Is there too much athletic activity among some children?

Main Category: Sports Medicine / Fitness
Article Date: 22 Aug 2005 - 11:00 PDT

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Although obesity, especially among sedentary children, is an increasing national health issue, doctors are also seeing a worrisome problem on the other end of the spectrum - too much athletic activity.

As young peoples' participation in competitive sports soars, doctors are increasingly treating preventable athletic injuries that could have a lifelong impact if not properly treated. Untreated injuries in bones that have not yet fully formed could result in the incorrect growth of shoulders, elbows and knees.

"Sports injuries are becoming the most common reason young people are going to the emergency room," said Jordan D. Metzl, M.D., medical director of the Sports Medicine Institute for Young Athletes at New York City's Hospital for Special Surgery (HSS). Dr. Metzl, who has conducted studies on youth sports injuries, and other experts spoke recently at HSS's "2nd Annual Sports Medicine for Coaches Fall Sports Safety Seminar."

Coaches and parents should be aware of warning signs and find a balance for young athletes. "Sports will always be injury-laden, but statistically it is safer to play sports than to travel to a game by car," said Dr. Metzl, himself an accomplished marathon runner and Ironman triathlete.

Coaches and parents should be alert to pain clues in young people that signal the need for a doctor visit where enhanced imaging technology may be used in the diagnosis. Other interventions include changing the young person's competitive routine, adding strength training, improving nutrition and, as a last resort, undergoing surgical repair. Some common problem situations in which young athletes might play through the pain include:

• "Little League shoulder" - a pitching overuse injury that can impact growth plates in the shoulder with future consequences;

• "Runner's shin pain" - pain that results in impaired performance and means rest and strength development are needed

• "I fell on my wrist" - disregarded pain after a fall that continues due to a hairline fracture sometimes overlooked by medical staff without special training.

Dr. Metzl also said coaches and parents should be concerned about young athletes' over-commitments in other areas of his or her life. Some signs that the young person is feeling overburdened include:

• Tense, moody, and irritable much of the time, especially around practice and game times;

• Doing poorly academically;

• Pursuing few activities besides sports;

• Spending little time relaxing or seeing friends;

• Focusing primarily on improving athletic skills and spending little time on the surrounding community;

• Treating games as an obligation rather than as fun;

• Demonstrating reluctance to go to games or practice;

• Feeling exhausted during the school day.

Improved time management, said Dr. Metzl, can help create a healthier frame of mind, putting the young athlete's life into a healthier balance and thereby helping to prevent an over-dose of sports. He recommended parents and coaches collaborate to help young people:

• Plan ahead and make daily prioritized to do lists;

• Start major projects early;

• Break tasks down into smaller units;

• Use energies efficiently based on individual peak performance periods;

• During the sports season avoid watching television and spending extensive amount of time talking on the phone or online;

• Nap when needed;

• Keep long term goals in mind to avoid wasting time.

Still, despite the best efforts of coaches, parents and the young athletes, injuries may still occur. According to Robert Marx, M.D., orthopedic director of HSS Sports Medicine Institute for Young Athletes, there are some clear signs that a young athlete should consult a sports medicine specialist.

"If the kid hears a pop in his or her knee and it swells, that's bad. If they can't bear weight right away or if they have trouble coming off the field on their own, that's also a sign a specialist is needed," said Dr. Marx.

Adequate nutrition is equally important can make or break an athlete and a game, said Lauren Antonucci, MS, RD, CDE, CDN, director of Nutrition Energy, a company that works with the HSS Sports Medicine Institute for Young Athletes.

She urged coaches to:

• Discuss the importance of good nutrition with athletes;

• Encourage hydration with sports drinks and water;

• Reinforce the need for adequate calories and carbohydrates in the diet;

• Deal with body weight and body image issues tactfully and carefully.

"The most important thing a coach can do for nutrition awareness is to set an excellent example for kids to follow," Antonucci said.

About HSS

Founded in 1863, Hospital for Special Surgery (HSS) is a world leader in orthopedics, rheumatology and rehabilitation. HSS is nationally ranked as No. 2 in orthopedics, No. 3 in rheumatology and as among the best in geriatrics and neurology by U.S. News & World Report, and received Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center. A member of the NewYork-Presbyterian Healthcare System and an affiliate of Weill Medical College of Cornell University, HSS provides orthopedic and rheumatologic patient care at NewYork-Presbyterian Hospital at NewYork Weill Cornell Medical Center. All HSS medical staff are on the faculty of Weill Medical College of Cornell University. The hospital's research division is internationally recognized as a leader in the investigation of musculoskeletal and autoimmune diseases. Hospital for Special Surgery is located in New York City, http://www.hss.edu.

The Sports Medicine Institute for Young Athletes is country's only hospital-based, multidisciplinary center designed to treat and prevent sports injuries in kids and teens. Services include injury treatment, preventive conditioning programs and nutrition for young athletes. Co-Founder and Medical Director Jordan Metzl, MD, is the author of The Young Athlete, A Sports Doctor's Complete Guide for Parents (Little Brown, 2002).

Hospital for Special Surgery
535 E. 70th St.
New York, NY 10021
United States
http://www.hss.edu