“This is a problem we see daily,” Dr. Brenner said. “We can see the young dancer, who’s dancing 6-7 days a week, who develops back pain and continues to dance, and develops a stress fracture in her lumbar spine known spondylosis.
“Or we see the young soccer player who plays on multiple teams and develops heel pain, who starts limping with activities of daily living, continues to play soccer despite limping, and develops calcaneal apophysitis, known as Sever’s disease. Or the young baseball pitcher, who pitches for two teams, who develops arm pain and weakness, who has a stress fracture through the proximal humeral epiphysis, known as Little League shoulder.”
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Two broad pieces of guidance can help reduce the risk of injuries, particularly from overuse. First, young athletes should take off at least 1 month from a specific sport at least three times a year to give them adequate time for physical and psychological recovery. Second, ensuring young athletes take at least 1 or 2 days off of practice each week further reduces the likelihood of injury.
In addition to the physical problems these young athletes may develop, they also risk anxiety, depression, burnout, early retirement, and social isolation from peers who don’t play their sport, Dr. Brenner said. Family members also may experience greater stress, he added. And then there’s the risk of missing out on learning other sports they may excel in that offer a lifetime of enjoyment, such as tennis or swimming.
It is not clear where the threshold of involvement is for reducing overuse injury, burnout, and attrition, but Dr. Brenner provided some guidelines as a starting place. High school athletes should not train more 16 hours a week, and organized sports should not exceed free play time by a greater ratio than 2:1. Another guideline is not to exceed more hours per week in organized sports than a child’s age in years.
The primary focus of sports should be learning lifelong physical activity skills and having fun, Dr. Brenner said. Pediatricians should encourage patients to play in a wide variety of sports at least until puberty, thereby decreasing the chance of injuries, stress, and burnout, he said. That can include sports that are not necessarily an official part of school or club competition. Waiting until later to specialize may lead to a higher likelihood of athletic success.
Dr. Brenner said he had no relevant financial disclosures.