It can be exciting when a child displays a special aptitude for a sport. Whether it's gymnastics, baseball, hockey or figure skating, tomorrow's elite athletes are often identified at a very early age. In response, some parents encourage them to pursue a year-round schedule of intense training and competition — a practice referred to as sport specialization.
But these rigors can have negative physical and emotional consequences. In 2016, the American Academy of Pediatrics reported that increased emphasis on sport specialization has led to a rise in overuse injuries, overtraining and, ultimately, burnout.
What are the risks when kids concentrate on one sport? How much training is too much? And, at what age is specialization most advisable? Dr. David Lisle, an orthopedic sports medicine physician at the University of Vermont Medical Center, shares his perspective on the topic, including what causes burnout and how to avoid common sports-related injuries.
KIDS VT: How often do you see young athletes experiencing ailments associated with sport specialization?
DAVID LISLE: Well, it's a little unique in Vermont because we like our sports, but there's not one sport that's dominant here the way football, baseball and tennis are down South, where they're played all year round. Our athletic seasons are shorter and spaced out, so kids naturally diversify. Do we see some overuse injuries? Of course. We are seeing an increase in year-round club sports and travel teams. We also see kids who are specializing too soon and then burn out. But it's not quite as common, and the burnout often happens later, in high school or college.
KVT: What's the definition of overtraining?
DL: There are two concepts — overreaching and overtraining. Overreaching is when training is very intense and athletes note decreased performance and sometimes psychological problems, such as depression and anxiety. This all improves with rest. Overtraining syndrome is more extreme than overreaching. This is training that is so intense, leading to a longer period of psychological and physiologic changes resulting in prolonged negative sports performance.
KVT: Is burnout a clinical term?
DL: Yes. The term burnout is generally defined as leaving a sport that was once enjoyable because it's no longer fun or an important part of your life. There are different theories as to why it happens, but it's typically due to the stress of competition. Intense competition over many years may cause enough stress to create burnout to the point where people aren't interested in doing that sport anymore.
KVT: So burnout has both a physical and emotional component?
DL: Absolutely. In fact, it's probably more an emotional component. You can suffer an injury that causes you to leave a sport, but that's not burnout. Burnout is more of a psychological transition where you're no longer enjoying an activity the way you once did. It's usually due to being in a repetitive, stressful, intense, competitive atmosphere. But I should point out that the majority of young athletes don't leave a sport due to burnout. It's usually about time conflicts or changing interests.
KVT: At what age is it advisable for kids to begin specializing in an athletic activity?
DL: It's typically felt that before the early teens — and there's no hard and fast age, because the onset of puberty varies — specialization is not a good idea. Most young athletes are specializing around sophomore or junior year of high school. Any sooner than that has a much higher risk of burnout and much higher risk of overuse injury. Also, early sports specialization does not guarantee future elite-level performance. Nothing has proven that if you get your child into a sport early and focus on only that sport that your child will succeed at the highest level. That being said, there are some sports that you will not be good at unless you start early and specialize. They're called the technical or early entry sports: figure skating, gymnastics, diving and some would throw swimming in there, too. If you start late or don't commit to those sports early on, you won't succeed at the higher levels. Unfortunately, that's just the way it is. And we do see a lot of overuse injuries from those sports, such as gymnasts with wrist pain or back problems.
KVT: Are there benefits to athletes participating in multiple sports?
DL: Yes. Sport diversification does help athletes because of what's called skill transfer. Some sports can help you get better at others. Say you play soccer in the fall, and in the winter you alpine ski race. In soccer, there's a lot of footwork and balance. Those soccer skills will help in other sports that require similar skills. And you'll also reduce the risk of overuse injuries.
KVT: What advice do you give to young patients who are striving to become elite athletes?
DL: It's critical for all athletes to have an off-season to let their bodies recuperate, not just physically but also psychologically. We don't have, say, that epidemic of pitchers' elbow injuries like they do in the South because of the year-round training. Fortunately, the four seasons in Vermont help us see more diversified athletes. But a lot of our athletes are still overscheduled and compete in three or four sports a year and don't really have an off-season.