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What overuse injuries are telling us about youth sports

Posted by Dr. Claire McCarthy  March 6, 2012 09:14 AM

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It's just about time for baseball season to start, and the American Academy of Pediatrics recently released a 14-page report full of recommendations on how to keep kids safe and healthy while they play baseball and softball.

It's a great idea, and the report is chock-full of helpful information. But I have to say, reading it made me a little sad.

First of all, I can't help feeling nostalgic for the days when we didn't worry so much about safety. Don't get me wrong -- I want all children to be safe. But as I read about sliding pants, the safest bat and ball, the appropriate head and eye protection gear, and making sure that no bacteria are spread by sharing equipment ... well, it's enough to make a parent sign their kid up for chess instead. I worry sometimes that we get so caught up in safety concerns that we not only freak out our kids, but miss the point that it's supposed to be fun.

But what really made me sad was the part about overuse injuries. Too much pitching, it turns out, is bad for you. The stress on the joints can cause conditions called Little League Shoulder and Little League Elbow. To prevent this, in 2007 USA Baseball issued "pitching limits", with actual number limits on pitches based on age. There are guidelines on how many days of rest pitchers need depending on how many pitches they do, total pitches per season, and how many months out of a calendar year a child should pitch.

What does it say about youth sports that we need to have these kinds of guidelines?

I think it says that we are starting them too early and taking them too seriously. It's not just baseball; it's all sports. Somehow, youth sports have moved from being about fun and exercise to being about achievement. Not that achievement is bad -- achievement is good. But we need to have some common sense.

Here are some interesting numbers from the NCAA. Of all the high school seniors on baseball teams, only about 6 percent will play on an NCAA team in college (most without scholarships, which are harder to come by than people realize). And of those same seniors, only one in 200, or 0.5 percent, will be drafted by Major League Baseball. Are those numbers really worth the risk of Little League Shoulder?

The achievement thing isn't just about getting a scholarship or going pro, of course. It's about achieving to achieve. Parents want their kids to shine and stand out in what they do, including sports. My kids are swimmers, and I understand that feeling; it's normal to want your child to succeed. The kids get caught up in it too; winning and recognition are exciting.

But there is an edge, and a downside, that we need to be aware of. When my older son was seven, he was on the fence about trying out for the swim team (he was worried he wouldn't be good enough). I told the coach that we might wait another year. "I don't think that's a good idea," she said. "He will be at a disadvantage it he waits until he's eight." I was floored. Really? He needed to start when he was seven?

Zack ended up deciding to try out, and was immediately hooked. As he entered the world of competitive swimming, I discovered that indeed, for the most part, the kids who swim fast and go to championships are the ones who start young and go to lots of practices and races. The kids who start later -- like 10 or 11, which is hardly late -- or the ones who go to fewer practices and meets, don't do as well (unless they are naturally very talented). Which makes more parents sign their kids up early and send them to lots of practices and races ... and the whole thing perpetuates itself. No wonder we are seeing overuse injuries, stressed-out kids, and the Hockey Dad phenomenon.

Somehow, we need to stop this cycle. Somehow, we need to take youth sports back for our kids and find a way to turn them back into what they should be: a chance for kids to be active, have fun, set goals, and learn sportsmanship. We need to see overuse injuries for what they are: a big red flag waving in our faces.

What do you think? What can we do?

This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About MD Mama

Claire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »

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