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Doctors See a Big Rise in Injuries for Young Athletes


Published: February 22, 2005


A competitive swimmer since she was 7, Alex Glashow of Barrington, R.I., logged 8,000 yards a day in the pool, until her arms ached. She learned to dislocate one shoulder intentionally to ease the pain in the water, but after shoulder surgery and a year of physical therapy, Glashow quit competitive swimming forever when she was 15.

Jeret Adair, a top young pitching prospect from Atlanta who started 64 games in one summer for his traveling baseball team, last year had Tommy John surgery, an elbow reconstruction once reserved for aging major leaguers.

Ana Sani of Scarsdale, N.Y., a 13-year-old budding soccer star, practiced daily until she tore the anterior cruciate ligament in her knee.

Around the country, doctors in pediatric sports medicine say it is as if they have happened upon a new childhood disease, and the cause is the overaggressive culture of organized youth sports.

"They are overuse injuries pure and simple," Dr. James Andrews, a nationally prominent sports orthopedist, said. "You get a kid on the operating table and you say to yourself, 'It's impossible for a 13-year-old to have this kind of wear and tear.' We've got an epidemic going on."

Typical injuries range from stress fractures, growth plate disorders, cracked kneecaps and frayed heel tendons to a back condition brought on by excessive flexing that causes one vertebra to slip forward over another vertebra. Most are injuries once seen only in adults.

Dr. Lyle Micheli, a pioneer in the field of treating youth sports injuries and director of the sports medicine division of Boston Children's Hospital, said that 25 years ago, only 10 percent of the patients he treated came to him for injuries caused by overuse. Back then, most childhood injuries were fractures and sprains. Dr. Micheli said overuse injuries now represented 70 percent of the cases he sees. In interviews with more than two dozen sports-medicine doctors and researchers, one factor was repeatedly cited as the prime cause for the outbreak in overuse injuries among young athletes: specialization in one sport at an early age and the year-round, almost manic, training for it that often follows.

"It's not enough that they play on a school team, two travel teams and go to four camps for their sport in the summer," said Dr. Eric Small, who has a family sports-medicine practice in Westchester County. "They have private instructors for that one sport that they see twice a week. Then their parents get them out to practice in the backyard at night."

Pushing Children to Overachieve

Dr. Angela Smith, an orthopedic surgeon at the Children's Hospital of Philadelphia, said parents in virtually every sport were pushing their children to excess in pursuit of college scholarships or the dream of a professional sports career. "The volume of training has increased beyond the maturing young body's ability to handle it," she said.

Doctors lament the loss of what has become a cultural artifact: the playground athlete. Two decades ago, sports for children were often unorganized, with pick-up games common in schoolyards and community parks.

"Children might have played baseball, basketball and football all in the same day," Dr. Micheli said. "This was good for their bodies, which developed in balance. Now young athletes play sports supervised by adults who have them doing the same techniques, the same drills, over and over and over.

"By playing one sport year-round, there is no rest and recovery for the overused parts of their body. Parents think they are maximizing their child's chances by concentrating on one sport. The results are often not what they expected."

In his office in Birmingham, Ala., Dr. Andrews hands the parents of new patients a piece of chalk and points to a blackboard in the corner.

"I say, 'Write down when your child started playing his sport, how many teams he's played for, what camps he went to, for how many years, what private instructors he's seen, what championships he won, what his stats were, all that stuff,' " Dr. Andrews said. "Then I walk out of the room. I come back in and they've filled up the blackboard. They're proud.

"And I say, 'You all know why he's here seeing me?' And I point to the blackboard. That's when the light bulb goes off."

Doctors in pediatric sports medicine say the cause is an overaggressive culture of organized youth sports.

According to several pediatric sports-medicine specialists, not all parents - and they come from all economic classes - see the light so clearly. It is not uncommon for the damage done by an overuse injury to be irrevocable, and the doctor's advice is to quit the sport.

"That's usually not received too well," said Dr. Michael Busch, an Atlanta orthopedic surgeon. "The parents will ask if there isn't some kind of surgery that can be done, so their child can keep doing the things that brought this injury on in the first place. I explain that an operation might be necessary just to alleviate the pain and to set a course for normal everyday use again.

"To tell you the truth, the kids usually take it better than the parents. Many kids are relieved. They can be kids again."

Doctors are also seeing what could be called the Curt Schilling effect in their examining rooms. Schilling was the Boston Red Sox pitcher who underwent a radical medical procedure - a ruptured tendon sheath in his ankle was sutured in place - so he could pitch in the postseason last year.

"I recently had a mother ask me if there isn't some kind of shot or fix-it procedure I could do for her 11-year-old daughter's ankle so she could be ready for an upcoming regional competition," Dr. Smith, the Philadelphia orthopedist, said. "I told her that if it were the Olympic Games coming up, perhaps we could treat this situation differently. But as far as I understood, her upcoming competition wasn't the Olympics.

"At this point, the daughter is giggling but the parent is in the corner crying. I said: 'This isn't Curt Schilling in the World Series. It's not worth not being able to run anymore for a plastic gold-plated medal.' "

The doctors who treat young athletes said they were proponents of youth sports, which they said were vital to the health of America's children. Participation in sports should be encouraged, the doctors said, but with certain precautions.

"I agree there are more overuse injuries, but I am still more worried about the high rate of inactivity and obesity in children," said Dr. William O. Roberts, president of the American College of Sports Medicine. "We need more kids to do a lot more and a few kids to do a little less."

It's also true that not all young athletes, maybe not even a majority, break down from overtraining even after years of rigorous workouts. But doctors warn that many young athletes will not complain about pain from sports because they believe it is just soreness, or part of the price for overachieving.

Learning to Play in Spite of the Pain

"My arm hurt for years but I never went to the doctor," said Jeret Adair, 16, the Atlanta pitcher, who underwent the surgery named for the Major League Baseball pitcher on whom it was first performed 30 years ago. The surgery involves removing a healthy tendon from one arm and inserting it into the other. Jeret had Tommy John surgery last year after the ulnar collateral ligament in his right elbow snapped in two as he was delivering a pitch.

"You know, like they say, you play with pain. If you're a good pitcher on a team of 14- or 15-year-olds, you're going to be throwing too much. Everybody wants to throw their ace out there."

Jeret was one of 51 high school pitchers upon whom Dr. Andrews performed elbow reconstructive surgery last year, a tenfold increase from a decade ago.

One approach to limiting overuse injuries involves training that is specially designed to prevent injuries.

Vinny Sullivan, a certified strength and conditioning coach and director of sports performance at Formé Health and Fitness in Scarsdale, said he saw more than 300 young athletes a week in a program designed to reduce overuse injuries. Mr. Sullivan has his athletes do exercises to correct muscle imbalances brought on by overtraining in a single sport. He works on their flexibility, balance, and running and jumping biomechanics.

Of special focus is teaching young athletes how to decelerate correctly, because many knee injuries result from a sudden stop or change of direction.

Among Mr. Sullivan's pupils is Ana, the soccer player, who came for help as a 13-year-old after tearing the anterior cruciate ligament in her left knee. The injury occurred without contact from another player as she was running down the field. She had recently stopped playing other sports to concentrate on her soccer.

"Ana is a phenomenal soccer player, but her hamstring muscles were much weaker than the rest of her leg structure," Mr. Sullivan said. "Her body hadn't developed anything but the muscles to play soccer."

After a 10-month rehabilitation, Ana returned to playing soccer - on three teams at the same time no less - and at 18, she just completed her first season at Williams College in Williamstown, Mass. She recently tore the meniscus cartilage - which helps distribute body weight evenly - in the same knee she hurt when she was 13.

"I don't know if it's a coincidence or not," said her mother, Ana Cristina Sani, "but she hadn't been in her injury prevention program while at college, and that's when she hurt her knee again."

Dr. Micheli, of Boston Children's Hospital, and many of his colleagues said they believed that better coaching would help reduce overuse injuries among children.

"The coaches are volunteers and mean well, but they are not trained," Dr. Micheli said. "And every five years, a new batch comes along and the problems go on unabated. We are vigorously promoting mandatory coaching certification programs where youth coaches can get the education they need to protect the children.

"I think town leaders will eventually say to soccer leagues, 'We'll give you the access to our fields but we want certified coaches.' "

Dr. Andrews advocates a laundry list of changes. It begins with stopping year-round play in one sport. "At least three months off," he said. For baseball and softball pitchers, he would also ban the radar gun.

"That thing has wrecked more arms," he said. "I'm sick of seeing these kids being torn apart."

Efforts to Reverse the Trend

Next month, a public-service campaign to educate young athletes, their parents and coaches about overuse injuries will be started through a partnership of the American Academy of Orthopedic Surgeons and the National Athletic Trainers' Association. The campaign includes a poster that shows a youth baseball team celebrating after a game with the headline: "What will they have longer, their trophies or their injuries?"

Alex Glashow still goes to the pool, helping out as a lifeguard. "I can stay involved in other ways," she said. She tried diving, but that bothered her shoulder, too. She has recently devoted more time to another sport, skiing.

Jeret Adair is tossing a baseball again and is hopeful about returning to pitching - with a strictly enforced pitch count - by this summer. He wants to pitch in college.

"I'm the living example of someone who did too much," Jeret said. "I would tell young kids coming up now: 'Don't be such a hero. Take a rest.'

"I look back now at all those games I won when I was 14 or 15. They don't mean so much anymore. They weren't worth it."

Bruce Weber contributed reporting for this article.





Dads' attention little girls in the game

NEWHALL -- Coaching girls' soccer for 12 years, Jose Leon has seen girls
with all types of personalities, as well as parents who encouraged their
daughters and those who pressured their children to the point where the game became a chore.

So Leon was not surprised by a recent study that found that fathers who are
interested in their daughters' activities -- whether traditionally masculine
pursuits such as sports or traditionally feminine ones such as music --
increase the chances that the girls will stay involved with those

And this continued participation bodes well for the girls' development.

Findings from other studies have shown that girls who remain involved with
constructive activities outside of school -- especially sports -- benefit in
many ways, including skill-building, identity development and psychological
well-being, said Susan McHale, a professor of human development at Penn
State University. She is also the lead author of the new study that gauges
what influences girls to participate in so-called "sex-typed activities."

Leon, who currently coaches a team of 10- and 11-year-old girls in the local
AYSO league that plays at Placerita Junior High in Newhall, said the ratio
of mothers who attend the games and offer support to their daughters versus
the number of fathers is about 60 percent to 40 percent.

"When I think about it, yes, I would say that the girls whose fathers come
to the games and support them, they stay involved in the sport longer," said
Leon. "They seem more balanced, more happy. They need that family unity."

McHale said the traditional roles mothers play in their young children's
lives -- bonding, teaching, setting boundaries -- are alive and well, but
the role of fathers is still crucial.

"Mothers are there in childhood and get things started for their daughters,
but to keep them involved in so-called masculine activities, like sports,
takes a father's interest," McHale said.

Terry and Carl Hartzler of Valencia spent part of Saturday at the Placerita
Junior High soccer field watching their 9- and 11-year-old daughters play, a
regular weekend activity in their family.

Terry Hartzler said she was in her school band growing up but was never
encouraged by her father, or even her mother. That sense of detachment as a child was not something she wanted to pass on to her own daughters.

"My parents weren't really there (for band performances) and that bummed me out," Hartzler said. "I definitely think I would've been more interested and
stuck with it longer if my father was more supportive. If parents show
interest, kids show interest."

The new research appears in the September-October issue of Child

For the study, McHale and her colleagues followed 290 girls, ages 8 through
15, and their parents for several years. The goal was to determine how the
girls' interests, the interests of their parents (including the parents'
gender-role attitudes), testosterone levels in the girls and peer pressure
might affect how the girls chose to spend their free time.

The girls were divided fairly evenly into three groups -- middle childhood,
with an average age of 8; early adolescence, with an average age of 12; and
middle adolescence, with an average age of 15.

Through a series of three at-home interviews with the families, as well as
follow-up phone calls on seven evenings following each interview, the
researchers charted how the girls spent their free time. Questions included
how many times they had participated each day in a list of approximately 30
activities identified as stereotypically masculine -- such as sports,
model-building, hunting or fishing -- or traditionally feminine -- art,
music and dance. They were asked how long they had pursued each activity
during the day and with whom.

The age at which the girls recorded the highest levels of traditionally
feminine activities occurred during middle childhood. And the highest levels
of traditionally masculine activities were reported in early adolescence, up
to the age of 13, and then declined through age 17.

Of all the variables, the most significant influences on the girls' choices
of how they spent their time were their own personalities and their parents'
interest in their activities, McHale said, rather than testosterone levels,
peer group influences or parents' views of gender roles.

"Our findings suggest that parents, particularly fathers in middle
adolescence, influence their daughters," McHale said.

When a daughter reaches puberty, it can be an uncomfortable time for a
father, McHale said, "but there are fathers who are able to express their
interest in their daughters' different types of activities, and daughters
will pick up on this."

Daily News staff writer Amy Raisin Darvish contributed to this story.


Science & Society

June 2004

Fixing Kids' Sports

Rescuing children's games from crazed coaches and parents

By Peter Cary

Fred Engh has seen it all. A wiry former college wrestler and father of seven, Engh has been a baseball dad, a coach, an athletic director, and, for nearly 30 years, an evangelist out to fix youth sports. Mention any ugliness at a kids' sporting event, and Engh, the founder of the National Alliance for Youth Sports, can counter with tales even worse. There's the father telling the kid, "You little bastard, you could never get anything right." Or the beefy guy, captured on video, telling his young baseball player, "I'm gonna get you tonight because you let me down, buddy." Or the one that started Engh on his crusade, the kid pitching in a local recreation league, who, after every pitch, grabbed his elbow and winced. When the umpire stopped the game, the boy's father and coach came out to the mound. "What's wrong?" he asked the boy. "It's my arm; it hurts," said the child, crying. "Son," said the coach, "this is a man's game. Now stay in there and pitch."

Cal Ripken Jr., the former Baltimore Orioles star shortstop and a father of two, has his own catalog of youth sports at their worst. He has seen coaches use what he calls the "loopholes" just to get wins. They will, in the younger leagues, tell players not to swing the bat because of the likelihood that the pitcher will throw more balls than strikes. Soon the bases are loaded. "So," Ripken continues, "you exploit the base-running, and you create an environment that is frustrating to the defensive team, especially the pitcher. He starts crying. He's thinking, 'How terrible that all these kids are crossing the plate on passed balls and wild pitches and they are stealing on me. It's not fair; it's not fair.' And they break the kids down emotionally, and that's how you win."

On a plane not long ago, Ripken read Engh's Why Johnny Hates Sports and found himself highlighting passage after passage. "I was struck by how the things he wrote about were things I cared about," Ripken recalls. He arranged to meet with Engh, and last week they got together again to talk. The topic: How to give kids' sports back to the kids.

That Ripken, a perennial all-star, would find common ground with Engh, a 68-year-old grandfather of 13, isn't quite as surprising as it may sound. Just about anyone who has spent time around youth sports these days has had a bad experience or has heard of plenty more. A survey of 3,300 parents published in the January/February issue of SportingKid magazine last year found that 84 percent had witnessed "violent parental behavior" toward children, coaches, or officials at kids' sports events; 80 percent said they had beenvictims of such behavior. A survey in South Florida in 1999 of 500 adults found 82 percent saying parents were too aggressive in youth sports, and 56 percent said they had personally witnessed overly aggressive behavior. An informal survey of youngsters by the Minnesota Amateur Sports Commission found 45 percent saying they had been called names, yelled at, or insulted while playing. Twenty-two percent said they had been pressured to play while injured, and an additional 18 percent said they had been hit, kicked, or slapped while participating. Not surprisingly, the dropout rate of all children from organized sports is said to be 70 percent.

Suffer the family. In the past decade, some disturbing new trends have emerged. Children are starting in sports younger, specializing in one sport earlier, and may play the same sport year-round. The consequences of such activity are not yet fully understood, but sports physicians say stress injuries among kids are way up, and coaches say some of the most talented athletes drop out by their teens. And for many parents the demands of toting kids to practice, travel games, and tournaments are taking a big toll on what used to be called family life. In the past 20 years, says Alvin Rosenfeld, a New York psychiatrist who specializes in adolescents, structured sports time has doubled while family dinners have been cut by a third and family vacations have decreased 28 percent. "There's been a huge growth in youth sports," says Paul Roellig, a Virginia coach and parent. "The question nobody's asking is, is this a good thing?"

Perhaps it all began way back in 1929, when the owner of a Philadelphia factory set out to stop neighborhood youths from breaking his windows. He got a friend to organize a youth football league to keep the kids busy. Five years later, they named their club after the legendary Temple University football coach, Glenn Scobie "Pop" Warner. About the same time, in Williamsport, Pa., a sandpaper plant worker named Carl Stotz decided to organize a league for the little kids left out of sandlot play. It came to be called "Little League." The first pitch was thrown on June 6, 1939.

From those humble beginnings, kids'sports exploded. Pop Warner Football came to enroll more than 225,000 children in 36 states. Little League has 2.5 million kids playing in 50 states. Babe Ruth League baseball, whose younger divisions now bear Cal Ripken's name, has 945,000 players and, like Little League, a World Series of its own.

The real boom in youth sports, however, was driven by soccer. Here was a sport--unlike batting a pitched ball or shooting a basketball through a high hoop--that any tot could play. In 1964, the American Youth Soccer Organization was formed in Torrance, Calif. Its founding principles included the ideas that every kid had to play at least half of every game and that teams had to be balanced in talent to ensure fairness. Soccer leagues grew like kudzu. In 2003, the Sporting Goods Manufacturers Association reported that 6.1 million kids from ages 6 to 17 played soccer more than 25 days a year. All told, more than 26 million, or two thirds of America's youth, play a team sport in America.

The boom in youth sports coincided with the suburbanization of America, but it was stoked by the maturing of the baby boom generation and its unprecedented focus on its children. Parenting became "the most competitive sport in America," says Rosenfeld, the psychiatrist. "Soccer mom," meanwhile, came to conjure up more than just the image of a mother shuttling her kids to and from practice. "It's the culture," says Andrew Holzinger, athletic programs coordinator for Palm Beach County, Fla. "Maybe all I wanted to do was have my daughter kick the soccer ball around because she's driving me crazy. But Soccer Mom gets out to the field, and she has a new personality. She gets to bond with the other parents about the lousy call, or 'Why is this an 11 o'clock game; I told them to schedule it earlier.' Soccer Mom, she gets to have her own sport."

"Child abuse." As parents got more involved, some got too involved, and things turned ugly. By the mid-'70s, Engh had seen enough. His daughter played on a softball team whose coach was caught urging his girls to shoplift for him, Engh says. And then, coaching his own son's baseball team, he ran into the father who told his boy with the sore elbow to stay in there and pitch. This was nothing more, Engh says, than "legalized child abuse."

He decided to do something about it. By 1980, he began working out of a tiny second-floor office in West Palm Beach, creating a training manual for coaches. The idea: to make team sports less pressurized, safer, and more child friendly. Engh still remembers the day when the bank called and told his wife, Michaele, they were $440 overdrawn. With seven kids to feed, Engh thought it was the end. Then he opened his mail, and in it was his first order for the new manual, a check for $732. He never looked back.

Today, Engh's National Alliance for Youth Sports has certified 2.1 million volunteer coaches. But that, he says, isn't enough; everyone in youth sports--administrators, coaches, officials, parents--should be trained and sensitized. Indeed, one evening in February 2000, the Jupiter-Tequesta Athletic Association in Florida packed more than 1,500 parents into a stadium to watch a video on how to be a good sports parent, pick up a handbook, and sign a sportsmanship pledge--or their children could not play. Engh's National Alliance has even created a program to teach basic skills to kids as young as 3, so they can enjoy sports from the start. Near Buffalo, N.Y., the town of Hamburg adopted all of the alliance programs. "The coaches used to show up like, 'We're going to war here,' " says Tim Jerome, president of the junior football league. "It was pretty bad." Verbal abuse, shoving matches, parents misbehaving, it's all "changed dramatically," he says.

"The one thing people need to understand," Engh emphasizes, "is that they don't need to put up with this anymore." Mike Murray agrees. "Here in Northern Virginia," says Murray, a high school coach, teacher, and a director of youth baseball training programs, "you've seen a real cultural shift. All the things you'd want, people policing themselves. I think in large part people have bought into this." Murray is a trainer for another organization, the Positive Coaching Alliance. The alliance shares many of the same goals as Engh's organization--and even some of the same tips--but their approaches are different. Engh's organization wants all volunteers trained and certified; the Positive Coaching Alliance is focused more on the zen of coaching.

The PCA is the brainchild of a soft-spoken former college basketball player named Jim Thompson. While studying at Stanford University Business School in the mid-1980s, he found himself coaching his son's baseball and basketball teams. Seeing too many "negative interactions" between coaches and players, he recalled his earlier experiences working at the Behavioral Learning Center in St. Paul, Minn. There he had learned the power that positive reinforcement had on severely disturbed children. He wrote a book called Positive Coaching, which stressed some basic principles: Athletes perform best when they feel good about themselves. The way to keep them confident is with positive comments. Athletes so motivated will be confident, try hardest, take chances, and play "over their heads." And when that happens, the team wins.

Thompson's manuscript made its way to Phil Jackson, then the head coach of the Chicago Bulls. Jackson, recalling his own trying years in youth sports, was struck: "It fused a lot of my thinking," he said. He decided to test Thompson's theory at the pro level. At the time, Jackson was riding one of his players, Horace Grant, pretty hard, and their relationship had fallen apart. Jackson tried the positive approach, and things turned around. Jackson, now with the Los Angeles Lakers, became the PCA's national spokesman.

Its influence has been sizable. The PCA's 65 trainers have run workshops for 400 youth sports organizations, training an estimated 60,000 coaches and parents. "I can tell you the first year we ran PCA programs the number of coaches being ejected from games was cut drastically," says Tim Casey, former vice president of Chicagoland Pop Warner football conference. The Dallas Parochial League, with 3,500 fifth to eighth graders enrolled in 11 sports, began offering PCA workshops to all coaches. In basketball, "our most volatile sport," says athletic director B. J. Antes, technical fouls dropped from over 100 to 26 in three years. This year, PCA workshops will no longer be optional, Antes says. "It's too darned important not to make it mandatory." Coaches say they like the PCA's "dual goal" approach: striving to win, but using sports to teach life lessons. PCA workshops stress "honoring the game," mastering sports skills, and shrugging off mistakes. "The way I see the world of youth sports," Thompson says, "is that the win-at-all-costs mentality is the root of all evil."

Studies confirm this. A survey last summer at the National PTA Convention in Charlotte, N.C., found 44 percent of parents saying that their child had dropped out of a sport because it made him or her unhappy. These parents were not wimps. In fact, 92 percent of the respondents said sports were either important or very important to the overall development of their children. But 56 percent said that youth sports were too competitive, nearly half said that organized youth sports need to be completely revamped, and half said if they could change one thing, they would want their coach to be less focused on winning. Many surveys support this conclusion: Most kids would prefer to play a lot on a team that loses than sit on the bench of a team that wins.

For all the progress that the Fred Enghs and Jim Thompsons have made, however, they have yet to address a development of the '80s and '90s that has swept up many families. Known as travel teams, they are formed of the best players in a league or a community, may be coached by a volunteer parent or a well-paid coach, and travel to other towns--and sometimes even other states--to play teams of their own caliber. Also known as elite, select, or club teams, they're found in virtually every town in the nation.

At their best, travel teams provide young players with professional-level coaching, better competition, and even family bonding. "The clubs get very tight. They like each other; they travel with each other; they go on trips. It becomes much more of a long-term social thing as well as a competitive thing," says Craig Ciandella, California director of United States Specialty Sports Association baseball, which has 1,300 teams. Many young athletes believe their clubs give them the accelerated development they need to make the high school varsity or go beyond. "It's no longer a myth: If your kid wants to make a high school team, he has to play club ball," says Jim Tuyay, a tournament director with the California Beach Volleyball Association. "They're getting the training and the attention that the normal rec leagues are not providing."

Pressure. Travel teams can be nothing if not intense. They may practice twice a week and play twice more. They can travel one, two, three hours each way for games, chewing up entire Saturdays or weekends. "It becomes a way of life. It winds up being what you do on weekends. You don't go away; you don't go on vacation; you do baseball. I wouldn't have had it any other way," says Ciandella. And most kids playing on elite teams are encouraged to play the same sport again in one, two, or three more seasons--even if they are playing other sports. Some are told--and believe--that if they don't play, say, soccer year-round, they will fall behind their peers.

One effect is even more pressure in the early years. Children now play travel hockey at the age of 7, and baseball tournaments are organized featuring pitchers as young as 8. "Where we live, travel soccer starts at the U-9 [8-year-old] level," says Virginia father Roellig. If you resist, he says, "you will be told, 'Your kids will quickly fall behind and not make the team when they are 10.' If you want your kid to play in high school, you have to start [travel] at 10, and if you want to travel at 10, you have to play travel at 8." Roellig says his community recently started a U-5 soccer program. Called the "Little Kickers," children can play at age 3 1/2. In 2003 it enrolled 50 kids, he says; now it has more than 150. "It's an arms race," complained one soccer mom in Washington, D.C.

Some wonder whether things have not gotten out of hand. Roellig, who coaches soccer, has three children, ages 10, 15, and 16--all involved in sports. His 15-year-old daughter, a high school freshman, plays year-round soccer and two other sports to boot. In the spring, she plays high school and travel soccer. In the summer she attends camps, does a basketball league, and has August soccer practice. In the fall, she has travel soccer and field hockey. And in the winter, she plays indoor travel soccer and basketball. Most nights she gets home at 7:00 or 7:30 from practice, has to eat and do her homework. She may make it to bed by 10 p.m., but she has to get up at 5:40 for school. "What gives is the homework and the sleep," Roellig says, adding that his daughter often looks exhausted. "If I had to do it again as a parent, I'd definitely scale back sports," he says. "I think I'm doing more harm than good."

He's not alone. Holzinger, the parks administrator in Palm Beach County, oversees 120 athletic fields and issues permits for their use by 65 different youth organizations. Only 2 to 5 percent of children under the age of 13, he believes, qualify as "elite" athletes. But in his region, the proportion of kids being placed on "elite" teams has grown to 25 to 30 percent of the athletic pool in the area. It's not that more kids have become better athletes; more parents are simply insisting that their kids be enrolled on select teams. "As we see these children as elite players, we stop thinking of them as children," Holzinger says. "You're not a child; you're my defensive line that nobody ever gets through. So if someone gets through, you let me down." The 25 percent of kids who shouldn't be on the select teams, in other words, frustrate the team and the coach. Parents get down on the coach because the team isn't winning, and coaches sometimes take it out on the kids. Or some kids simply ride the bench. "You, the kid," Holzinger explains, "are now becoming frustrated with a sport, and it's a sport you loved. Past tense."

Much of the problem, Holzinger and others say, stems from coaches. "You'd be surprised," Holzinger says, "by how many parents are really impressed when a coach tells them, 'I'll have your child in a scholarship; stick with this program.' " What parents don't understand, and what the coaches don't tell them, are the real numbers. Dan Doyle, a former collegiate basketball player and head coach, is the executive director of the Institute for International Sport at the University of Rhode Island. For his forthcoming book, The Encyclopedia of Sports Parenting (to be published in September 2005), Doyle's research team surveyed young basketball players. Using data from nationally affiliated basketball leagues, they estimated that the total number of fourth-grade boys playing organized basketball was about 475,000. At the same time, the team found, only 87,000 teens were playing basketball as seniors in high school. Of the 87,000, they say, 1,560 will win Division I college scholarships, 1,350 will get Division II scholarships, and 1,400 more will play at Division III schools. And of those 4,310, about 30 will make it to the National Basketball Association. An additional 130 will play pro ball in Europe.

In soccer, the odds are even longer, because so many colleges recruit foreign players. "It's not a worthy objective at the fourth- or fifth- or sixth-grade level," Doyle says, "which is what some of these coaches are telling them. You know, 'If you don't play for me you're not going to get to college.' " And tennis? Doyle found that there are approximately 3 million males between 10 and 18 worldwide aspiring to be top tennis play-ers. How many make money on the pro circuit? 175. "The professional aspiration," he says, "it's just crazy."

Equally crazy, experts say, is the idea that child stars can be created by starting early. "It doesn't matter when you start a sport. If you start at 3, it doesn't necessarily help," says Paul Stricker, a pediatric sports medicine specialist in San Diego. "Kids develop sports skills in a very sequential manner, just like they do sitting up and walking and talking. Parents and coaches just don't understand that sequence. They feel that after they're potty trained, if they practice something enough they'll get it." Parents, some coaches say, are often fooled by "early maturers," kids who are big and well-coordinated at a young age. But often it's the late bloomers, who had to work longer and harder at sports, who turn into the stars.

Breakdown. Pushing kids to play sports too early and too often can result in pain and worse. Since he began his specialty practice in 1991, Stricker says, "I've had at least a 30 to 40 percent increase in overuse injuries like stress fractures and tendinitis. Those are things we just didn't see much in kids previously." Stress fractures, which occur when kids overtax their bones, are common. "These only come from forces that are repetitive," Stricker explains. "The bone breaks down faster than it can build up." Tendinitis is also common, especially in pitchers and swimmers, because young muscles aren't strong enough yet to keep up with adult training regimens. In young pitchers, Stricker says, "the growth plate gets pulled apart like an Oreo cookie."

The American Academy of Pediatrics has taken note. "Those who participate in a variety of sports and specialize only after reaching the age of puberty," the academy said in a statement four years ago, "tend to be more consistent performers, have fewer injuries, and adhere to sports play longer than those who specialize early."

What overeager parents should really worry about, some experts say, is burnout. Jim Perry is director of athletics at La Quinta High School in Westminster, Calif., a public school where club sports are hugely popular. He says he recently read an article about a national powerlifting championship for kids as young as 9. "What 9-year-old gets up in the morning and says, 'I want to be powerlifting'?" he asks. "That came about because of a coach or a parent." Perry says many kids, so pushed, tire of sports by the time they reach high school. "It's not a matter of [club sports] sucking talent away [from high school]. They're driving high-end kids away from athletics in general," he says. "They're sick and tired of playing 135 travel baseball games a year by the time they're 12 years old. They're sick of playing 100 soccer games a year before they ever set foot in high school. They don't need it anymore."

Besides, it's not yet proven that year-round play, travel teams, and specialization make better athletes. "Most of today's top professional athletes didn't even think to specialize in just one sport until they were in high school, around the age of 15," says Rick Wolff, chairman of the Center for Sports Parenting at the University of Rhode Island. Cal Ripken, for one, attributes his success on the diamond partly to playing three sports into high school. Soccer taught him footwork and balance, he says. Basketball gave him explosiveness and quick movements. "I think athleticism is developed," he says, "by everything you do." For that reason, he tells his 10-year-old son, Ryan, "put down your glove" when spring baseball is over.

All the emphasis on winning, perversely, can make for inferior skills. The Virginia Youth Soccer Association, with 138,000 registered players, recently posted a long note on its website from Technical Director Gordon Miller assailing "overly competitive travel soccer." In their zeal to win games, Miller warned, some Virginia travel teams emphasize the wrong things. Big kids are recruited and taught to kick the ball long down the field instead of being taught to make tight, short passes and ball-handling skills. "You don't encourage flair, creativity, and passion for the game," he says, emphasizing that it is in practice, not games, that young athletes develop their skills. Studies show, Miller says, that in a typical game a player on average has the ball in his or her control for only two to three minutes. "The question is, 'Is playing all of these matches the best way to develop players?' " he asks. "And the answer is, 'No.' "

If we could only start over--that's one of Fred Engh's dreams. Engh has been traveling and speaking abroad, hoping to learn from others and to find countries where it's not too late to fix things. In the course of his travels, he came across the tiny Caribbean nation of Dominica, a place where organized youth sports do not yet exist. The Dominicans agreed to let Engh and his Alliance for Youth Sports start a complete roster of kids' sports there, from scratch. Engh told Ripken of the venture. Ripken says he was intrigued by the idea of starting a youth sports program with the slate entirely clean. "I never thought there was a place on this planet that hadn't played baseball as an organized sport," he says. "Maybe I could help participate in something like that--rebuilding the joy of baseball."



Want to read more about youth sports? Here is U.S. News' recommended reading list.


The Cheers and the Tears : A Healthy Alternative to the Dark Side of Youth Sports Today
By Shane Murphy

Fair Play: Making Organized Sports a Great Experience for Your Kids
By Scott B. Lancaster and Bill Walsh
Prentice Hall Press

Good Sports: The Concerned Parent's Guide to Little League and Other Competitive Youth Sports
By Rick Wolff
High Top Sports Production

Just Let The Kids Play: How to Stop Other Adults from Ruining Your Child's Fun and Success in Youth Sports
By Bob Bigelow, Tom Moroney, and Linda Hall
Health Communications

Play Baseball the Ripken Way : The Complete Illustrated Guide to the Fundamentals
By Cal Ripken. Jr., Bill Ripken, and Larry Burke
Random House

Positive Coaching: Building Character and Self-Esteem Through Sports
By Jim Thompson
Warde Publishers, Inc.

Why Johnny Hates Sports
By Fred Engh
Square One Publishers

Will You Still Love Me If I Don't Win?: A Guide for Parents of Young Athletes
By Christopher Andersonn and Barbara Andersonn
Taylor Publishing Co.