The goal of a sports medicine surgeon is to help people remain healthy and active throughout their lives. Like all things, the patterns and habits of adulthood begin with youth. Unfortunately, there are several childhood trends that do not foster a lifetime of health and activity.
The first, and most obvious trend, is the increasing childhood obesity rate. As of 2016, more than 31% of 12-year-old children were considered overweight or obese. This rate is significantly worse than even 15 years ago, and the obesity epidemic is worse in poor and minority communities.
There are multiple causes of the youth obesity epidemic. Like their adult counterparts, children are not consuming a healthy and balanced diet, and are not getting enough exercise. Some notable statistics tell the story of the obesity epidemic. Over 50% of children do not attain the recommended minimum of at least one hour of activity per day. One in four children watch greater than 3 hours of TV per day, ⅔ of children consume a sugar drink per day, and the American Heart Association states that only 9% of kids consume a “healthy” diet. Additionally, anyone with eyes knows kids are now glued to their mobile devices in all situations, whereas once they were impossible to keep still.
Childhood obesity is associated with multiple troubling outcomes. Obese children have an increased risk of developing a range of health problems, including high blood pressure and high cholesterol, which are both risk factors for heart disease. Obesity can also cause sleep apnea, bone and joint problems, and chronic health conditions such as asthma and type 2 diabetes. Obese children are at increased risk of being bullied and suffering from depression and are less involved in school sports and activities. Obese children are also much less active as adults and are more likely to grow up to become obese adults.
There is no magic wand for the youth obesity problem. We are fortunate that Flagstaff is a community that is generally encouraging of physical fitness. Many of our schools do emphasize recess, PE class and wellness, and are cooperative to the outreach of non-profit organizations who strive to get kids to be active. When sports medicine surgeons interact with obese youth, we recommend simple, healthy tricks for children and parents. Get kids outside after school to play rather than staying inside to watch TV or to have a snack. Say no to all sugary drinks. Never eat after dinner. When snacking, eat things that don’t come out of a bag or a box.
Paradoxically, the other group that is at risk for decreased activity and fitness into adulthood are youth athletes who specialize and focus on only one sport. Early single sport specialization is defined as youth athletes who participate in only one sport for greater than 8 months a year. Recent studies estimate that ⅓ of youth athletes are single sport specialized by age 12.
There are multiple reasons why committed, one sport participation has become such a frequent path for young athletes. Ultimately, our intuition as parents tells us that if our child focuses on and participates in only one sport, that they are going to have the greatest chance to become a successful athlete. There are riches to be made as a professional athlete, and college is so expensive that any sane parent would hope that their child might develop into a scholarship athlete. Unfortunately, our intuition as parents is not supported by recent scientific findings.
Single sport athletes are much more likely to sustain both chronic, overuse injury as well as acute, major injury than their peers who play more than one sport. Single sport athletes participate in fewer practices and games and are much more likely to quit their chosen sport due to burnout and injury. These single sport athletes are more likely to develop orthopaedic problems like osteoarthritis later in life and ultimately are much less physically fit and active as adults.
But, is it worth it for your child to specialize in one sport? Will it help your child become a more successful athlete? Recent data doesn’t support this idea either. Of course, there are many athletes (think Tiger Woods) who focus on one sport as a young youth and become wildly successful. But if we look at other successful athletes, we observe trends that suggest playing multiple sports as kids is associated with becoming a successful adult athlete. When we look at recent NFL drafts, we see that 90% of all NFL draftees played two or more sports in high school. In evaluating the United States Olympic Teams over the last two decades, we observe that future U.S. Olympians on average participate in three sports up until age 14 and still participate in two sports in high school. Recent studies looking at the NBA and professional swimmers also found that multiple sport athletes also had much longer professional sporting careers then athletes who committed to their chosen sport at a young age.
Fortunately, many of the solutions for the epidemic of youth obesity and the problem of hyper-competitive single sport specialization are the same. Encourage our children to sample as many sports as they want. Encourage free play and fun, even during an organized sporting practice. Even if a young athlete loves only one sport, don’t plan to fully “commit” to that sport until high school and avoid the trap of having the athlete play on more than one team at the same time. Athletes who are single sport specialized, should also take at least 6 weeks off per year to participate in focused, neuromuscular training. Neuromuscular training programs, like the six-week Injury Prevention and Performance Enhancement Program (I.P.P.E.P.) offered by the non-profit Flagstaff Sports Institute, have been shown to significantly decrease youth sports injury rates while resulting in improved sport performance. For more information visit flagstaffsportsinstitute.com.