Early Sports Specialization Wise to Specialize? Brian Purchase, DO, FACOEP, CAQ Sports Medicine Covenant Sports Medicine

Goals and Objectives Define Sports Specialization Why is it important? What should we do and recommendations? Specific examples Trivia Question

$$$$$ Cross Train Rest Compete: but just one team Have Fun Stay in the Game

Definition Early Sports Specialization Year round training in one sport at the exclusion of other sports before the age of 12

Benefits of Sports Teamwork Socialization Leadership Discipline Exercise Downside Sports related injuries Burnout

Statistics 30 million children participate in sports 7.3 million high school students participate in athletics annually High school athletics accounts for more than 2 million injuries annually 500,000 doctor visits 30,000 hospitalizations

The Problem Young athletes are specializing in sports at earlier ages More than 3.5 million children < 14 are treated annually for sports injuries Immature bones, not enough rest, and poor training and conditioning contribute to overuse injuries Overuse injuries account for half of all sports injuries in middle and high school

Importance Overuse The lasting problem Excessive and repeated use that results in injury to bones, muscles or tendons involved in the action The lasting problem Risk for future injury Contributor to long term degenerative diseases Leads to higher rates of adult physical inactivity If commit at a young age, often first to quit

Importance Burn out 70% of kids participating in sports drop out by the age of 13 because of stress, decreased motivation and lack of enjoyment

How to Spot Overuse Continued pain with activity Pain with drastic increase in workouts Burnout Change in technique Nighttime pain Swelling Numbness

Overuse Pain that lasts until the next workout Can’t perform at usual level Loss of accuracy or form Dead-arm sensation, heaviness or numbness Child complains (more than usual) Loss of motivation – doesn’t want to go to practice

Recommendations Stress the importance of rest Enforce warm-up and cool down sessions Encourage proper strength training/techniques Encourage Multiple sports/Discourage early specialization Limit quantity Eg. Pitch counts Limit tournaments/matches played/multiple teams Eliminate Radar Gun

Benefit of Multi-sport Participation Better overall skills and ability Smarter, more creative players Most college athletes come from a multi-sport background In fact, colleges are increasingly recruiting multi-sport athletes Urban Meyer scouted Tim Tebow when he was playing right field on his HS baseball team 10,000 hours is not a rule Free play equals more play

Examples Baseball Tennis Swimming Gymnastics Soccer Basketball

Baseball Elbow Injuries >50-75% of youth baseball players Elbow surgery has increased 50% in high school pitchers in the past 5 years Can be preventable Fewer pitches = Longer Career

Baseball Elbow Injuries

Common Injuries Ligament/Tendon Bone/Growth Plate UCL (Tommy John) Medial/Lateral epicondylitis Bone/Growth Plate Occur in growing children Medial apophysitis (Little Leaguer’s Elbow)

Pitch Recommendations

Age Recommended for Learning Various Pitches Pitch Age Fastball 8 ± 2 Change-up 10 ± 3 Curveball 14 ± 2 Knuckleball 15 ± 3 Forkball 16 ± 2 Slider 16 ± 2 Screwball 17 ± 2

References www.STOPSportinjuries.org____ (Sports Trauma and Overuse Prevention)

Benefits of running Healthy Inexpensive Engaging activity that promotes fitness and discipline

Pitfalls of running Physically and Psychologically damaging if not carefully supervised Adverse conditions Inadequate clothing or equipment Improper form: quality/quantity Burn out is high if child starts too early (i.e. pre-teen)

Recommendations Soft running surfaces Less stress on growing bodies Avoid competitive environment Keep it low-key and keep it fun Avoid pressures of high expectations for others (i.e. parents and/or coaches) Parents need to be careful not to push a child beyond their mental or physical limits

Avoiding overuse injury Adhere to comprehensive program of strength training and stretching Resistance training High repetitions/lower weight Core exercises Push-ups Abdominal crunches

Common injuries Knee Lower leg Foot/ankle Pelvis/hip Heat injuries Skin injuries

Signs/Symptoms Pain with running Pain at rest Can’t sleep Limping Stiffness Other symptoms to be aware of Increased shortness of breath Headache during or after runs Dizzy or light headed

Further prevention strategies Stop at first sign of injury/pain Do not run through pain Proper techniques and training Stick to appropriate goals Determine reason for running Fitness Recreation Training Competition Set safe and achievable goals and advance slowly and cautiously

Safety tips when starting out Hydrate Stretch Speed up slowly Proper attire Flat terrain Soft, all-purpose track surfaces Well lit areas Run with partner Run in safe temperatures/humidity

How young is too young to run a Marathon? International Marathon Medical Directors Association If attempted at a younger age Must enjoy the activity Be asymptomatic Runners choice to do so

$ummary Cross Train: Rest: Take time off Play multiple sports Learn proper mechanics Rest: Take time off Compete: but avoid multiple teams Have Fun: Prevent burn out Stay in the Game: Remain injury free.

Trivia Question How many Little League World Series pitchers have made it to the MLB?

4 In fact, fewer than 30 LLWS players have made it to the Majors

Counter Argument Available data on injury rates is not accurate No proof that single sport specialization is more harmful than free play Need to be cautious with some sports and certain positions Inactivity is more detrimental than the risk of overuse injuries

THANK YOU