CHILDREN AND SPORTS
Children and Sports
All parents know that children take
to sports like ducks to water. Almost as soon as they start to walk,
they're chasing balls, swinging sticks, and running races against nobody
in particular.
Children's sports used to mean baseball,
basketball, or football. That's changed. Soccer has leapt onto the youth
sports scene, as have wrestling, tennis, and lacrosse with older children.
The starting age for training in individual sports such as swimming,
skating, track, and gymnastics grows younger every year.
Parents should encourage their children
to participate in sports, but never forget that competition should be
fun. Too much emphasis on winning can alienate a child from athletic
competition.
Children active in sports programs
will improve their cardiovascular and musculoskeletal systems, coordination,
and state of mind. Participation in sports develops a sense of self
discipline, teamwork, and recognition of the importance of a healthy
body -- good habits that last a lifetime.
Training Emphasis
Every child physically matures at
his or her own rate, and has a different degree of athletic ability.
No amount of training can improve a child's natural athletic ability,
but training helps improve coordination, and therefore performance.
Early training should emphasize
proper technique and basic movement skills in all sports, especially
in children younger than 10. Podiatric physicians, specialists in treating
the lower extremities, say children who concentrate on a single sport
at too young an age are more likely to develop injuries of the foot
and ankle. Save specialization in sports for the late teens, they advise.
Warming up before participating
in sports is more important for adults than children, but it helps loosen
the muscles and prevent injuries in athletes of all ages. Light jogging
and smooth stretching exercises (be sure not to bounce when stretching)
are all that's necessary for young athletes. Learning to stretch at
an early age will set a good pattern for sports activities as the body
develops.
Footwear
Whether parents like it or not,
part of a child's image revolves around footwear. Expensive sneakers
have become fashion statements as much as athletic equipment. But for
good foot health, the condition of the shoe is more important than the
price tag or brand name.
Podiatric physicians agree it's
often better to buy a child two $50 pairs of shoes than a single $100
pair, so the shoes can be rotated, to avoid rapid wear deterioration.
Excessive wearing of the outsole, loss of shoe counter support, or wearing
out in the midsole indicate it's time to replace the shoes.
Because a child's feet are constantly
growing, it is important to allow at least one finger's width from the
end of the longest toe when buying shoes. Remember, proper fit is very
important. You can have the best shoe in the world, but if it doesn't
fit right, it doesn't do its job.
In the shoe store, children should
put on both shoes, with their athletic socks and the laces tied tight,
for several minutes to properly check the shoes' fit. Shop for shoes
in the afternoon, when the feet are naturally slightly swollen.
In young children, an "all purpose"
sports shoe works well for most sports. A running-specific shoe is not
suitable as an all purpose shoe; moving laterally in a running shoe
is more difficult and presents greater risk of injury for children.
After the age of 10, sport-specific shoes can help improve performance
and protect the feet. With the exception of the running shoe, a degree
of crossover between sporting shoes is usually not harmful to the feet
of a child athlete.
Rubber cleats are not usually necessary
for children under 10, though they pose little potential harm for them.
They are most useful on a soft-field sport such as soccer. Podiatric
physicians recommend molded shoe rubber cleats rather than the screw-on
variety. Metal baseball spikes can be dangerous and should not be used
until the teenage years.
Growing Bones and Ligaments
The immature bones of children are
different from those of adults. The "growth plates" in children's bones
do not finish closing until age 15-17 in boys and 13-15 in girls. When
stressed, these plates are more susceptible to injury than the tendons
and ligaments that support the joints. Ligaments tend to "give" before
bones in adults.
Podiatric physicians warn repetitive
overuse can cause inflammation of the growth plates. They advise parents
to promote diverse physical activities for their children rather than
one sport. This is especially important with individual sports such
as running, gymnastics, and tennis, which require long hours of practice.
Statistics show children who concentrate
on just one sport for long hours at a time are setting themselves up
for injuries. Because of the susceptibility of bones with open growth
centers to overuse injuries, sponsors of the Boston Marathon recently
increased the minimum age to participate from 16 to 18.
A sports medicine podiatrist can
offer a thorough examination of the entire lower extremity, and identify
a leg length imbalance, weakness, or biomechanical imbalances that may
need to be addressed to prevent injuries on the athletic field.
Injuries and Treatments
Many children suffer from mild "torsional"
imbalances, commonly known as in-toeing and out-toeing. Most children
outgrow these imbalances without medical treatment. However, if a child
has obvious torsional imbalances, he or she may be more susceptible
to injury. If that is the case, keep a close eye out for foot and ankle
injuries associated with sports activity. Foot injuries commonly seen
in very active children include:
Ankle Sprains. In older
children, stretched or torn ligaments in the ankle, known as sprains,
are more common than fractures. A sprain may cause extensive swelling
around the ankle just like a fracture. Immediate treatment is crucial
to quick healing. A podiatric physician can provide treatment as well
as recommend balancing and strengthening exercises to restore coordination
quickly.
Fractures. Fractures from
overuse in child-athletes are commonly seen in podiatric medical offices.
Growth plates are particularly susceptible to injuries, but mid-shaft
fractures of the bone also occur. If a fracture is not severe, rest
and immobilization may be the best treatment. More complicated injuries
may require casting or surgical correction. If swelling and pain persist,
see a podiatric physician.
Sever's Disease. An inflammation
of a growth plate, Sever's Disease is often felt as pain behind the
heel caused by inflammation of the apophysis, a growth center where
a tendon is attached to the bone. Rest, ice, and heel lifts are usually
prescribed.
Shin splints and stress fractures.
Shin splints are microtears or inflammation of the anterior leg muscles,
as are Achilles tendon pulls in the posterior region of the leg. Again,
rest is most important in healing these injuries. If pain is persistent,
see a podiatrist, who can recommend strengthening exercises, certain
shoes, or, if indicated, prescribe custom-made shoe inserts known as
orthoses.
A Word to Parents
All parents want to see their children
do well in sports. But putting too much pressure on a child to become
a star athlete may result in both physical and emotional injury to the
child. A child should enjoy playing a sport, but if forced, could be
turned away from all sports for a lifetime.
Especially with individual sports
such as swimming, figure skating, and gymnastics that require long hours
of practice every day, be certain the child's heart is in the endeavor,
not just yours. When it comes to sports, overzealous parents can potentially
do their children more harm than good.
The American Podiatric Medical Association operates a toll-free telephone
service, 1-800-FOOTCARE (1-800-366-8227), from which consumers
can obtain informative literature on a variety of foot health topics.
The American Academy of Podiatric Sports Medicine, an affiliate of APMA,
may be reached at 1-800-438-3355.
Produced in cooperation with the American Academy of Podiatric Sports
Medicine
