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Why are so many kids getting injured in sports?

Andrew Merritt, MD and David Lessman, MD | Sports Medicine Physicians at Proliance Orthopedic Associates

Gone are the days of playing football in the fall, basketball in the winter, and track in the spring.

Gone are the days of putting down the basketball or hanging up the soccer cleats in the off season.

Gone are the days of developing different skills in different sports.

We have entered a world where kids and teens are hyperspecializing in a single sport at a young age.While the motivations for this have been reasonable -- as kids and parents try to become better athletes in their chosen sport -- the result has been a rapid increase in injuries.ESPN has written a wonderful article detailing this issue and the concerns related to youth basketball (linked below).

I am a sports medicine surgeon and I feel that this has become the defining health issue of my career.As the article points out, overuse injuries have become so common that NBA Commissioner Adam Silver has called it "the highest priority for the league."The NBA is concerned that by the time teenagers reach the NBA their bodies are already breaking down.The number of games missed and the rate of serious injuries to players in the first 2 years in the league have hit record marks because they are coming in as "ticking time bombs."In my practice, this is not isolated to basketball.I have commonly seen this in soccer, swimming, track, cross country, volleyball, and wrestling.

There is essentially unanimous consensus among orthopedic surgeons and sports medicine physicians that single-sport specialization has a detrimental effect on the body.Studies have shown both an increase in overuse injuries as well as an increase in severity of the injuries.

Muscle imbalance is one contributing factor to the incidence of adolescent ACL tears increasing 2-3% per year over the last 20 years. In my practice, this has been most commonly seen in year-round soccer and the reason why this happens has been well-studied.On a daily basis, I see very athletic and strong athletes who are actually imbalanced and weak in areas that do not receive the proper training.Hyper-specialization in soccer, especially in females, leads to the over-development of the quadriceps muscle and hip flexors and a relative underdevelopment of the hamstring and hip abductor muscles (and usually core muscles). This is a very common and well-studied pattern of muscle imbalance that leads to increased stress in the ACL during play and increased risk of injury. Additionally, players are 125% more likely to have a significant injury (fracture, ligament tear, cartilage injury) with single-sport, year-around dedication.

At Proliance Orthopedic Associates we have seen an increasing trend in adolescent overuse injuries and have recently hired a non-operative sports medicine physician who specializes in adolescent sport injuries. Dr. David Lessman is pediatric-trained and received additional training in sports injuries. I recently asked him about this growing issue and he had some great insights.He noted that up to HALF of all adolescent injuries are from overuse - and therefore, preventable. Dr. Lessman has some practical advice for avoiding these injuries:

Early sport specialization (quitting other sports to focus on one main sport) and year round participation are the biggest culprits of overuse injuries.There is significant pressure from friends, parents, and even coaches on these young athletes but the medical community agrees on a few common guidelines to help prevent injury:


  1. An athlete should participate no more hours per week than their age (a 12 year old should not be playing basketball more than 12 hours per week) until they are 16 years old.
  2. Children should not be playing a particular sport more than 8 months per year.
  3. Sport specialization should not occur before late adolescence.


There continues to be a lot of research in this area. Unfortunately, it shows very little benefit to early sport specialization with a large increased risk of injury.

Dr. Merritt and Dr. Lessman both grew up playing sports and find the athleticism and the competition of sports to be one of the highlights of life.We all share a goal of having healthy, active kids, and the fastest way to see this taken away is with an injury.So, let them play and play hard, just mix it up.

Part 1 of ESPN Article

Part 2 of ESPN Article

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