Early sports specialization: How to support your child

Female soccer player kicks the ball back into play from the corner of the field.
Kids are specializing in a single sport at a younger age and sports medicine physicians see a rise in serious injuries as a result. (Adobe Stock)

Early sports specialization — intensive training and competition in a single sport at the expense of other activities — has become the expected norm for young athletes hoping to excel. While parents may believe they’re helping their children achieve future athletic glory, getting too serious too early has produced a rash of “adult” injuries in very young kids.

Early sports specialization: The new normal?

Say your child plays in a local sports league. As the season wears on, another parent tells you about a club team that will continue training after the official season ends. A bunch of kids are joining and your child seems interested, so you sign them up. Time passes, new opportunities come along, and pretty soon, your child is playing a single sport at an increasingly competitive level. Your child used to play a variety of sports but now they don’t have time.

“Kids used to specialize in a single sport in high school, if they specialized at all,” says Dr. Mininder Kocher, chief of the Sports Medicine Division at Boston Children’s Hospital. “Now it’s happening in middle school, even grade school.”

Dr. Kocher, like many of his colleagues, has seen an increase in serious sports injuries such as anterior cruciate ligament (ACL) tears and osteochondritis dissecans. “More kids are getting injured, the injuries are more severe, and they’re happening to younger patients,” he says.

What’s at stake?

Kids who specialize in a single sport miss out on the benefits of cross-training. “They’re not giving their bodies a rest between seasons or participating in a variety of sports that put different kinds of stress on the body,” explains Dr. Kocher. This, plus the increased hours specialized athletes typically spend training, put kids’ bodies at risk of injuries that could affect them well into adulthood.

In the worst cases, young athletes’ sports injuries require surgery. Meanwhile, the stress of high-level competition increases the chance a young athlete will burn out and not want to play at all.

By contrast, sports at an appropriate degree of intensity can boost a child’s health and confidence. “Physical activity is good for a child’s fitness and coordination,” says Dr. Kocher. “And playing sports can provide a group of friends and identity. If a child has to quit playing because they get injured or burned out, they miss out on all those benefits.”

EARLY SPORTS SPECIALIZATION INJURIES

The ACL is a band of tissue that provides stability to the knee joint. The most common type of ACL injury in children is a complete tear, which usually requires surgery to repair.

EARLY SPORTS SPECIALIZATION INJURIES

This overuse injury of the knee causes pain and swelling. Treatment usually includes rest, ice, compression, and elevation (R.I.C.E.), time off from sport, and sometimes, physical therapy.

EARLY SPORTS SPECIALIZATION INJURIES

This injury occurs when the blood supply to the joint is disrupted and a loose piece of bone and cartilage separates from the end of the bone. The two most commonly affected joints are the knee, as a result of frequent high-speed landings, and the elbow, from pitching and throwing. If caught early, OCD can be treated with R.I.C.E. In more severe cases, the condition requires surgery and months of complete rest.

EARLY SPORTS SPECIALIZATION INJURIES

Over time, repetitive stress can cause a small crack in the bone. Stress fractures often occur in the shin or foot bones as well as the hip. A child with a stress fracture needs to take time off from all activity while the bone heals. The amount of time out will depend in part on the severity of the injury.

EARLY SPORTS SPECIALIZATION INJURIES

Spondylolysis is stress fracture in the lower spine. If left untreated, the fractured vertebra slips out of alignment with the rest of the spine, a condition known as spondylolistheses. In most cases, both conditions can be treated with rest and physical therapy, but severe cases often require spinal fusion surgery.

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Early sports specialization: Driven by mistaken beliefs

If early sports specialization is bad for kids, why is it so popular? “Many parents are acting on the mistaken belief that in order to have any chance of achieving in a sport, their child has to specialize early,” says Dr. Kocher.

In fact, in surveys of elite athletes around the world, those who make it to the top of their sport started specializing in that sport later, not earlier. Those who specialized before the age of 11 or 12 were far more likely to have had to stop competing than those who ramped up their training in adolescence.

How parents can support their kids

Given all the pressure to specialize, how can parents protect their young athletes from overtraining and burnout? Dr. Kocher offers the following advice:

  1. Trust your parental instincts. If you have a gut feeling your child is training too much, you’re probably right. A good rule of thumb is that the number of hours your child trains per week should not exceed their age. A 10-year-old should train no more than 10 hours a week, for instance. They can, however, be physically active during their time off, ideally doing something fun that adds variety, even spontaneity, to their routine.
  2. Encourage sports sampling. Give your child a chance to try different sports, at least through age 12. The sport they love in third grade may not interest them in fourth or fifth grade. Not only that, playing a variety of sports will give your child’s body a chance to develop in a balanced way.
  3. Take pain seriously. The maxim, “no pain, no gain,” does not apply to youth sports. “If there’s pain, there’s usually something wrong,” warns Dr. Kocher. Encourage your child to let you know if they’re in pain. If they do, consult with a physician. “It might turn out to be something that can be treated with rest, ice, and ibuprofen,” says Dr. Kocher. “But playing through pain increases the risk of serious injury that could require surgery and lead to arthritis later in life.” 
  4. Remember why children play sports. “The two main reasons kids are doing sports are to have fun and be with their friends.” For young children in particular, “play” is, and should remain, the reason they keep returning to the field, track, or pool.

Related
Nurturing strength: Tips for parents of female athletes
When athletes push too hard: How to screen and when to refer

Learn more about the Sports Medicine Division.

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