In honor of March Madness, I thought I’d devote a post to youth sports participation.
I love this time of year. So much chaos. So much fun. My husband and I have a little bet with each other over our bracket each year. And despite the fact that he claims to be the bigger sports fan (and probably is), I am undefeated! Thanks Florida!
But while we are both big fans of sports, we don’t quite see eye-to-eye on our kids’ participation in sports.
While it seems like a pretty straightforward concept, children’s participation in youth sports, it turns out, is a complex consideration. And one researchers have been looking at for a long time.
There are a lot of positives to sports participation in kids. From a health standpoint, the physical activity provided by sports participation can last long past a child’s sports career. Many studies have found positive impacts on cardiometabolic profiles both during participation and for years after reaching adulthood. Cardiometabolic risk factors include things like BMI, blood pressure, cholesterol, and glucose levels – all things that American adults struggle mightily with. But adults who participated in organized sports as kids have a leg up on keeping their levels in a healthy range compared to adults like me, who grew up afraid of the ball, despite my parents’ best attempts to try me in different sports. Kids in sports also often see improved endurance, muscular strength, and even are more likely to be physically active as adults, which reduces the risk of any number of diseases from heart disease to cancer.
Youth athletes are also less likely to participate in risky behaviors like smoking or illegal drug use. Interestingly, sports participation doesn’t seem to affect underage drinking. But on a personal level, the risk of drug use scares me so much more than the risk of alcohol. And I feel more prepared to help my kid navigate the world of alcohol than I do for drugs. So if sports can help me there, I’m all for it.
There is also social and mental health benefits to youth sports participation. Kids who participate in sports have higher self-esteem, less depression, higher levels of social support (which is a concept in health research that is associated with lots of positive health outcomes), and less anxiety than kids who didn’t do sports activities. However, it is a bit complicated. Specifically, kids who did team sports had significantly better mental health outcomes than kids who participated in individual sports. Kids in individual sports were more likely to have higher levels of depression and anxiety than their team sports peers.
In addition to differences in mental health benefits, there are injury differences between individual and team sports. Injuries represent the biggest downside of sports in my opinion, especially in youth whose bodies are still growing and developing. And researchers have found that the risk of overuse injuries are higher in individual sport athletes but acute injuries (injuries caused by a single, traumatic event) are more prevalent in team sports.
However, not all team sports are created equally. For example, two different studies, one conducted in 2005 and one conducted a decade later both demonstrated that football (the American version) had the highest risk of injury and, specifically, injuries that required athletes to take at least one day (or more) of rest. According to both studies, if you watched 1,000 high school athletes either participate in practice or a game, over 4 of them would get injured. Another way to think about it is if you watched the same athlete practice or play in a game 1,000 times, they would injure themselves more than 4 times.
Conversely, if you considered a baseball player over the same amount of time, they would be injured less than 1 time. At a giant soccer tournament with 1,000 girls and 1,000 boys would see 2 and half girls get injured and a little less than 2 boys get injured.
Scientists call this athlete exposure time and it represents a type of measurement used in research called person-time. It’s a good way to assess risk given that risks will naturally be higher when more people are exposed or when fewer people are exposed but over a lot of time. And even higher when many people are exposed for long times.
Person time is a great way to consider risk in youth sports given that the majority of injuries are overuse injuries. Using the same muscles or joints over and over again stresses these body parts and often leads to injuries, such as fractures or sprains, among others.
Researchers have identified great ways to help reduce these overuse injuries though. A slow build-up in the intensity, duration, and volume of activity, improved conditioning, using the right equipment, and using good training techniques specific to the sport. A gymnast is going to require different methods than a football player to avoid overuse injuries.
However, this also shows us where person-time isn’t always the best way to measure risk. Because yes, the more frequently someone engages in an activity, the more likely they are to injure themselves, it also works a bit in reverse. The more experienced an athlete gets in their sport, the more trained they will be. Their conditioning will improve and their knowledge of the sport and what it takes to do it safely will also, hopefully, increase. A good coach and trainer can really make a difference in reducing risk.
Person time, or here, athlete exposure time, only really captures this if you consider athletes at the same point in their knowledge and training. The two studies I cited above both looked at high school students. So they attempted to make the comparisons as even as they could. But even that leaves some room for potential bias in their results. For example, is the risk the same in freshman as in seniors? What about JV versus Varsity sports? So even among high schoolers, risk can vary and person time won’t capture it well.
Still, I like person-time as a measure of risk, as long as you consider it’s limitations.
The other injury that is always of concern but especially in kids is concussions. Concussions have received a lot more attention over the past decade or so but are still massively underreported and not managed correctly. Despite how many concussions go unreported, the number of concussions in youth has grown substantially in recent years. But it’s important to consider increased attention and knowledge about concussions. Because of this increase in awareness, more concussions are recognized as concussions and therefore reported and treated. This is great. But it also makes it look like the number of concussions have been increasing rapidly. This isn’t necessarily true. It is likely just that we are recognizing concussions more often now whereas before, they were even more severely underreported than they are now.
Kids in contact sports have the greatest risk for concussions. When the news first started covering this risk, I was a graduate student and a massive football fan. And frankly, I still am. But it’s been hard to reconcile my love of football with my public health side, knowing that this sport I love causes risk to the people who play it.
And this leads to my husband and I’s disagreement on how to handle sports in our household. We both love the benefits of sports – both the physical, health benefits and the social and mental health aspects. But where we differ is how big of a concern the injury risk is.
Our kids are still young so we still have time to debate this. Personally, I love them participating in team sports. But individual sports have me a bit more skeptical. As do contact sports. With where the research stands right now, I’d be hesitant to let my kids play competitive football or try individualized sports like gymnastics or dance. But at the same time, I love those sports. So I feel very much like a hypocrite saying I’ll watch your kids take the risk but won’t let my kids. Especially because I have seen the benefits, despite the risks.
As a scientist, I know the research is complicated. Frankly, there is so much more to this that I’ll likely have more posts about sports in the future. Because there isn’t a clearcut answer to what sport is best, which sport is safest, what sport will provide the best positive impact. There are so many considerations. How knowledgeable is the coach in preventing injuries and burnout? Is it better to focus on one sport and get the benefits of learning how to avoid overuse injuries by learning the techniques inside and out? Or is it better to do multiple sports, which has different benefits and risks? How can we maximize the benefits while reducing the risks.
Right now, my kids are little. They play whatever they want. Right now it’s soccer and it is ridiculously cute. Last year it was dance and it gave me flashbacks to my own childhood dancing. But as they get older, I don’t know what they will want to do. Or what I’ll feel comfortable with them participating in. I think the science suggests that sports are so beneficial for kids. But the best way to minimize the risk is still up for debate.
References
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