Kids and sports: How much is too much?

Parents urged to keep safety, child’s abilities in mind.


DALLAS — He was in tears. I told the boy that he could not participate in the upcoming middle-school football game because his foot fracture had not completely healed.

Thankfully, mom and dad were supportive, and together we were able to manage their son’s injury until he was back to 100 percent.

When it comes to their sick or injured children, parents usually comply with physicians’ orders. But sometimes, parents want their kid back in the game before healing is complete.

Over the years, kids’ physical activities have become more rigorous, sometimes surpassing their physical capabilities.

Little League baseball players have school teams, select teams, running coaches and throwing coaches (the costs must be phenomenal). Young children are encouraged to become focused on a single sport and are engaged in more aggressive training schedules. Many return to practice too early after an injury.

According to Johns Hopkins Children’s Center, 30 million to 45 million U.S. children ages 6 to 18 compete in specialized, intensive, year-round sports. The Centers for Disease Control and Prevention reports that more than 2.6 million children are treated in emergency rooms each year for sports-related injuries.

My friend Mike Richardson, a Southern Methodist University Hall of Fame running back and former Houston Oiler, has witnessed the rise of intensity and competitiveness in children’s sports over the last few decades. As a retired professional football player and a volunteer middle-school football coach, Mike tells me that today’s school weight rooms are far larger than what the Oilers used. During his professional football career, weight training was not required. Today, middle-school weight-training continues off-season, and high school year-round workout intensity is “even more incredible.”

Players are bigger and faster, he says, and improved safety equipment means that players can hit harder, making the game more violent.

My concern for parents is that bigger plus faster minus fear of self-harm equal elevated numbers of injuries and more severe injuries.

The advent of competitive cheerleading and tumbling has added to the growing number of complex injuries. According to the United States Sports Academy in 2011, cheerleading is responsible for the most catastrophic female sport injuries in the U.S. Cheer-leading ranks second only to football among all catastrophic sports injuries (such as head and neck injuries and fatalities). The USAA reports that many cheerleading injuries and falls do more damage than being tackled by a professional football player.

Young athletes, also, are more susceptible to injuries. With developing bones and ligaments, growth plates (areas of developing cartilage and bone growth) are weaker than their attached tendons and ligaments.

Injury to, and lack of recovery time for, these areas can lead to lifelong pain and might result in abnormal bone or joint development. A child’s complaints of severe pain, swelling or decreased range of motion should trigger a visit to the doctor for evaluation.

According to the CDC, almost half a million kids visit emergency rooms annually for traumatic brain injuries. Concussions are not unusual in kids’ sports. Just this past week, my office saw a volleyball head injury and the results of a dance team head-to-head collision, which sent two girls to the hospital.

Here is another sobering fact: By age 13, up to 70 percent of kids drop out of youth sports. The top three reasons cited according to the Safe Kids Worldwide campaign website 2009: adults, coaches and parents. What could have been a lifelong source of exercise or fun competition is discarded due to injuries, stress and burnout.

Sometimes we need to pull back on the reins of kids’ competitive sports. As both a physical-fitness major and physician, I love that sports help build teamwork skills and improve both endurance and strength. But the intensity of some sports activities can press kids beyond their physical limits.

We endured my son’s separated shoulder in lacrosse, but after his second hip MRI, we knew we had pushed him too far. For him, it was not a good fit.

My advice is to find an activity that your child can both enjoy and that promotes good health. Match kids with an activity that they safely can participate in beyond their growing years.