paper, which was published in the July issue of the organization's medical journal, admit that much of the information is anecdotal. Studying kids at risk is difficult because it's hard to define them, and the sports and training regimens vary widely.

And one could argue that overuse injuries are acceptable risks.

"In truth, to compete professionally, in college, or even in high school, you have to be pretty good," says Dr. William Howard, director of sports medicine at Union Memorial Hospital. "I haven't seen any harm at all -- none -- in starting at an early age and getting good at it. [Overuse injuries] are part of the hazard. You can get tendinitis. You can treat it. If you want to make the team you have to concentrate on your sport."

Howard believes the policy statement is overstated. "Imagine our Olympic teams -- the gymnasts, the swimmers," he says. "Where would they be if they weren't allowed to specialize before age 14?"

He does urge parents to be sure their children understand that when they stop enjoying the sport it's OK to quit. If they have pain they need to have it checked out. And well-defined periods of rest should be built into their schedules.

"Only milking cows needs to be done twice a day for 365 days a year," he says. "Take a month off. There's no harm to it."

Sidelined by injury

Patrick McGrath started playing baseball at age 5. He's 16 now and on the bench, waiting for his rotator cuff to heal. Waiting isn't quite the right word, because he goes to a physical therapist twice a week and does exercises and stretches on his own twice a day.

He was doing fine, says his mother Claudia, until he made varsity at Broadneck High School in Annapolis and also played on summer and fall teams, including a travel team that went to a tournament in Ohio.

"That's when it may have started," she says. "Athletes just expect to have pain, so he kept throwing. It wasn't anybody's fault. But eventually he said, 'I can't do this.' The minute his coaches knew, they said absolutely not until you have a doctor's OK."

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