Youth in Sports

The participation of children in organized athletic activities raises many concerns in parents’ mind:

  • At what age is my child ready to participate in organized athletics?
  • What is the risk of significant injury?
  • What sports carry the highest likelihood of injury?
  • Are there specific injuries related to specific sports?

In 2001, American Orthopaedic Society for Sports Medicine (AOSSM) prepared this information to help provide parents with some answers.

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Should my child participate in organized athletics?

Yes!  Participating in sports is a fundamental part of our way of life.  When kept in the proper perspective, athletic activities can become an important part of a healthy growth and development pattern.  A child’s participation in sports should be regarded as an extension of school time, playtime or family time – coaches or parents should never view it as an end unto itself.

Participating in sports is a very healthy way, both physically and socially, for a child to channel youthful energy in a positive manner.

When is a child mature enough to begin participating in organized sports?

Understanding a child’s social development is the first step in answering this question.  Children under age six cannot compete in an adult sense.  They live in a “play world” of their own where even play with other children is often incidental.

These youngsters have minimal ability appreciate achievement in a sporting sense and are difficult, if not impossible, to organize.  The adult measurements of competition are lost on pre-schoolers.  Sports activities for children in this group are best promoted as playground opportunities.

Between ages six and ten, children come to appreciate interaction with their peer groups but, psychologically, still do not compete in the adult sense.  Play and fun are the primary goals for these youngsters, with structure, organization and scoring, at most of secondary importance.  Children in this age group generally have very short attention spans and generally cannot perform in the adult-imposed structure of most sports activities.  They are ready for group interaction but not for many restrictive rules or structure.

Between age ten and the onset of puberty, a youth develops increasing awareness of the goals, structure and discipline require for team sports.  The prime motivation of children this age is still joining in and having fun with their teammates. However, they will accept increasing amounts of structure and are becoming more goal-oriented.

During and after puberty the aspiring athlete develops an increasing sophisticated perspective of the structure and organization of team sports, the post-pubescent athlete is ready to develop sports-related discipline.

When is a child physically capable of participating in organized sports?

In terms of physical capabilities of the young athlete, participating in sports depends upon both chronological age and physiological maturation.

The positive effect of sports activity or training on the body is measurably less in the pre-pubescent (before puberty) athlete that in the post–pubescent (after puberty) athlete.  The benefits of conditioning to the cardiopulmonary system (heart and lungs) are scientifically measurable in the younger athlete, but are of a much lower magnitude than in the older child.  Training with weights also can have a positive effect in the pre-pubescent athlete, but it cannot result in the dramatic increase in muscle mass or strength that is seen in the post-pubescent athlete.

One of the major factors responsible for this lack of response to weight training is that the pre-pubescent child has not undergone the hormonal changes, which physiologically permit the muscle-bulking phenomenon to occur.

It should be noted that no matter what the form of specific training or sport activity, stretching and flexibility drills should be included in any pre-participation or warm-up program, even in the very young.

Is there anything to be gained from sports activity and training at an early age?

Given the fact that children have certain physiological and psychological limitations is there any reason for them to participate in sport before puberty?  Once again, the answer is yes!

Youngsters involved in such activities develop motor skills, proper training habits and a work ethic, which can carry over to life in general.  They will also benefit from proper training with weights, cardiovascular conditioning and from the non-parental discipline.  Involved parents, coaches and administrators should encourage such activities, while refraining from imposing adult performance standards.

How should organized youth sports programs be structured?

The phenomenon of puberty is a troublesome period in any youngsters’ life and athletic participation during this time may actually compound nature’s “built-in” problems.  A major reason is that most youth sports programs group participants according to chronological age.

Anatomic age (stage of body development), emotional age (maturity) and social age do not always coincide with calendar (chronological) age.  An ideal system would be to group athletes by more than one standard.  For example, arrange them not only by chronological age and weight, but also by emotional and physiological maturity.

The post-pubescent athlete can be thought of in near-adult terms.  This athlete will practice with competitive goals in mind and can physically benefit from strength and endurance training. A youth in this age group should also participate in an aggressive stretching and flexibility program, which is sport specific.

However, the best system is only as good as the coach or parent who understands the psychosocial and physical maturity factors involved – and who will foster athletic participation at a level appropriate for each individual child.

What type of sports should a youngster participate in?

The young athlete should participate in a variety of sports activities.  Psychologically, the sports goal for a child under ten, and perhaps even the older pre-pubescent should be fun.  Physically, the young athlete should be encouraged to acquire basic individual skills.  There is no overriding reason to recommend participation in non-contact sports over contact sports.

Sports participation by these younger athletes should be an opportunity to develop motor skills and to have fun.  These limited goals will give the child a healthy mental attitude as well as a healthy body, both of which will benefit him or her throughout life.

Above all, a pre-pubescent child-athlete must not become the focus of the personal athletic dreams of wishes of a parent or coach.  While parental and coaching guidance is of immense value, the young athlete should not be pressured to swim or play football, for example, when another sport better fits his or her emotional and/or physical make-up. The post-pubescent athlete will usually select athletic endeavors based on a personal skill or through associations with a particular role model or peer group.

What is the risk of injury in youth sports?

The question is not whether injuries accompany youth sports, but whether there is undue risk.  Many studies have documented a very low incidence of injury in the total spectrum of youth sporting endeavors.  Interestingly, the occurrence of injury in the pre-pubescent athlete has been documented as being much lower than in the post-pubescent athlete, and lower in the post-pubescent than the young adult.

This is probably due to the fact that the younger athlete has a lower ratio of kinetic energy to body mass – the more immature the physical body, the lower the speed and power.

Since the magnitude of injury is almost always directly related to energy expended in a traumatic event, the younger athlete is less likely to get injured then his older counterpart.  The athletic injuries, which do occur, are usually minor contusions and sprains.  Fractures, dislocations and major ligament injuries can happen, but are more common in older age groups.

Parents have expressed concern about the potential for injuries to the growth areas of developing bones and muscle in the pre-pubescent athlete.  This concern has proven to be more perceived than real, as several scientific studies have failed to document a significant increase in physeal injuries (damage to the growth areas of bones) in young athletes. Only in extreme cases, such as young gymnasts in intense training for long periods of time, are at some risk to growth plate injuries.

An argument against organized youth sporting activities, which is based on the potential for injury, is not realistic.  Although documentation is not available, it is probable that injuries resulting from participation in organized sports are fewer than those suffered on the playgrounds, or by falling off bicycles or skateboards.

Young people have definite physical and emotional energies.  It is probably less hazardous to release these energies in directed endeavors than through alternative means.  Any traditional organized sport is certainly safer than riding a motorcycle, for instance.

Are there specific injuries associated with specific sports?

While each of the individual and team sports has a family of injuries most common to it, listing of individual sports and injuries will be ignored her in favor of a generalized discussion based on contact versus non-contact sports.

The most notable examples of contact sports practiced in the United States are football, ice hockey, wrestling and basketball.  In each of these sports the athlete’s body is used to physically control the opponent and, thus, to influence the play of the game. Using the body in this manner creates the opportunity for injury.

Fortunately, the majority of injuries in these contact sports are bruises and scrapes.  The more significant injuries such as fractures, dislocations or major ligament damage occur in the post-pubescent athlete.  Parents should be responsive to complaints of pain and discomfort from athletes in all age groups and be aware that any athlete who is not playing up to skill level may be suffering from a significant injury.

In non-contact sports, major fractures, dislocations or ligamentous injuries are usually associated with accidental rather than intended collisions.  Minor sprains, muscle pulls, blisters and overuse syndromes are commonly seen injuries in non-contact sports.

The overuse syndrome is usually related to sports requiring repetitive, high-stress motion such as tennis, swimming, track, golf and baseball.  Injury occurs as a result of constant repetition of a particular movement.  Stress fractures, shin splints and tendonitis are examples of overuse injuries.

The treatment in each case is early recognition of the problem, followed by abstinence from competition and at least a decrease or change in training until the affected area is totally symptom free.  Training intensity and duration can then increase again. Return to the previous level of training should be gradual and well planned.  If the symptoms of overuse persist beyond a few day of rest or it they recur, a physician should evaluate the athlete.

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Are youth athletics worthwhile?

Yes! While very few athletes participate on organized teams beyond high school, and even fewer beyond college, sports activity creates a physical fitness discipline and a positive learning experience which carries through to an active, healthy adult life.

Participation carries a risk of injury but, once again, the question is not whether the risk is present but whether the risk is undue.  A question of similar importance is how best to direct the naturally occurring physical energies of youth.

The American Orthopaedic Society for Sports Medicine is convinced that appropriate sports and physical training are safe and healthy applications of these energies. Physical fitness is advisable throughout an entire lifetime and is achievable only through physical activity.  The discipline, motivation and training required to remain fit should begin as a youngster.

This is general information.  It does not purport to encompass all risks associated with youth sports activities, nor is it a substitute for your own good judgment.

Expert Consultant:  Louis C. Almekinders, MD

Revised 2001.