The benefits of physical activity for younger children are particularly evident when they participate in a variety of sports.
When you encourage patients and families to pursue multiple activities, you can foster normal physical and emotional development in your preschool and elementary school–age patients. Children aged 6-12 years typically experiment and explore before figuring out what they like to do. This is a crucial time to expose children to a number of different activities.
A limited, one-dimensional sense of self is a risk for a 5- or 6-year-old who "specializes" in one sport year round. Many will perceive themselves only as an athlete.
Many parents ask me, "Okay, if my child cannot specialize in sports now, when can they?" I tell them, in general, around sixth grade or age 12 years, because the child will developmentally be at an age when they can understand what they are going to give up if they specialize. They also understand the importance of school and education. Ideally, I encourage patients to wait until high school to specialize in the one or two sports they really like.
Some families will say, "Well, if my kid is not doing this, Johnny down the street is doing this, and he’s going to get way more advanced." I tell these families that if they look at how most professional athletes grew up, most played different sports year round. A professional basketball player likely played soccer, football, and a different sport each season. It’s only been in the last 10-15 years that the culture really changed, and children have been encouraged at younger and younger ages to choose just one sport.
A family also might say, "My kid really loves playing football." I point out that their child doesn’t know anything else, and the child might also like basketball, and might even be better at it.
Well-child visits are a good time to ask about sports and how often your patients play them. Good questions to ask include: How often do you play sports? Is it year round? Do you play multiple sports? Do you take any time off during the year?
If a parent seems convinced that a single sport is best for their young child, it’s a good time for you to step in and explain that most kids do better in the long run when they develop the motor skills that come only from a variety of sports. Also encourage parents to allow their child to take 2 days off a week from structured activities. A pick-up game with their friends is okay, but they really need the time to recover while they are growing.
Sports-specializing children generally peak in their sport much earlier than do kids who play a variety of sports, and they also tend to burn out more. If they eventually start performing for everybody else rather than for themselves, they lose their intrinsic motivation.
Sometimes, the signs of burnout will be subtle at first. If one of your young athletes starts complaining of more injuries that take longer than expected to heal, you might start to suspect that your patient doesn’t really want to be playing. These children might feel uncomfortable being forthright with their parents, especially if a significant amount of time and money has been invested in their sport.
If you don’t feel entirely comfortable sharing your suspicions with the parents, that is a perfect time to refer the family to a sports medicine specialist. I often spend more time counseling parents than children about burnout, and it’s a difficult conversation that often better comes from specialists who deal more directly with sports psychology.
It’s helpful if you call your sports medicine colleague and tell him or her that you’re referring the kid for his knee pain, but you’re really concerned about burnout, parental pressure, or something else. It’s nice for us to get that heads up from the pediatrician before we see the patient.
When a child does specialize in a sport, recommend a good core-strengthening program. We see overuse injuries from the core musculature breaking down. For example, our overhead athletes (swimmers and baseball/softball players) typically develop overuse injuries at 1 to 2 years after they begin specializing in these sports, often because they lose the core stability that playing multiple sports gave them.