The PCA Blog - Minnesota

How An Orthopaedic Physician Sees Youth Sports Today


As an Orthopaedic physician who regularly treats athletes of all ages, what trends are you seeing for youth athletes and what is driving those trends?

Unfortunately, we are seeing more and more overuse injuries in children due to sports specialization. Children's bodies are different than adults. They are not meant to be trained like little professionals. They have open growth plates that are susceptible to injury. Their bones are growing longer while their muscles and tendons attached to those bones take more time to lengthen. This sets up a musculoskeletal imbalance that can lead to injury.  Playing multiple sports throughout the year and playing one sport at a time (sport of the season) can prevent these overuse injuries. Burnout is also a problem for kids who specialize early with 70% quitting by age 13. As parents, we think we are advocating for our children by providing them with every opportunity to improve their skills in sports. However, we have been misguided and misinformed by peer pressure and economics, the forces which have driven these trends.

What sports show the most devastating injuries that have long-term effects?

Most injuries will heal and resolve with time, rest, and appropriate management and without long-term sequelae. However, there are some catastrophic injuries, like a cervical spine injury, that can have devastating outcomes, but these are very rare. Following the rules of the game and wearing adequate protective equipment can prevent most of these from occurring. There are some injuries that can have some future implications such as growth plate fractures causing the bone to grow asymmetrically, or ACL tears which can cause the earlier development of knee osteoarthritis.

From a medical perspective, is there an age that you think it is a safe to specialize in a sport?

From a developmental and anatomical perspective, they are not ready to specialize until age 13-14. Most kids are not even ready to understand the concept of a team sport until they are 8 years old, and by then, many are already specialized and on traveling teams.  I do think it is ok to start having kids play team sports recreationally younger than age 8.

What are the most disturbing injuries you are seeing and why?

I am seeing spondylolysis (vertebral stress fractures) with increasing frequency. The old literature used to report a 47% incidence in athletes. In my clinic now, 80% of young athletes who present with low back pain have a stress reaction or stress fracture in their back. All overuse injuries are preventable injuries.

What is your hope for athletes and treating injuries?

My hope is always to get these kids back to play as soon as possible and to prevent injuries from occurring in the first place. My bigger hope is that we can restore the fun and sanity in youth sports and keep these kids in the game to benefit from all of the life lessons sports have to offer. Positive Coaching Alliance manifests this hope by educating athletes, coaches and parents about the importance of maintaining youth sports as a positive, character-building experience to create "Better Athletes, Better People." My advice to families is to focus on the 3 F's: fun, fitness, and friends, and the rest will take care of itself.