Sports Training and the Young Athlete:
How Much Is Enough, How Much Is Too Much?
Lyle J. Micheli, M.D.
The past 25 years have seen a dramatic increase in the number of
sports programs being offered to youngster.
In most communities, organized teams and leagues are available
for baseball, soccer, football and basketball, while ice hockey
is found in northern climates. Individual sports such as
gymnastics, figure skating, swimming, dance, tennis and martial
arts are now also frequently available.
In addition to this broad menu of youth sports, the age range for
organized sports has also moved downward. Most programs are now
offered at age six, while some communities are offering
pre-training as young as four years of age.
The common thread of all these organized sports is systematic and
repetitive training: kicking at goal, practicing forehands,
breaststrokes, plie or releve. Inevitably, if the child
progresses in the sport, the amount of training and its
complexity increases.
It is widely recognized in coaching circles that talent alone
will never ensure excellence in sports at any level without a
program of training which not only teaches and refines the skills
and techniques particular to each sport, but also the special
qualities of strength, flexibility, coordination and physical
power needed to perform without injury.
The general characteristics of any sports training program
include the duration or volume of training per day; the intensity
or variation in intensity through the training session; the rate
of progression of training per day, or week; and the periodicity
of training through the sports season and off season. The ideal
training program progressively refines the skills of the athlete
without setbacks such as injuries or "burnout".
In recent years, much attention in the allied fields of sports
medicine and sports science has been given to the topic of over
training. This research has been focused primarily on elite adult
amateur or professional athletes.
These studies have used various parameters to identify over
training; decline in performance; psychological parameters such
as irritability, depression or altered sleep patterns;
physiological parameters such as alterations in the body's
hormones or immune systems; and finally, the occurrence of
overuse injury.
These overuse injuries in sports are the result of some
repetitive pattern of mechanical micro trauma, plus additional
physiological or anatomic risk factors. At the present time,
these occur with frequencies in most sports that rival acute
injuries.
Acute injuries are the result of exposure to a single high-level
force, such as a twisted ankle or a fall on the outstretched
hand. Overuse injuries in sports, as an example, are shin splints
from training on a hard surface or heel pain from repetitive
training on a soft field with inadequate shoe wear.
These overuse injuries: stress fractures, tendonitis, bursitis
and fascitis are seen in the adult. Youngsters also may have
these injuries from repetitive training, but with the addition of
injuries to the cartilaginous growth plates and joint surfaces
that are specific only to the very young. While addition "risk
factors" such as anatomic abnormalities, muscle imbalances,
inadequate show wear and excessive hardness of training surface
appear to play a role in many of these injuries, the recurrent
theme in almost any overuse injury diagnosed is inappropriate
changes in the volume, intensity or progression of training.
Lyle J. Micheli is the Director of Sports Medicine at Children's
Hospital in Boston, Massachusetts. This article was originally
featured in the National Youth Sports Safety Foundation's
Sidelines publication.
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