Are kids having a rough time of it in sports?
- Correspondence to Dr D J Caine, Department of Physical Education, Exercise Science and Wellness, University of North Dakota, Grand Forks, ND 58203-8235, USA;
Participation in children’s and youth sports is increasingly popular and widespread in western culture. In the USA, for example, more than 30 million children participate in sports each year.1 Trends over recent decades include increased numbers of participants, particularly girls, increased duration and intensity of training, earlier specialisation and year-round training, and increased difficulty of skills practised. In addition, children and adolescents are increasingly visiting wilderness recreational destinations and participating in a growing number of “extreme sports” such as skate boarding, BMX, mountain biking and rock climbing. Physical activity has important and wide-ranging health benefits. Indeed, no one has disputed it as being the solution to the biggest public health problem of the 21st century.2 In particular, in children physical activity increases physical fitness (both cardiorespiratory fitness and muscular strength), reduces body fatness, improves cardiovascular and metabolic disease risk profiles, enhances bone health and reduces symptoms of depression and anxiety.3
Balancing risks and benefits
Engaging in sports and recreational activities at a young age also involves a risk of injury.4 Young athletes may be particularly vulnerable to injury due to such growth-related factors as the adolescent growth spurt, susceptibility to growth plate injury, differences in maturity status, longer recovery and differing physiological response after concussion, and non-linearity of growth.5 6 They might also be at risk because of immature or underdeveloped coordination, skills and perception.7 Concern has also been raised regarding the young female athlete who may be at increased risk of non-contact anterior cruciate ligament injuries due to such factors as anatomy, hormones and menstrual cycle, neuromuscular characteristics, muscle strength and flexibility.8 The frequent and intensive training and competition of young athletes now may create conditions under which these potential risk factors can more readily exert their influence.
The increased sports and recreational activity of children …