Are Competitive Sports Healthy for Your Kids?

On every field and court across the United States, young athletes dream of making it to the pinnacle of their sport, whether it’s earning an Olympic gold medal or a Super Bowl ring. While most kids play sports just to have fun, they’re also building character, developing self-esteem, and learning about teamwork and fair play.

In a nation where the collective concern about childhood obesity and seemingly unlimited screen time is increasing, it would seem that participation in competitive sports would always be a good thing; however, experts from Texas Health Resources point to a few issues parents should be aware of as their kids head into another competition season this fall.

Ross Teemant, senior director of Behavioral Health Outpatient Services, says athletic participation has many benefits for kids, including improved self-esteem, an improved body image and the encouragement to remain active throughout life, but he also warns of the potential pitfalls.

“Self-imposed and sometimes system-imposed expectations can lead to potential negative outcomes,” Teemant explains. “With proper training of coaches and athletes, a positive environment can be developed to help athletes live healthy lifestyles that enhance their sport, instead of harming their health and body image.”

Warning signs will vary from sport to sport, but Teemant says some of the higher-risk sports are endurance sports and those that focus on the individual rather than the entire team, as well as those in which the overvalued belief that lower body weight will improve performance is prevalent. Additionally, an elite athlete or one who has trained for a single sport since childhood may also be in more danger of falling into negative patterns.

Signs to watch for include:

  • Low self-esteem, depression and/or performance anxiety
  • Losing interest in activities or friends
  • Thoughts of suicide or not wanting to be alive
  • Abuse of alcohol or drugs to escape feelings of low worth
  • Family dysfunction, including parents who live through the athletic success of their child
  • Coaches who primarily focus on success and performance rather than the athlete as a person
  • Obsessive self-scrutiny in mirrors, thinking or making disparaging comments about his/her body, and/or the frequent comparison of his/her own shape and size to others
  • Social influences emphasizing thinness
  • Negative self-appraisal of athletic achievement or a negative change in performance due to fatigue

“Sometimes low self-esteem and body image problems are too much for a young person to handle alone,” Teemant says. “Seek help if your child is showing any of the above signs and encourage him or her to talk to you, a coach, religious leader, guidance counselor, therapist, trusted adult or friend.”

In addition to the psychological issues athletes may encounter, female athletes may experience amenorrhea, or the disruption of menstrual cycles, which is often associated with the female athlete triad. Sheri Puffer, M.D., obstetrician/gynecologist and physician on the medical staff at Texas Health Arlington Memorial, explains that this condition is identified by a low caloric intake, menstrual dysfunction and low bone density.

“The female athlete triad causes a dysfunction in the hypothalamus-pituitary-ovarian axis, which causes amenorrhea,” Puffer says. “Additionally, the lack of estrogen increases the risk of infertility, vaginal and breast atrophy and osteopenia, or low bone mineral density. Amenorrhea can occur in athletes that are training for a competitive sport and have a rapid increase in their training.

“Exercise does not normally cause amenorrhea, so all medical causes must be evaluated in new onset of the condition. The patient should be worked up for eating disorders, as this form of amenorrhea occurs with caloric restriction.”

In a scientific article published in Sports Health, researchers report that the occurrence of the three significant issues associated with the female athlete triad affects both the general population and female athletes but to significantly varying degrees. While amenorrhea affects 2 to 5 percent of the general population, it occurs in up to 69 percent of athletes who participate in sports that emphasize aesthetics or leanness, such as ballet and running.

“If the patient has exercise-induced amenorrhea, caloric intake needs to be monitored,” Puffer says. “Sometimes starting an estrogen-containing birth control can help prevent some of the side effects, and I would recommend a baseline bone density scan and daily vitamin D and calcium supplementation as well. Parental and coach involvement is key in making sure the athlete is mentally and physically fit to continue training and has medical follow-up.”

Young athletes may also experience orthopedic-related issues, most often caused by overuse or injury. According to the American Academy of Orthopaedic Surgeons (AAOS), overuse injuries are most common in the knees and feet and can affect muscles, ligaments, tendons, bones and growth plates.

Lindsey Dietrich, M.D., orthopedist and sports medicine specialist on the medical staff at Texas Health Arlington, says she and her colleagues often encounter different injuries in younger and older teens.

“In younger athletes under 13, we see mostly injuries or fractures to the growth plates of their bones and very specific cartilage injuries in the knee, as well as overuse injuries in the shoulder, elbow and knee,” she explains. “In athletes ages 14 and over, anterior cruciate ligament (ACL) and meniscus injuries are most common.”

Due to the popularity of organized youth sports and the increasing trend for kids to specialize in one sport year-round, repeated stress to the same parts of the body with little to no rest can cause lingering problems. Acute injuries include fractures and partial or completely torn ligaments, muscles or tendons, which can result in health problems later in life if not treated quickly or if the athlete doesn’t allow enough time for a complete recovery.

“The key to minimizing bone and joint issues is to have a consistent cross-training regimen that includes flexibility and age-appropriate strength training, as well as periods of rest from their sport or activity of choice,” Dietrich says. “Growth plate injuries and overuse injuries can become long-term problems that prohibit involvement in their sport of choice for months or years if not addressed appropriately. Additionally, ligament, cartilage and meniscus injuries can hasten development of osteoarthritis in future decades.”

Dietrich recommends close parental involvement to prevent long-term issues in athletes who may be pushing too hard or have an injury.

“The concept of ‘no pain, no gain’ is generally not favored in the younger athlete because their bones are often not fully mature and they also tend to have a higher tolerance for pain than adults,” she explains. “If they are limping, complaining often, or losing accuracy or speed with throwing or overhead activities, it is a sign that they may need to be evaluated by a physician. Young athletes hate to be held out of a sport, but it’s imperative to protect their growing bodies so they can have a long athletic career, whether it’s professional or recreational.”

Parents and coaches can work together to catch small issues before they become big problems by watching for changes in their athletes and educating themselves on the warning signs of potential concerns.

“Prevention and recognizing symptoms in early onset are vital to avoiding serious medical and psychological problems in athletes,” Teemant says. “Focus on proper nutrition and look for signs in which athletes may be turning to extreme measures to be thin or succeed at the risk of their health. Emphasize improving performance through mental and emotional strength instead of focusing on weight, and recognize when training routines are becoming obsessive and unhealthy.

“Encourage counseling when needed, be supportive and praise the athlete for the dedicated work he or she puts in, no matter what place they finish in a competition.”

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