How much sport is too much for my kids?

Written by Megan Fraumano

Physical activity for children and teenagers is extremely important for health and fitness. It helps build self-esteem, is social, teaches co-operation, is critical in the development of the child into and adult and it’s fun. Exercise and physical activity also reduces the incidence of many chronic diseases later in life. In Western countries, we have seen the rate of organised sport grow immensely, with multiple options and pathways for talented young athletes. With this increase, the rate of overuse injuries in children and adolescent athletes has also increased.

Here at Eureka Osteo, we see a wide variety of complaints in this age group including Osgood-Schlatters Syndrome, Sever’s Disease, rotator cuff tendinopathies and stress fractures – in particular those of the feet and spine. Overuse injuries are different to acute injuries like muscle strains and joint sprains, in that exercise load over an extended period of time is generally a major factor. Often these injuries occur during a peak growth period, and some are more likely to occur if underlying biomechanical problems are present.

Factors thought to contribute to this include:

  • overtraining
  • early specialisation in sport
  • increased organised sport and decreased free play
  • parental pressure to compete and succeed

In addition, some specific overtraining issues include weekend sporting tournaments, year-round training on multiple teams, participation in endurance events, and multisport athletes with similar mechanics or load on body parts. In Ballarat, we are commonly seeing young soccer and AFL players as a group at risk of playing for club, school and representative teams on a regular basis. We often see swimmers and rowers who both tend to have very large training loads.

Some sporting codes have been at the forefront of minimising overuse injuries in adolescents. In the United States, Little League Baseball has been a frontrunner in protecting their young athletes from pitching injuries. They have implemented guidelines for the daily maximum amount of pitches and required rest for each age group. The AFL discourage sport specialisation before the age of 10. They also point out that kids rarely complain about pain for more than a few days unless they have a definite problem.

The American Academy of Pediatrics Council on Sports Medicine and Fitness recommends “limiting 1 sporting activity to a maximum of 5 days per week with at least 1 day off from any organised physical activity. In addition, athletes should have at least 2 to 3 months off per year from their particular sport during which they can let injuries heal, refresh the mind, and work on strength, conditioning and proprioception in hopes of reducing injury risk.”

Overall, the athlete that has the highest chance of a successful sporting career (whether that be professional or amateur), is one who misses the least amount of sport. There is evidence too that strongly suggests that later specialisation (mid-teens) in one sport leads to less injury and more champions.

Here is some advice for parents of keen athletes:

  • Encourage athletes to have a 2-3 month break yearly from their chosen sport – ie have an “off season”. This may be a time for cross-training, or participating in a different sport.
  • Monitor training loads with coaches, so that total number of hours, repetitions or distance doesn’t increase by more than 10% each week. This may become particularly relevant for the adolescent rower over the summer holidays – off water training needs to continue in some form in order to prevent burnout in term one.
  • Monitor total training load – if the athlete is a member of multiple teams for the one sport, the total weekly workload may need to be modified. This has become the norm for adolescent footballers playing school, club and TAC Cup football.
  • Encourage and celebrate things other than winning – fun, personal improvement, teamwork and sportsmanship should be a strong focus.
  • Discuss and encourage learning about injury management, principles of recovery, appropriate nutrition and hydration. This takes planning particularly if competition involves long drives or early starts/late night games.
  • Take any complaints of pain seriously until proven otherwise – we would always advise investigating any pain and have a clear diagnosis from your chosen health professional before proceeding with sport.
  • Surround your athlete with a supportive team – this may include teammates in team sports, but also family members, health professionals and coaching staff that are all positive, skilled and supportive of healthy and safe sport.

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