Young Athletes – The Positive and The Negative

There are significant advantages and potential drawbacks of children becoming young athletes and participating in sports. While engaging in physical activities can offer immense benefits for both physical and mental health, it’s crucial to approach sports with caution. A well-designed training program can lead to a wide array of positive health outcomes. However, if not managed correctly, the same activities can lead to overuse injuries, burnout, and other serious issues due to imbalances between training intensity and recovery time. These problems can affect young athletes but there are strategies to prevent them. The goal should be to support families, schools, and pediatricians in fostering safe and beneficial sports participation for children.

Youth Sports Participation: Benefits, Risks, and Recommendations

Pediatrics published an extensive research report on young athletes. Youth sports are a key way for American children to get active, offering both physical and mental health benefits. They also set the stage for a habit of lifelong physical activity. However, despite over 60 million kids participating in organized sports, many quit by the age of 13. This dropout contributes to a lack of physical activity among adolescents.

Key Issues Leading to Sports Attrition:

• High Dropout Rates: 70% of young athletes leave organized sports by age 13.
• Injury and Burnout: These are major reasons why kids stop playing sports.
• Excessive Training: Since a 2007 report, evidence shows that too much training can cause injuries, overtraining, and decrease quality of life.
• Professionalization and Pressure: The push towards specializing in one sport and the pressure to succeed at a young age can lead to burnout and injuries.

Contributing Factors:

• Training Volume and Specialization: High amounts of training and focusing on a single sport from a young age are problematic.
• Psychosocial Impacts: The mental and social effects of injuries, overtraining, and quitting sports are significant.
• Role of Pediatricians: Doctors play a vital role in guiding young athletes and promoting safe, enjoyable sports experiences.

In summary, while youth sports can offer many benefits, the risks of overtraining, injury, and burnout are significant. We need to educate and learn about how to mitigate these risks, emphasizing the importance of balanced training, the dangers of early specialization, and the role of pediatricians in promoting healthy sports participation.

Understanding Overuse Injuries in Young Athletes

Overuse injuries are common but preventable with the right approach to training and recovery. It’s important for young athletes to vary their activities, get enough rest, and follow healthy habits. Coaches and parents should watch for signs of overuse and adjust training to keep kids safe and healthy in sports.

What are Overuse Injuries?

• Overuse injuries happen from repeated stress on bones, muscles, or tendons without enough time to recover.
• These injuries can start with pain after sports, then during, with more pain limiting activity, and finally pain even at rest.
• Common in the lower leg of young athletes, especially girls, endurance athletes, and those who’ve been injured before.

Common Overuse Injuries:

• Injuries like Sever’s disease, Osgood-Schlatter disease, and stress fractures are typical.
• Areas affected can include the heel, knee tendon, shoulder, wrist, and knee cap.

Why Kids Get Overuse Injuries:

• Children’s bones are still growing and can get stressed more easily than adults.
• Focusing too much on one sport can increase the risk because of repetitive movements.
• Not enough rest, bad eating habits, or not sleeping enough can also lead to these injuries.

How to Prevent Overuse Injuries:

• Avoid increasing training too quickly. A good rule is not to increase by more than 10% to 20% each week.
• Sports like baseball have guidelines to limit how much young players pitch to reduce stress injuries.
• Proper nutrition, hydration, and enough sleep help the body recover and adapt to training.
• Getting help to improve sports techniques and managing stress can also prevent injuries.

Understanding Overtraining in Young Athletes

Overtraining is a large risk for young athletes and can hurt their performance and health. It’s important to balance exercise with rest, keep an eye on stress from all parts of life, and make sure kids are running and playing for the right reasons. By managing training loads and ensuring proper recovery, kids can enjoy sports without the risks of overtraining.

What is Overtraining?

• Overtraining happens when athletes exercise too much without enough rest, stopping their bodies from getting better after workouts.
• First, athletes feel very tired and perform worse after increasing their exercise, called overreaching.
• If they keep pushing without enough rest, they move from overreaching to overtraining, making their performance drop even more.
• Overtraining can disrupt their bodies in many ways, like making them tired all the time, disturbing their sleep, and moodiness.

How Common is Overtraining?

• It’s hard to say exactly, but some studies think as many as 35% of young athletes will deal with overtraining at some point.

What Causes Overtraining?

• Doing the same sport all year round or playing in too many games back-to-back can overload young athletes.
• Stress from other parts of life, like school or family, can also make overtraining worse.
• Not getting enough sleep can make it hard for athletes to recover between workouts.

How to Prevent Overtraining:

• Young athletes should not play more than one sport in a day and should take at least one full day off each week.
• They should also take a break from each sport for 2 to 3 months every year.
• Playing for fun and not just competing can help keep sports fun and less stressful.

Endurance Events and Kids:

• More kids are running long races like marathons, and studies show they can do it safely with the right training and motivation.
• Instead of setting an age limit for these races, it’s better to look at each kid’s fitness, health, and reasons for running.
• Kids should slowly increase how much they run and not focus on just one sport too early to avoid injuries.

Weekend Tournaments:

• Tournaments with lots of games in a few days can be too much for young athletes, risking injury and making them very tired.
• These intense weekends can also make kids feel burned out, leaving them no time for other fun activities.

Burnout and Quitting Sports: A Simplified Explanation

Burnout in sports is when too much stress and not enough rest make athletes feel exhausted and less interested in their sport. Recognizing burnout involves looking at both physical symptoms and how athletes feel about their sport. To prevent burnout, young athletes need a healthy balance of training, rest, and support from those around them. They also need to feel like they have a say in their sports participation and focus on enjoying the process, not just the outcomes.

What is Burnout?

• Burnout is when athletes get really tired, both emotionally and physically, feel like they’re not achieving anything, and start to care less about the sport they once loved.
• It’s related to training too hard without enough rest, just like overtraining, but it also makes athletes feel bad mentally.

How Do You Notice Burnout?

• Athletes might feel super tired and sad, lose interest in things they used to like, have trouble sleeping, get irritated easily, worry a lot, can’t focus, have unexplained body aches, lose or gain weight, do worse in school or sports, and enjoy sports less.
• Doctors need to make sure other health problems aren’t causing these feelings. They might check for things like anemia or thyroid issues with blood tests.
• Understanding why an athlete plays their sport and looking into their mental health can help diagnose burnout.

Why Do Athletes Burn Out?

• Training too much or all year round, and feeling pressured by parents, coaches, or friends can lead to burnout.
• Having a positive relationship with parents and coaches, focusing on personal goals rather than just winning, and feeling in control of their sports life can protect athletes from burning out.
• Burnout can make athletes want to quit. But often, they stop playing because they’re not having fun anymore, they want to try other activities, they don’t get enough playtime, they’re not getting better, or they’re injured.

Strategies for Keeping Young Athletes Healthy and Happy in Sports

Try supporting young athletes in enjoying a healthier, more balanced approach to sports. This not only enhances their immediate sports experience but also contributes to a lifelong appreciation for physical activity and well-being. Here are several suggestions to get started:

• Comprehensive Preparticipation Exams: Conduct thorough health checks before the sports season starts. This allows doctors to offer personalized advice on avoiding injuries, overtraining, and burnout, tailoring care to each young athlete’s needs.
• Fostering Independence and Enjoyment: Encourage athletes to take charge of their sports participation. Success should be measured by how much they enjoy the activity and their effort, not just wins. Positive interactions with parents, coaches, and teammates are crucial for a fun and fulfilling sports experience.
• Developing Skills and Balance: Focus on improving skills and encourage a variety of physical activities to create well-rounded athletes. This approach helps prevent the negative effects of overtraining and having a packed sports schedule.
• Addressing Problems Together: Athletes, parents, and coaches should work as a team to change any practices that might lead to stress or burnout. Bringing in mental health experts could be beneficial when needed.
• Using Mindfulness: Teach young athletes mindfulness techniques to enhance their focus, reduce stress, and improve their overall well-being.
• Keeping Training Fun: Design training sessions that are enjoyable and suitable for the athlete’s age. Games and creative activities can make practice something athletes look forward to.
• Scheduled Rest Periods: Ensure athletes have regular breaks from structured sports activities. Time off is essential for both physical and mental recovery and should be planned weekly and annually.
• Promoting Self-awareness for Wellness: Teach athletes to be attentive to their body’s signals. Understanding when to push and when to rest can prevent injuries and burnout.
• Encouraging Diverse Sports Experiences: Investigate how factors like healthcare access and the opportunity to try different sports affect the risk of overuse injuries, overtraining, and burnout. Expanding access to varied sports experiences may help reduce these risks.

Supporting Young Athletes: A Comprehensive Guide for Health Professionals

Pediatricians, physical therapists, athletic trainers, and occupational therapists can play a pivotal role in promoting the well-being of young athletes, ensuring they have a positive and healthy sports experience. Here are some suggestions:

• Incorporating Risk Awareness into Routine Care: Health professionals can integrate discussions about the risks of overuse injuries, overtraining, and burnout during preparticipation examinations and routine health check-ups for young athletes. Sharing this information with community organizations, such as schools and clubs, can also raise awareness broadly. Incorporate guidelines from the American Academy of Pediatrics on mental health competencies into these discussions to address the mental aspect of sports participation comprehensively.
• Recovery Time: Advise young athletes to take 1 to 2 days off per week from both competitions and sport-specific training to facilitate physical and psychological recovery. This downtime is crucial for maintaining overall health and preventing burnout.
• Seasonal Participation: Recommend that athletes commit to only one team per season and encourage taking breaks of 2 to 3 months from any single sport annually. These breaks can be split into shorter periods and should be a time for diverse activities or unstructured play to promote well-rounded development.
• Emphasizing the Right Focus: Underline the importance of sports being enjoyable, focusing on learning new skills, ensuring safety, and promoting good sportsmanship. The primary goal of youth sports should be to foster a lifelong love of physical activity, not just to win games.
• Identifying Signs of Burnout and Overtraining: Be vigilant for signs of burnout or overtraining in athletes reporting vague symptoms such as muscle or joint pain, fatigue, mood changes, or declining academic performance. Inquire about their feelings towards sports to gauge if loss of motivation might be a factor.
• Balancing Stress and Recovery: Stress the balance between training stress and recovery. Encourage a diet that supports recovery and adequate sleep, while also managing other life stressors that could compound the physical demands of training.
• Gradual Training Increases: Advise on gradually increasing training intensity to prevent injuries. Incremental increases in weekly training time, repetitions, or distance can help safely build endurance and strength.
• Advisory Boards for Tournaments: Support the establishment of medical advisory boards for weekend sports tournaments. These boards can offer valuable education on nutrition, hydration, supplement use, and injury prevention to athletes, parents, and coaches.
• Educational Initiatives: Promote educational programs for the sports community about healthy eating and hydration, the appropriate use of supplements, sports safety practices, and strategies to avoid overtraining. These initiatives can help ensure athletes perform at their best while maintaining their health over the long term.
• Special Considerations for Younger Athletes: Caution parents of younger athletes about the risks associated with participating in tournaments that feature multiple games over short periods. Encouraging rest and diversification in sports can help mitigate these risks.

Key Points Regarding Young Athletes and Sports Participation

• Benefits of Sports Participation:
  • Improves physical health and fitness.
  • Enhances mental well-being and social skills.
• Risks Associated with Improper Training:
  • Overuse Injuries: Caused by repetitive stress without adequate recovery, leading to damage.
  • Overtraining Syndrome: Occurs when training intensity exceeds recovery time, affecting performance and increasing the risk of injuries and illnesses.
  • Burnout: A state of physical or mental exhaustion that reduces accomplishment feeling and devalues sports, often leading to quitting sports altogether.
• Strategies for Safe Sports Participation:
  • Balanced Training Programs: Ensuring that training and recovery are properly balanced to prevent overuse injuries and overtraining.
  • Monitoring for Signs of Burnout: Keeping an eye out for symptoms of burnout and taking steps to address them early.
  • Health Professional’s Role: Pediatricians, physical therapists and others can play a crucial role in identifying at-risk children, treating young athletes, and guiding families towards promoting safe and healthy participation in sports.

Participating in sports offers valuable opportunities for children to improve their health and develop important life skills. However, it’s essential to recognize the potential risks associated with sports participation, such as overuse injuries, overtraining syndrome, and burnout. By implementing balanced training programs, monitoring for signs of stress, and involving pediatricians in the process, we can help ensure that children enjoy the benefits of sports while minimizing the risks. This approach not only supports the physical and mental health of young athletes but also promotes the goal of lifelong physical activity and its associated health benefits.

REFERENCE

Brenner, J. S., & Watson, A. (2024). Overuse Injuries, Overtraining, and Burnout in Young Athletes. Pediatrics, e2023065129.