← The Pediatrician Next Door - Simple Advice on Parenting and Family Health
The Pediatrician Next Door - Simple Advice on Parenting and Family Health
Are Youth Sports Pushing Kids Too Hard?
00:29:20
Loading summary
Transcript21 lines
- [00:02]
A
All right, listen up. Nacho chips, quiet down. Crispy potatoes. This is the moment Velveeta's been preparing you for and you're not about to crack under pressure. Today's the day to go all in on the drip. Velveeta's heat and eat queso is the MVP of any game day spread. So stick by them and you'll be golden. Now get out there and make delicious history. No tailgate party is complete without Velveeta.
- [00:31]
B
This episode is brought to you by State Farm. Checking off the boxes on your to do list is a great feeling. And when it comes to checking off coverage, a State Farm agent can help you choose an option that's right for you. Whether you prefer talking in person on the phone or using the award winning app, it's nice knowing you have help finding coverage that best fits your needs. Like a good neighbor, State Farm is there.
- [00:59]
C
Just a few months ago, I met these parents in my clinic and they were super worried. They looked worried, just like a lot of parents do. Their daughter had been at a soccer tournament over the weekend and hurt her knee. She was seen there at a local emergency room in the town where they were traveling to for the tournament. And then they came back home and were in clinic to see me to get a referral to orthopedics. So the father says to me, I don't understand. She's only 14. What if this is a career ending injury? And what struck me obviously wasn't the injury itself. It's the word career. Like, when did kids sports become this high stakes pipelined like glory? The other thing that made the moment interesting was the parents both kept saying she did everything right. And what they meant by that was she trained year round, she never missed practice, she pushed through her pain. And I know this isn't a rare experience for parents today. It was a freak accident that happened to their daughter. We're seeing tons of serious injuries among student athletes. I'm seeing more and more kids with injuries that I used to associate with adults like ACL tears, meniscus damage, overuse injuries, and even worse than that. But what really worries me is that these kinds of injuries don't just sideline kids for that one season, they, they can cause problems for the rest of their lives. So my question is this. Why are today's kids getting old person sports injuries and what impact might these injuries have on them as adults? Like lifelong joint problems? If the goal of youth sports is to build strong, healthy adults, we have to talk about what's happening to These young kids bodies long after their team spirit Sports Stop. I'm Dr. Wendy Hunter and I'm the pediatrician next door. I'm that doctor friend you call for practical advice about your kids health. I mix the science of medicine with the reality of parenting. When we talk about youth sports injuries, especially knee injuries, it's easy to assume this is just bad luck. A wrong step, a collision, something that was unavoidable compared to adults where it's like something stupid because we're just old and I don't know, decrepit. But what if for kids this is not the full story. To help us figure out what's really going on in youth sports injuries and what happens years after the injury, I spoke with someone who sees the full arc from the middle school playing field all the way to adulthood. Dr. Matt Tao is an associate professor at the University of Nebraska Medical center in orthopedic surgery. And, and he's the medical director of the sports medicine program. He specializes in knee preservation surgery. So ACL injuries, meniscus, tears, cartilage damage, and he works with athletes of all ages, from kids to adults who want to stay active. Dr. Tao's research doesn't just try to get athletes back on the field though. He studies what happens years later, including the surprisingly high rates of early arthritis and after injuries like ACL tears. Is this really an issue or is it something I'm seeing where I practice? How big of a problem are knee injuries, especially for young athletes? Here is what Dr. Tao said.
- [04:26]
D
Certainly knee injuries are something that is kind of at the forefront of people's minds, not just us as physicians, but the general population. It just seems like every day if you look at ESPN or some of the other media outlets or online, there's always a high level athlete, college pro, et cetera, that had some type of knee injuries, often in acl. That's the one that really comes to mind most I think for people. And certainly the prevalence of ACL injuries has gone up over the last 10 years. In fact, I was just reviewing a paper the other day about that, that it's just become much more common. And so it's something that we're dealing with a lot of surgeons and certainly patients have to deal with it as well.
- [05:07]
C
There are about two and a half million sport related knee injuries in adolescents every year in the U.S. most of them are in age 15 and older. And surprisingly, female athletes have a higher rate of ACL injuries than boys. If these injuries are becoming more common, we really need to understand why and maybe Ask what we can do differently. Are we training? Right. Before we get into why this is happening, let's look more closely at what the research shows about student athlete injuries. Because the patterns are surprisingly consistent across large injury surveillance studies. In high school sports, the most common injuries are still the classic ones like sprains and strains, especially the ankles and knees. And concussions are pretty high too. When you look at summary reports from the National High School Sports Related Injury Surveillance Study, that's a mouthful. Year after year, strains and sprains are the most common in sports. Concussions are next, especially in cheerleading and boys ice hockey. So if your child comes home with an ankle sprain, a knee injury or a concussion, unfortunately they're not an outlier. They're part of the most common injury bucket that we see in youth sports now. Has that changed over the last 10 or 15 years? Yes, but also no. The types of injuries have not significantly changed. Kids still sprain their ankles, strain their hamstrings, get hit in the head and hurt their knees. But what's changed is, is the rate and in some categories the severity and long term implications. We're seeing worse injuries. The injuries haven't changed, but there are more kids getting hurt and they're getting hurt worse. However, if you look at concussions, there is an important caveat, and that is that part of the increase is because of better recognition and more reporting. And it's not that kids brains are more fragile. Today, doctors, coaches and parents are paying far more attention than they used to to concussions. Even the surveillance systems have changed over time. High school reporting began capturing all concussions more comprehensively, which pushed the numbers up just because we're finally counting what we used to miss. Okay, now let's talk about the knee because this is where the conversation gets really intense for parents. ACL injuries in kids and teens do appear to be rising over time. Pediatric research has shown increasing incidence of ACL tears over the past couple of decades. And data on ACL reconstruction obstruction also shows increase over time with big peaks in those adolescent age groups. That lines up with what Dr. Tao said earlier, that ACL injuries have become more common in recent years. And it also helps explain why parents feel like they're hearing about ACL tears constantly. It's not just espn, it's youth soccer fields and school gyms. So what is driving this increase in injuries?
- [08:09]
D
There are certain people that may have an anatomic or genetic risk factor and fortunately that's probably relatively rare. Unfortunately, there's always going to be some level of Injury with sports, it's just one of those things that's not completely preventable. I do think one of the things that we see often is just overuse injuries. And so I'm not trying to pick on baseball, but in terms of our young guys that throw, a lot of that's something that we see just as an example of kids that throw all the time, all year round, with no breaks. It just sets you up for overuse injuries. And there's pretty good data on that in terms of just needing breaks. The body's just not built for that at a young age. But in general, it's something where we love sports because it keeps people active, whether you're young or old. It's part of kind of an active, healthy lifestyle. So I wouldn't say not to participate because of the risk of injury, but it's certainly something to be aware of.
- [09:07]
C
So some of it is simple math. More participation, more exposure, more opportunities to get hurt. But a big piece of it is something we don't love to admit because it's cultural, it's emotional, and it's happening in the car ride to practice. We are asking kids to train like they are adults. Over the last decade or so, youth sports has shifted toward higher intensity early, earlier specialization, and few off seasons. And when you look at the research on early sport specialization, the signal is consistent. Specialization is associated with a higher risk of overuse injuries, and especially serious overuse injuries. That's the part parents don't always see coming. We picture sports injuries as a dramatic moment. Somebody lands wrong, someone collides, someone hears a pop. But a lot of youth injuries are more like a low, slow leak, repetitive load, not enough recovery time, and tiny changes in body mechanics. As kids grow, suddenly, their body hits a limit. Then, of course, there's the modern pressure cooker. Playing time, scholarships, club teams, showcases, private coaches. There's this unspoken fear that if your child rests, they're gonna fall behind. Which brings us to the real pivot point of this episode. As Dr. Tao said, we can't eliminate injuries completely. We shouldn't expect to. So how do we change the conditions that are making them more likely and in some cases, life altering?
- [10:41]
D
One of the things that comes up, and I'll use ACLS as an example, is there's certainly some very good data and some good programs out there that have been well validated with research to reduce the risk of ACL injuries. But any of these kinds of things, whether it's ACL or something else, they really do require a fair amount of effort on the part of the athlete, the family, and particularly the team as a whole. So there has to be a level of dedication there. I think something simple with regards to overuse injuries. If it's somebody that's just doing a single sport all year round with no breaks, there's very good evidence that that's probably not the best thing. It certainly sets you up for injuries. So taking a break for a month at a time from a given sport a couple times a year is a really good way to try to prevent some of those overuse injuries.
- [11:28]
C
That idea overuse sounds almost too simple, but it's one of the most powerful and most preventable causes of injury we see in kids today. The thing is that kids bodies aren't smaller versions of adult bodies. They are growing and changing and adapting in real time. And their bodies need massive time for recovery. This is part of the conversation where a lot of parents get really uncomfortable when I bring it up. Because what they're doing doesn't sound reckless. It sounds like they're being responsible. Their child loves their sport, they're good at it, they were invited to a club team, they want the extra training. And without anyone deciding it, one sport defaults to become the sport. So what used to be a seasonal practice turns into year round. What used to be a team practice turns into some private lessons. And what used to be play turns into almost a job. Think of it this way. Specializing a sport feels like dedication. It feels like opportunity. It feels like you're doing right. But biologically, it's a different story. When kids specialize early, especially before puberty, Their bodies are asked to repeat the same movements over and over and over again. During a time when their bones, their muscles, their tendons and ligaments are all growing at different speeds. The brain is still figuring out coordination that makes things more complicated. And growth plates are open, so strength isn't evenly distributed through a body. So instead of spreading stress across the body, we concentrate it into the same knee or the same shoulder, the same hip, the same throwing motion, the same jump and landing pattern. That's why so many youth sports injuries aren't dramatic collisions. They can be gradual, cumulative injuries. A sore shoulder becomes a torn labrum. Knee pain that's brushed off as growing pains gets worse. And in my experience, kids often don't complain. They don't want to miss practice, they don't want to disappoint their coach, they don't want to fall behind their teammates. So they ignore the pain. And adults with the best intentions, we normalize it too. But as Dr. Tal pointed out, the research is clear on this part. Early intense sports specialization is associated with a higher risk of overuse injuries, especially serious ones. So what can athletes and parents do? We're going to get to that after these messages. Every year around this time, people talk about New Year's resolutions. But instead of resolutions, I make a list of my values and then I build simple rituals that support them. My best friend knows I do this, and this year she said her values are her home and her family and and that means new bedding. She's right. For me, the rooms I spend the most time in and that really shape how I feel are my bed and my bath. That's why this year my reset started with Cozy Earth sheets and towels. I upgraded to Cozy Earth's Baja Bedding Set and transformed my bedroom. It's a complete matching set, sheets, duvet, cover, quilt coverlet with this beautiful, calm design inspired by the Baja California landscape. It feels elevated but inviting. Then there are Cozy Earth's luxe bath towels. They're plush, absorbent and they dry you off quickly. It's a small ritual, but stepping out of the shower and using a towel that feels this good changes how I start my day. When the holidays wind down, I need rest and the feeling that I'm ready to take on the new Year. And that's exactly what Cozy Earth delivers. Luxury comfort that makes home my best part of life. Plus, it's completely risk free. Cozy earth offers a 100 night sleep trial so you can try it out and return it hassle free. And everything comes with a 10 year warranty because once you've experienced this level of comfort, you'll want it to last. Start the new year off right and give your home the luxury it deserves and make home the best part of Life. Head to cozyearth.com and use my code DrWendy D R W E N D Y for up to 20% off. And if you get a post purchase survey, be sure to mention you heard about Cozy Earth right here. Refresh your routines with comfort that makes every day feel like a new year.
- [15:46]
E
The French Dip from Firehouse Subs is here for a limited time, piled high with premium roast beef, caramelized onions and melty cheese on a freshly toasted garlic butter roll. Every French dip is served with warm sea savory au jus for dipping. This melty French dip is only at Firehouse Subs for a limited time, so head to your nearest Firehouse subs or order on the app and try the French dip before it's gone. Limited time at participating Firehouse Subs restaurants while supplies last.
- [16:16]
F
This episode is brought to you by Peloton. Break through the busiest time of year with the brand new Peloton Cross Training Tread plus, powered by Peloton iq. With real time guidance and endless ways to move, you can personalize your workouts and train with confidence, helping you reach your goals in less time. Let yourself run, lift, sculpt, push and go. Explore the new peloton cross training tread.
- [16:39]
G
+@1Peloton.Com hey, it's Brooklyn Adams and I'm partnering with Abercrombie to tell you about the newest drop from their active brand. Your personal Best YPB leggings are made with buttery soft fabrics that hug you in all the right places and come in Abercrombie's viral curve love fit designed to eliminate waist gap. Paired with sports bras and super soft sweatshirts, it's activewear that supports every part of my busy lifestyle and gives me my best butt ever. Head into the new year feeling your personal best Shop Active by Abercrombie in the app, online and in stores.
- [17:17]
C
As we talked about before the break, it's ironic, maybe, but one of the the best ways to protect long term performance is variety. Different sports load the body differently. They build balance, coordination and strength in ways that protect your joints and rest allows tissues to recover and adapt. Time off does not erase your progress, it enhances it. You may want to bring your kid into the room to hear that part. So how are parents supposed to deal with the pressure on their kids to stay in the game? What can you do? This is the moment I see over and over in clinic. A kid shrugs when I ask if something hurts and a parent says he doesn't want to say anything. I know this mindset doesn't come from laziness or lack of toughness. It comes from a kid's commitment, from their loyalty to teammates, from kids who really love what they're doing. But there's a big difference between discomfort and injury, and kids are still learning how to tell that difference. They really might not know that they shouldn't be in pain. They don't have decades of experience interpreting pain. They don't know which aches are normal and which ones are warning signs. And what if they are in a culture that rewards pushing through the pain? Dr. Tao explains what athletes should do after an injury during a game, especially kids and teens. His answer was thoughtful and, honestly, pretty reassuring.
- [18:39]
D
One of the things sometimes that we try to emphasize with our athletes, particularly kids, middle school, high school, and even college, is there's oftentimes this mindset of I don't want to come out of the game, which I love. I love that about working with athletes, that people want to just stay active. But one of the things that I would urge people to do is at least just consider the situation. You know, if it's something that really bothers you or if it was an injury that's limiting you. Concussion is one that comes to mind. That's really a hot button topic the last couple of years. It's always safest to at least ask the question and get evaluated. Doesn't necessarily mean you can't go back in the game, but it's at least worth asking and making sure it's safe before you do.
- [19:17]
C
What I appreciate about this answer is what he doesn't say. He doesn't say every ache means you're done. He doesn't say kids should be afraid of sports. He doesn't say toughness is bad. He says pause, assess and ask. Many injuries that turn into season enders or career ending injuries, as the parent in my office said, aren't caused by the first hit or the first misstep. They happen when a kid keeps playing on something that's already compromised. An unstable knee, a head that's not quite right. And for parents, this is often where guilt sneaks in. They think, I wish I had trusted my instincts. I wish we had pulled him out sooner. So here's the reframe I want your kids to hear. Coming out of the game doesn't mean you're quitting. It means you're committed to being your best. Getting evaluated is not a weakness. Protecting a young body in the moment may be the very thing that allows them to keep playing. Tell your kid the goal isn't to win today's game. It's to make sure your body is still able to play. Okay, let's switch gears. What do you do once an injury is diagnosed, Whether it's a ligament sprain or something really serious like an ACL tear First, I know you are going to be frustrated. I often see my patients experience almost a sense of relief, though, because they've got a diagnosis. They have a name for what's going on and a plan that often includes physical therapy and rest from the specific sport. And that can be incredibly helpful. But for families, the plan might be surgery, rehab and then hoping to get back next season. And this is where I want to take a closer look. Because surgery is even when it's necessary is not the end of the story. It's not the fix. It's not even the middle. When Dr. Tao talked about treatment options for knee injuries, I thought he was going to talk about techniques and procedures. But what he emphasized instead was something families don't always expect to hear from a surgeon. Here he is.
- [21:17]
D
I'll start by just saying the goal really for any of us in sports medicine is to get people back to being healthy and active. And oftentimes it differs, depending on the injury, what course of treatment we're going to take. Certainly in general, there's either non operative or surgical options. Even as a surgeon, I guess my feeling is that no surgery is always better than surgery unless we absolutely have to. And there's certain things, maybe a fracture, ACL tear or something like that, where most of the time we're probably going to head down the road of surgery. But either way, we want to try to tailor that to the athlete and their injury. And sometimes that differs, really person to person and sport to sport. But again, as a surgeon, my goal is to try to set up that recovery process. Well, there's a lot of other people that factor into that, but to try to set people up for that recovery and ultimately get them back to the level of activity that they want to be at.
- [22:10]
C
We tend to think of surgery as a fix, the decisive step that solves the problem. But in pediatrics especially, the question isn't just can we operate, it's should we and when and for whom? Some injuries do need surgery. Certain fractures obviously do. Many ACL tears do, structural injuries that won't heal on their own. But even then, surgery is just one piece of the puzzle. What matters just as much is who the athlete is, what sport they play, where they are in their growth, and what they want their future to look like. And that's a really important reframe. Instead of asking, when can my kid get back on the field? The better question is what path gives them the best chance of long term health? And that's the idea I want you to take away. Seriously, I want you to write that down. This is the question to ask a surgeon because most of them want to operate. What path gives my child the best chance of long term health? Surgery can stabilize a knee, it repairs tissue, it creates conditions for healing, but it does not build strength, it does not restore your coordination, and it doesn't retrain the brain and body to move safely again. That work happens later, and that's when recovery begins. This conversation almost never comes up and it's rarely mentioned when a kid is finally ready to go back to play. Once an athlete is back on the field, we think the story's over. But it's not. Dr. Tao specializes in the long term consequences of knee injuries, especially ACL tears, and his explanation shifts the entire conversation. We're not talking about this season anymore. Now we're talking about our child's lifetime.
- [23:48]
D
One of the things that my research partner Liz Wellsand and I are really passionate about is ACL injuries, which obviously disproportionately affect young people. And it's something that as a surgeon, we're really eager to get people back to sports. And that's part of the fun part of this job, is seeing people get back to things like football and soccer and basketball. But what's not talked about a lot, certainly in the general public, but even in the medical community sometimes, is that there's a really high rate of arthritis after ACL tears. And so if you think about a kid may be in their sophomore year of high school getting an injury, playing soccer, hopefully they're back that next year playing again, being active. But if they end up getting arthritis 10 or 20 years down the road, they may still be in their 20s or 30s, which is a huge problem. It's something that people hear arthritis and think, oh, they can just get a knee replacement. But as a 20 or 30 year old, that's definitely not something that you want as an individual or a society that we want. So I think our hope is to help further that field, to have a better understanding of actually what causes the arthritis, and then certainly to try to reduce that risk going forward. Because if we can help to do that, certainly on an individual level, but definitely on a societal level, it really decreases the burden of pain, dysfunction and cost long term.
- [25:02]
C
Yes. He said arthritis. Arthritis is something we associate with aging, with decades of wear and tear with people later in life. But the research is clear. Even when ACL surgery goes well, even when rehab is perfect, the risk of early arthritis remains higher than we're comfortable admitting. And when that arthritis shows up early, there aren't great options. People often say, well, they can just get a knee replacement. But a knee replacement in your 20s or 30s is not a simple fix. It limits activity. It doesn't last forever. So why do I care about this and why should you? Because the true cost of a sports injury is during the young years, isn't just about one missed season. It can last forever. It can mean an adult who can't use their body to do Whatever they want. So to be honest, I think we've gotten the story wrong. We celebrate when an athlete returns to play, and that matters. But we don't often talk about prevention, rest, and rehab. So where does this leave us? If injuries are not always preventable? Dr. Tao said that for sure. If surgery is not your finish line, and if the long term risks of early arthritis are real, what should you do? The answer is to bubble wrap your kids. No, not really. We need your kids to get hurt so they will come and see us. But. So that's not true either. But parenting from a place of fear and overprotection is a bad idea. And a bubble wrapped kid is a nightmare when they're like, anxious and overly cautious. The answer is shifting our goals and our mindset. So when Dr. Tao talks about recovery, and he doesn't talk about it as a solo effort or even as something that happens mainly in the operating room, he talks about it as a team process.
- [26:47]
D
I love the rehab side of it. I don't pretend to be a physical therapist, but I do care about it a lot because I think it matters a ton for the ultimate outcome. I mean, if our goal is to get people back to high level activity, whether we're talking about high school kid or a weekend warrior, there's a lot more than just what happens in the office or in the operating room with us. And I think a big part of that ends up being strength and conditioning. Athletic trainers, physical therapists, they're a huge part of that recovery. I'll use ACLs as an example. I try to actually tell my ACL patients preoperatively. I think what I do is important, but my hope is that I'm setting you up well at time zero that you have a stable knee. But in terms of actually getting back to something like soccer or basketball or football, really all of that happens in the rehab process. And so I think that process with the ATCs and PTS is probably just as important, if not more important than the surgery itself. So it's kind of natural for sports to think of it from a team perspective, but we really do look at recovery as a team sport.
- [27:48]
C
Recovery is a team sport, and training is too. Preseason conditioning, workouts, recovery practices like stretching, these are all super important. You can find a strength and conditioning specialist by searching the directory of the National Strength and Conditioning association or ask around for a recommendation. I cannot say enough about working on strength and mobility. Here's what I learned. Strength, balance, and conditioning have enormous value. And it's not just about sports. Specific drills and skills. So things to consider when an injury occurs. Make sure rehab is not rushed. Take physical therapy seriously. Let kids fully heal before they go back to practice and remind them to listen to their body because that's part of being a good athlete. And this is where parents have more influence than they realize. You can normalize rest time, make it a habit to take certain days of the week off or take off weeks of the year. Remind kids that their future matters more than today's scoreboard. The real win of youth sports is not scholarships or trophies. I know it seems like it is, but it's raising kids who love movement, who love listening to their bodies, who can still be active adults down the line. So what should I have said to the parents that came into my office? The ones who couldn't get past their career ending injury? They were grieving. They were afraid they might lose their future, the one they had pictured for their daughter. And I don't really know what I should have said that day. I empathized with them and I made a referral to orthopedics. But no matter what, I know youth sports are one of the very best things we give kids. They teach teamwork and resilience and joy. So if you take just a few things from today's episode, let them be these rest is not bad. It's great. Pain is information. It's not something to ignore. Recovery deserves as much attention as high performance and the finish line is long term health. Being a healthy adult. If this episode, if this episode made you think of another parent, coach or family navigating an injury right now, please share this episode with them. These are conversations that we need to have before someone is injured. Thank you for being here and for looking out for the long game. For more from the pediatrician next door, find me on the web@ pediatriciannextdoorpodcast.com if you've got a question about the weird things kids do, send an email to hellopediatriciannextdoorpodcast.com for a chance to hear your voice on the show. I'm Dr. Wendy Hunter and I'm the pediatrician next door. This show is produced by Red Rock Music. Make sure to subscribe and leave a review wherever it is you're listening. I'll be back next time with more.