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Joey Wahler (Host): The growing popularity of youth travel leagues has made sports specialization more common than ever, which can be a negative. So we're discussing the dangers of focusing on one's sport. This is UK HealthCast, presented by UK Healthcare. Thanks for listening. I'm Joey Wahler. Our guest Dr. Ben Wilson. He's a surgeon for UK Healthcare, Orthopedic Surgery and Sports Medicine. Dr. Wilson, thanks for joining us.

Dr Ben Wilson: Thanks for having me. It's a pleasure to be on with you.

Joey Wahler (Host): Same here. So first, in a nutshell, what do we mean by sports specialization and why do children become subject to that in the first place would you say?

Dr Ben Wilson: So sports specialization is a topic that's come to the forefront in recent years, and when we say specialization, we're meaning athletes that are playing one particular sport, especially year round. And the key is that at the exclusion of other activities that they would otherwise be doing.

Joey Wahler (Host): Gotcha. So that being said, what are the first signs that sports specialization is having an adverse effect on a kid? And what are the most significant dangers before we get into more specifics?

Dr Ben Wilson: Right, so sports specialization can affect the kids in a number of ways. I personally see, the physical manifestations. So, what we've seen and why this has come to the forefront in recent years is because we've started seeing an alarming number of injuries in our young athletes, and not just the typical run of the mill ankle sprains and fractures that we're used to seeing, but what we've seen is an increase in more adult type injury. That are happening in younger and younger ages, so think Tommy John surgeries that used to just be in major leaguers. Now we're seeing high school and even middle school aged pitchers getting things like Tommy John surgeries.

The same thing with tearing ACLs or dislocating kneecaps injuries to the cartilage, et cetera. But almost more importantly, the mental or the psychologic aspects of sports specialization. We're seeing an alarming number of kids, becoming burnt out on the activity that they're choosing. And instead of falling back on a different sport, they're dropping out of sports participation altogether, which is, definitely something that we don't wish to continue.

Joey Wahler (Host): Well, first off, certainly alarming to hear that Tommy John's surgery is now happening in high schoolers and even middle scores. But let me ask you about the mental part you just alluded to. So what are some signs that a child is indeed starting to burn out, as you mentioned, from focusing too much on one sport?

Dr Ben Wilson: It's really disappointing when this happens in kids where children used to enjoy or used to take pleasure in certain activities. Certainly if you remember to the way we used to felt when we would go out and play baseball or basketball, what have you, Some of the current, environment around kids sports and travel teams, as you said, has made this more businesslike or more professional like. So kids are doing their sports less for fun and more for other goals, either whether to please their parents or their coaches or aspirations of gaining scholarships or becoming professional athletes. Certainly we all have that, but it's the fun that's dropping out and when kids stop having fun, sports become more and more dangerous from a mental aspect.

Joey Wahler (Host): And so what are some things we might see in a young person that's starting to burn out and isn't playing that one sport for the right reasons?

Dr Ben Wilson: Yeah, I think the parents may notice this as a change in previous attitude where a kid used to be excited to go to sport or excited to go and have fun, it now becomes more of a drag, more businesslike and they may regret, their decisions to continue participating in that activity. When left unchecked, it becomes a situation where the kids decide to instead of continuing or instead of falling back on other sports, when they're just playing one sport and don't have anything else to pull back to, then they stop their activities altogether. And that's really heartbreaking, especially in a situation where childhood obesity and even adult obesity is rampant.

We want kids to continue to be healthy and active and we want them to have fun. Remember, kids should be performing these sports more to learn the lessons and set the groundwork for a healthy lifestyle rather than putting so much pressure on the kids to either, obtain performance goals or to earn scholarships, etcetera.

Joey Wahler (Host): Absolutely. Now, from what I understand, doctor, there are ways that a child might be perhaps even unknowingly specializing in a sport without actively playing that sport. So how does that happen?

Dr Ben Wilson: I think the onus on this for sports specialization really lies with the parents the coaches as well. What happens is the kids start playing a sport when they're younger because it interests them. and then it becomes a situation where they feel the need to continue signing up for leagues because everyone else is doing it, because the coaches are telling them. It really gets back to the concept of needing 10,000 hours to perfect a skill or an activity. The fallacy is that in youth sports, is that more time practicing that sport is gonna equate to perfection or excellence, and that's not always the case.

What we see often is that when athletes are going year round, nonstop, especially in these days When before, when I was growing up, we would play baseball in the spring and summer. We would play football in the fall. We would play basketball in the winter. Now, take baseball for example, we've got spring leagues, we've got summer travel leagues, we've got fall ball, they've got winter workouts, or exhibitions and travel. And it becomes almost a vicious cycle where it, the kids feel pressure that if they stop, then they'll fall back and not be as skilled as their peers or fall behind those around them.

Joey Wahler (Host): So what if a kid is asked to be more well rounded and play another sport or two instead of focusing on just one. And he or she says, but I love this sport. I want to give it my all. What do you say to that?

Dr Ben Wilson: My wife and I are facing that with our own children is that they truly love the activities that they're doing. But I think it's important to expose and encourage multiple participation. If we look at studies on kids that have. Specifically specialized in a single sport, there's actually not been shown to be a significant competitive advantage to doing so, and the kids that specialize in a single sport have higher rates of burnout and dropout and higher rates of injury at the higher level. What kids don't realize sometimes is that playing an additional sport or doing a different activity in the off season, can both give them a rest.

Say a soccer player who swims in the winter that the swimming is a low impact way to, keep up their cardiovascular fitness, but allows their lower extremity joints, like their knees and their hips to take a break. The other aspect of playing an additional sport is they can gain skills that they may not have gotten otherwise. If you think of a football wide receiver, translating the skills that they learned in basketball, blocking someone out, going up for a rebound is eerily similar to going up for catch deep in the end zone. And although they may not be playing that particular sport that they want to play, they may still be developing skills that can be valuable for them in the long run.

Joey Wahler (Host): Sure. Let me ask you a few other things. So first, Is it in younger kids or older ones that impressing upon them and their parents? The importance of not focusing on one sport is more significant. Do we need to get the younger kids to be more well rounded or the older ones?

Dr Ben Wilson: This is something that we think of typically in the younger kids, the youth sports, the middle school and younger high school aged athletes. Certainly by the time that they're juniors and seniors in high school. I think most kids appreciate what they're good at, what their skill set is and what their body type is gonna be. But I have a lot of long discussions in my clinic with the parents of young kids. And really, until they're done growing, until they're done developing, we don't know exactly what the kid's body type is gonna be. We don't know what their skill sets are gonna be.

So I think encouraging kids to keep a broad list of options open, enjoying and experiencing other activities can help them decide, say if a gymnast who is, normally very short hits, a large growth spur and end up being taller. Her body type may not be appropriate for high level gymnastics, but then she could pivot to another sport, say basketball. Certainly here at the University of Kentucky, we've seen our fair share of our basketball athletes who started playing other sports and then hit large growth spur, and then their body types became more adept. So this is really a big risk in our younger patient.

One of the things that I like to say is that pediatric athletes, they're not just little adult athletes, and there's some things about their anatomy and their physiology that make them different than say our adult or professional, athletes. And one of the hot topics that has come around in professional sports, especially in the context of the NBA, is something called load management. so our, adult. Skeletally mature professional athletes, they're recognizing that they need to rest and they can't go year round and every single night.

Yet our teenagers who still have open growth plates, whose bodies can't, stand up to the same type of pounding and physical activity a lot of times are subjective to loads and hours on the court that are even longer than the professional guys are playing these days.

Joey Wahler (Host): Yeah, if LeBron James needs a night off every now and then for load management, if it's good enough for LeBron, it's good enough for a middle school or high schooler. Right?

Dr Ben Wilson: Absolutely, absolutely. One of the key guidelines that I like to tell my patients about is that a young athlete shouldn't be participating in a single activity for more hours per week than their age in years. So your average 12 year olds shouldn't be playing three hours a day for seven days a week. That would put them over that limit. But it recognizes the fact that as they age and mature, that they can tolerate more and more. But our youngest athletes should really just be playing one or two nights a week, and then as they get older and develop a little bit more, they can become more involved. Likewise, when we talk about sports specialization, they shouldn't be playing, on the same sport for more than eight months out of a year.

Certainly a sport like soccer that has a steady spring and fall season. They can do training in the summer, but they should really be thinking about doing another activity, say over the winter to give their bodies a break. And the other thing that I caution is that even though Not specifically specializing in one sport. Another quick way to burn out and overuse injuries is to try to play multiple sports within the same season. So I see a lot of kids that are playing both soccer and volleyball at the same time. And yes, they're playing multiple sports, but they're doing it at the same time, and that's almost as bad on their young bodies.

Joey Wahler (Host): Yeah. Great Point, seasonal specialization, if you will, not just sport specialization. Finally, let me ask you, is there one sport, one or two maybe in particular dock that's most potentially damaging to be focused on? What's the one or two sports where if a kid is playing that as their primary sport, they're in the greatest danger from not being more well rounded with others?

Dr Ben Wilson: I think the ones that come to light, the one that there's most publicity about in our literature, but also in, the news reels are certainly baseball. We think of pitchers. If you look at, maps of professional baseball players or baseball players who were able to reach the Hall of Fame, it's often pitchers, tend to come from more northern climates where they couldn't pitch year round. We see that kids that throw, full exertion pitches, even in the off season or with coaches, tend to have more injuries to their throwing arm.

A lot of the pitching leagues have come up with guidelines for how many pitches to throw during the season or during a specific game or weekend. But that doesn't take into account all the full effort throws that are done at off season showcases and with pitching coaches and things like that. So be weary of a pitching athlete who tries to throw and does pitching performance multiple times throughout the year. So, And then the other one that's very common these days is basketball. We think of the summer leagues and the AAU teams and all the pounding and the jumping and the running.

We certainly see a lot of injuries to the cartilage of the knee because the knee can't take that level of pounding that many steps up and down the court for years to come. I think both of those sports are easy, low hanging fruit to try other sports. They tend to be somewhat seasonal. And in fact, a good way to do it is if a young baseball player plays basketball in the winter, that gives them a nice time off. Same thing with a basketball player. They can play basketball all winter, but join a baseball team in the summer. That gives 'em a nice break from the pounding on a basketball court.

Joey Wahler (Host): And great advice indeed. Folks, we trust your now more familiar with the dangers of sports specialization. Dr. Ben Wilson, thanks so much again.

Dr Ben Wilson: Thank you and thanks for having me.

Joey Wahler (Host): And for more information, please visit the Kentucky Children's Hospital website or call 859-323-6211. Again, 859-323-6211. If you found this podcast helpful, please do share it on your social media, and thanks again for listening to UK HealthCast, presented by UK Healthcare, hoping your health is good health. I'm Joey Wahler.