Scott Webb (Host): This is Children's Health Checkup, where we answer parents' most common questions about raising healthy and happy kids. I'm Scott Webb. And today, we're discussing mental health in young athletes. According to the American Academy of Pediatrics, approximately 45 million children and adolescents participate in sports each year in the U.S. While sports can provide tremendous benefits, such as improved physical fitness and social skills, the pressure to perform can also lead to significant mental health challenges.

 And to help us navigate this critical issue, we have a special guest, Kimberly Williams, a Senior Behavioral Health Care Manager at the Children's Health Andrews Institute for Orthopedics and Sports Medicine, where she specializes in helping young athletes overcome psychological challenges and sports injuries.

Kimberly, it's so nice to have you here today. We were just talking about, you know, I have kids, one played baseball, one's still playing basketball, AAU and travel and all that that implies. And so, I deal with a lot of physical things, of course, as dad, but I also deal with the mental side with my daughter specifically. And that's what we're going to talk about today, mental health in young athletes. So, it's great to have you here.

Kimberly Williams: Thank you for having me. Happy to be here.

Host: Yeah, it's great to have your expertise. I'm really going to pick your brain. I'm sure listeners are going to appreciate this as well, but some free advice for a girl dad, so to speak, basketball dad here. What mental skills do young athletes need to perform, you know, and well, hopefully, in these competitive sports?

Kimberly Williams: You know, I think from a mental perspective to have some balance in their life, right? So, most young athletes feel that their sport is their sole identity. At the end of the day, we're still people. And so, understanding who we are as people first, so when we leave the court, the field, we come back to being a person and not just an athlete. So, when we are an athlete, we go into that athletic, that competitive mode. Learning to shut it off when you need to shut it off. And having a sense of balance with some self-care and taking care of, as I said, the total person, not just the athlete.

Host: Yeah, that's great advice. And, you know, I was sharing with you that my daughter plays, you know, this high-level travel basketball. And so, every time she steps on the court, it feels like a tryout, you know, and my heart goes out to her, but she often performs well and I'm like, "Ah, she's fine. She's got it." But I'm wondering in general and broadly speaking across different sports and different ages, what are the factors that can harm a young athlete's mental health?

Kimberly Williams: So many factors can harm a young athlete's mental health. Where to begin? To start, I'm going to be honest, it's that need for external validation as an athlete, starting at home, the parent, the guardian, coaches, of course, your peers, your teammates. Again, coming back to knowing who you are as a person and finding your own internal validation. So, you're not seeking what you need as an athlete from the coach, the parent. You're not reaching their expectations, you're doing the sport competing because you want to.

Actually, my favorite question to ask my patients is what's your why? Why are you playing the sport? How did you get to this point? I want you to tell me your why. And you'll see athletes take pause and often they're a little bit nervous to say, you know, "My parents expect me to get a scholarship," you know. But let's meet our own expectations for otherwise burnout, resentment towards sport, towards parent, coach, teammates, losing who you are in the sport, lots of risks. And of course, the physical aspect too, that comes back to balance self care and, you know, finding a way to unwind and turn it off.

Host: Yeah. That's one of the reasons our daughter also plays softball and her high school team did really well this year, which was great, but it's one of the reasons we encourage her to keep playing, even if, you know, the high school sport is just for-- I'm using air quotes-- "just for fun." You know, even though it's still really competitive, we encourage her to have other interests, obviously to have friends and a social life, to play another sport. Would you recommend that, because there's so much specialization? You know, basketball for her has turned into a year-round sport. It used to just be like when I was a kid, we just played in the winter for three months and then we went on to baseball and then to football. And now, she plays basketball year-round. So, we encourage her. And I'm wondering, do you do that as well with your patients and clients? You know, let them know that it's okay to play more than one sport. You don't have to specialize when you're 14, 15 years old, right?

Kimberly Williams: I love this question, actually. Not surprisingly, I've got lots of opinions on this. I do believe that an athlete will be better in whichever sport they end up playing by playing other sports. And, you know, learning different techniques, hearing different ways of coaching, adapting to different ways of coaching. I think, however, this day and age, the culture. Especially here in the state of Texas, there is this expectation of honing in on that one sport. And to use your word, the air quotes of for fun in high school, really important though, right?

Host: Yeah. Of course.

Kimberly Williams: Just today, I had a patient who does one sport primarily. He's kind of interested in doing track. Go run track.

Host: Yeah. Go do it. Right.

Kimberly Williams: I mean, if we're being honest, the percentage of high school athletes that go play D1 on scholarship is very small. And we want to consider, and what I want my patients to consider at this age. You want to be some sort of athlete through life. If that's golf, tennis, running...

Host: Pickleball.

Kimberly Williams: Pickleball, yes. Let's really listen to our bodies, find some fun in it. Because when you do choose and kind of specialize on that one sport, it becomes your everything. Eat, breathe, sleep, dream, read, watch. That's it. It's all consuming. And where are we going with it? I mean, sure, can we learn some grit? Absolutely. Are we going to get some bruises along the way? Yes. Sports teaches us a lot of great life skills, but there are other sports that can teach us the fun and show community and be so competitive.

Host: She said that she might, because she has the fall off, so to speak, even though she would normally be training for basketball and getting ready for basketball season. But she's like, "You know, some of my friends asked me if I wanted to play golf. They know that I'm pretty decent at golf and I was kind of thinking about going out for the golf team." I said, "Yes. Please do," right? Please do go have fun with your friends, go swing the clubs, tear up the course, whatever, and just have fun, because that kind of leads to my next question about how do we know when we're pushing them too hard to perform and, you know, one of the things we say to her is, basically, like, "Listen, you're going to college one way or the other, if that's what you want to do, right? So, let's make no mistake here. Basketball, it may be something you want to do in college, and you may be one of the lucky few who gets a scholarship, but you're going to go to college either way. So, let's take that out of this conversation, right?" So when you say you want to play basketball in college, let's not talk about the scholarship part of it. Let's talk about the love of the game and continuing to play, you know, until you're 22 or whatever. So, how do we know though, Kimberly, how do we know if we're pushing them too hard when we're trying to live vicariously through them or something like that?

Kimberly Williams: Yes, yes, great point. I always say parents are the experts of their own children, as they should be, and I would expect them to be. Looking out for those signs, you know, excessive worry, restlessness, you see their academic performance starting to decline, they're withdrawing from friends, they're easily fatigued. I would say the biggest one is irritability, just cranky, more muscle tension. You know, you kind of see them visibly breaking down and coming back to you referencing, "You're going to go to college, take sport out of it." I don't love to play a what if game in therapy, but I do say to these athletes, "Let's just say that sport doesn't exist. What are you? Who are you? What are you going to do?" And the best advice that I can give to parents, which is as a parent myself, my kids are younger, so they're not that level at sport, is to, again, when they're doing club sports, we all know it's expensive, but continuing to remind your child of how much money they're investing does so much damage and puts so much pressure on these athletes. I hear this almost every single day in my sessions, but they've spent so much money. They have all this guilt. If they actually don't want to play the sport anymore, then there's the shame of, "I let them down. What did I do to my family?"

Host: "My parents spent all this money." Yeah, I've said to our daughter before, I've said, "Listen, even if you hear mom and I just kind of like talking about the expenses and things," I'm like, "What you need to know is that doesn't concern you at all. If we didn't have the money, if we didn't want to help you, you know, pursue and follow your dreams, we just wouldn't do it. So just safely assume as long as you're still playing and we're paying for trainings and clothes and shoes and all that, just assume that we're okay and that you don't owe us anything other than just go be you, go have fun, play hard," you know, that kind of thing.

Kimberly Williams: Yes, I love that perspective because if they do leave a sport after playing club for a year or two, however long, they are still walking away with life skills. I cannot stress that enough. Just discipline, time management, social skills, learning to talk to adults, traveling. I mean, you name it. They're still walking away with a wealth of personal experience and it's a part of their story. They get to, you know, tell their kids someday, "I was on a traveling club soccer team." "Cool, mom. That's awesome"

Host: "That's really fun." Right. Yeah, totally.

Kimberly Williams: Yes. And come in and then also just come back to having conversations with your kid, with your teen. I, you know, I think we don't do enough of that. And again in this culture and in this time, that's disappointing because if you can sit down and have that conversation, and I always say this too, as a parent, try to listen to your child, to hear them, don't listen to respond. And then, the other thing that I love to ask, "Do you want my support or do you want me to help you find a solution?" And let them tell you what they need. And if they don't know what they need, meet them where they're at.

Host: Yeah, I know my daughter well enough to know, like, I can just read her face after a game. You know, when she's happy with how she performed or how the team did, you can't shut her up. Let's go get some Starbucks and let's talk about every little detail. And when it doesn't go her way and she struggles and the team struggles, she might still want the Starbucks, but she definitely is not interested in me peppering her with questions. And so, those can be some quiet drives home. But the way I figure is eventually she will open up to me, and try to just listen, try to just listen and take it all in and try to figure out, "Okay, am I supposed to respond to this? Does she want my help with this? Or, you know, "Just listen right now, dad." And it's a challenge. It's not easy being a parent of any teenager, especially those who play sports, who play at a high level, who want to play in college, all of that. And, you know, you gave us some of the signs we can look out for that a team is struggling with their mental health. I guess I'm wondering, parents, coaches, and otherwise, based on those things that we see, like you say, the irritability, the tension, whatever it might be, how do we help?

Kimberly Williams: Lots of ways to help. I never say just jump into therapy. I start with trying a new sleep routine, you know, come back to meals, like what are we eating? What are we fueling our bodies with? Letting them practice gratitude. That's huge. I know it sounds so cheesy. I'm sorry. You're probably rolling your eyes at me, but practicing gratitude and, you know, waking up in the morning and just in your own head, three things that you're, you know, I'm thankful for. Just asking your teen, "How can I help?" Or "What do you think you need?"

And the biggest thing is self-care. You know, getting these kids to disconnect, put their sport on the shelf when they get home or set intentional time where you don't let yourself think about sport or the next competition or meet or match and do something with that time that brings you joy, that makes you feel good, that, you know, yeah, it just takes you away from it.

Host: Right. That's such great advice. You know, her basketball between two different events was 14 games in 11 days between two different cities. And when we got to that last game, I mean, she just was amazing. I don't know how she does it. We call her the robot because she just keeps going and going and going. I mean, I don't know how she does it. But anyway, when we got to the end of that, I said, "Okay. Let's get all your basketball stuff washed and let's hide the basketball bag." Like, "Let dad just put that away so it's not sitting there, you know, calling your name," so to speak. "And I want you to just go be a kid for a while. Go hang out with your friends who don't play sports, who don't play basketball, go to the beach, go to Starbucks, whatever it is, but just go be a kid and have fun and enjoy what's left of your summer, because there's more to life than basketball." I know, I know. It's hard to say that out loud, you know, with as much as we've spent, as we're talking about, you're like, "How could you say that?" But there's so much more to life than basketball and so much more that I love about our daughter than just the fact that she's good at basketball and it makes me happy, like her and her brother, I mentioned pickleball, they just started playing pickleball together because he's home a lot this summer. And I'm like, "You guys are making me so happy." Of course, it's a huge competition and, you know, they always take it way too seriously but that's a separate podcast.

I guess I just want to ask you, you know, when we think about all of this and trying to help them strengthen these mental skills, because sometimes strengthening the mental side to help overcome the physical stuff. As you said, there's so many injuries and bumps and bruises and she's been playing through a sprained ankle for three months, keeps re-spraining it and her labrum may be torn from softball and she just keeps going and going. But I know there's a strong, like a big mental component that of overcoming the physical ailments. So, what's your best advice with that?

Kimberly Williams: And this is probably going to be difficult to hear for some, but a lot of it is is innate and we're either intrinsically motivated or not, it's not always learned. I would say be very alert to them making fear-based decisions. So if there is an injury, that fear of re-entry to sport can be very loud in their thoughts. Just having them as athletes and as people learning what their triggers are, so if they can start to have more awareness of the thoughts that they're ruminating over and Stop the cycle and come back to, again, what I love about the sport, what I know my own core values are outside of the sport, what I bring to the sport, and just focusing on the thoughts that are productive, that are positive.

 I will say this, this is another huge point that I want to make, in competition, even in practice, if, you know, an error is made, you miss a goal, whichever sport it is, allow yourself to sort of internally to have a human reaction. We're human. It's okay to in your mind say like, "Oh, like that was awful, but then follow up quickly, you know, with a productive thought. I learned from that. Here's what I'm going to do differently next time and then go." But allowing yourself to have a human response, following up, letting go, validating, moving on.

Host: Yeah. And, you know, these games are so fast too. Like I'll see her, she's a pretty good shooter, but I'll see her maybe miss a couple shots in a row and I'll see her just sort of shake her head. Like, what is happening? But the good thing is with sports, they're onto the next play, right? So, they don't have too much time to dwell on it. And I encourage her sometimes, I'm like, "Hey, you know, when you do something positive out there, it's okay to, I don't know, clap your hands a little bit."

Kimberly Williams: That's right.

Host: You know, because you're a human being and you hit a big shot and everyone's excited. It's okay to smile and show that side of you. You don't have to be so serious, the serious, athlete. Like, don't forget to have fun, right?

Kimberly Williams: Yes. Absolutely. I think that, you know, to reference the Olympics being on right now, so many of these athletes have spoken about that, and I love it because it is breaking down the stigma of mental health with athletes and how therapy has taught them to go out there and smile and try to stay light, even though you're still focused, you can do both, you can hold both in one hand. You don't have to be just completely zoned in to where you're at. Just be present, yes, be grounded, be in the moment. But also how lucky, like, be thankful. I've got a body that works right now. I am playing on a platform and getting to compete. And, you know, to quote one of my favorites, pressure is a privilege. So loving that almost. You just embrace that.

Host: Yeah. The American man who won the 400 after he crossed the finish line, he laid down on the ground and made snow angels on the track. I was like, you know, like even 25-year-olds deep inside, there's still kids and it's still like, " I ran the fastest, and how can I celebrate that now?" I just love seeing all the smiles and the happiness and, you know, tears when their anthem's being played, all of it. These are real people. Yeah, they're performing on the biggest stage and the stakes seem so high, but they're just real people and all really still kids at heart, right?

Kimberly Williams: Yes. I absolutely agree.

Host: Awesome. This has been a great conversation. I knew that you and I would have a great conversation and I would get a lot out of it. I'm sure listeners have as well. I ust want to give you a chance at the end here. Other tips, advice, final thoughts, takeaways when we're trying to achieve that balance, right, between athletic performance and mental wellness, what would your final thoughts be?

Kimberly Williams: My final thoughts would be to, again, listen to your thoughts. Our thoughts connect to our body. Our thoughts are what provoke feelings and emotions. So, be aware of your thoughts, the positive ones, the negative ones, the productive ones, and start to kind of break up those patterns of the negativity and your visceral response that you're having to your thoughts.

And to quote the great Simone Biles, practice smarter, not harder. So, listen to your body as well as your thoughts. And that's what I'll leave you with. And again, coming back to your why, why am I doing this? Why am I playing this sport? Why am I showing up every morning, 6:00 a.m. And keeping that in the line of sight.

Host: Yeah. I hope to never hear my daughter, our daughter say out loud, "Well, I did this for mom and dad. You know, yes, I tell her, I say, "Listen, I love watching you play. It's my happy place. And I would love for you to play in college. And I want to be able to come and see you or stream you on TV in the family room. But if you don't, you know, 'just go to college' and just be a person and get a degree and get ready for life. That's okay too. You're not going to disappoint us if for some reason it doesn't work out or you lose interest or whatever." I just always encourage her to just play for herself. And as you're saying, I never said it quite so eloquently as you do, but, you know, play for her why. And then, that's all I want as long as she's out there because it makes her happy, then that I'm good. No further conversations , right?

Kimberly Williams: And that's so great. She's so lucky to have a parent.

Scott Webb: That's what I keep telling her, Kimberly. You know, I don't know that she hears me, but I'm like, you're so lucky to have me.

Kimberly Williams: That's where I come in and I can reiterate to the patients what their parents are, you know, just gifting them, yes. So, it is a gift, yes.

Scott Webb: It's amazing just how much things have changed. Times have changed. You know, I played sports, played high school sports, but I don't remember anyone ever asking me about my mental health. Like, "Hey pal, how are you doing?" You know, not physically, but how are you doing mentally with all of this? And I'm just so glad that we have experts like yourself who specialize in working with young athletes and really listening to them and finding out their why and, you know, working with families and just trying to fight the good fight to make sure that these amazing kids of ours, these amazing athletes of ours, are out there for the right reasons. They're getting the right things out of it and trying to deemphasize the money and the stress, and the pressure and the stakes and all of that. I just really appreciate your time today.

Kimberly Williams: Yes, of course. Thank you. I mean, it is a very special population. I feel lucky to be working with these athletes. I mean, as you probably assumed, they give back to me as much as I give to them. They're awesome.

Host: Yeah. Well, thank you so much.

Kimberly Williams: Yes. Thank you.

Host: Learn more about how to support young athletes at childrens.com/andrews. I'm Scott Webb. And thank you for listening to Children's Health Checkup. If you found this podcast helpful, please rate and review or share this episode, and please follow Children's Health on your social channels.