Youth sports have more resources today than ever before — especially as this applies to treating sports injuries. Resources commonly available to injured kids include MRI technology, orthopedic specialists, physical therapists, strength coaches, athletic trainers, sophisticated rehabilitation programs, sport psychologists, and carefully designed return-to-play protocols. Perhaps most impressive, injuries that once might have ended a young athlete’s sports career can now often be successfully treated.
While all of these advances are impressive, there’s an interesting contradiction developing alongside all of this medical progress: At the same time we’ve gotten remarkably good at treating injured young athletes, we’ve created a sports culture that may be giving them more opportunities to become injured in the first place.
Youth sports & injuries today
Kids experiencing overuse injuries are now a major issue in pediatric sports medicine. The American Academy of Pediatrics has warned about excessive training loads, inadequate recovery, and year-round participation. Kids with growing bodies are particularly vulnerable because bones, muscles, tendons, and growth plates are still developing.
This news is not surprising when you consider the schedule of some young athletes today. A baseball player might move from spring baseball into summer travel baseball, then fall ball, followed by winter pitching or hitting instruction before starting over again. A basketball player may move from the school team to AAU and then directly into camps and private training. A wrestler might compete in summer wrestling tournaments until his or her traditional winter school season begins. The reality is most sports go year-round, and the “offseason” has become a thing of the past.
Sport specialization adds another observable concern. Recent research continues to associate high levels of youth sport specialization with greater injury risk compared with multi-sport participation. With more kids specializing today, the threat of injury becomes even more concerning.
But are kids actually suffering more injuries today, or are we simply much better at finding them? The answer might be a little of both.
An injury that might once have been dismissed as simply a “bad knee” or “sore shoulder” 20 years ago can now be precisely diagnosed through modern-day imaging and specialist evaluation. Greater awareness of the danger of concussions has similarly changed what we recognize as an injury, as well as the frequency in which we assess for concussions.
Still, certain serious injuries among young athletes, including ACL injuries, have generated increasing concern. And repetitive-stress injuries make intuitive sense when children repeatedly perform the same movements for increasingly long seasons.
Then comes another interesting question: Has modern medicine changed our attitude toward injury itself? Our healthcare providers have become extraordinarily good at getting athletes back onto the field — but “return to play” can subtly become “return as quickly as possible.”
While it’s not always witnessed directly, there can be tremendous pressure surrounding an injured young athlete to get back on the field as quickly as possible. The injured athlete doesn’t want to lose a starting position, and often feels the pressure that the team needs him back. Some injured athletes worry about how much money their parents have invested in the season, or all the effort coaches make in order to compensate for the injured athlete’s absence. The athlete sits idle and watches teammates continue playing, often resulting in even greater motivation to get back out there (even if not fully recovered).
Suddenly, recovery itself becomes a competition. Returning in five weeks when doctors initially predicted eight can become a badge of honor and earn respect from teammates, coaches, and even parents. Playing through pain becomes evidence of strength and toughness. And missing games can feel like failure — even if missing games is medically warranted. Putting it all together and we see more serious injuries, better medical care, and greater pressure than ever before for kids to return to playing as fast a humanly possible. Is this new sports landscape good for kids? Or have we created a situation worthy of much more attention and scrutiny?
Final thoughts
There is nothing wrong with wanting young athletes to compete, improve, and return to the sports they love after experiencing an injury. But perhaps our modern-day advances to repair injured bodies has made it easier to overlook why so many young bodies need repairing in the first place. Better medicine shouldn’t give us permission to demand more from children; it should give us better information about how to protect them. Maybe the real measure of progress isn’t how quickly we can get a 13-year-old back onto the field, but whether we can create a youth sports culture in which fewer 13-year-olds need MRIs, orthopedic surgeons, and months of rehabilitation.
drstankovich.com
