Children play hard.

But ask almost any parent in the Washington, D.C., area and they will tell you, “It’s not like it used to be.” Play, it turns out, isn’t just a game anymore; play is competition. Play is for a greater good, whether it’s a college scholarship or simply bragging rights. The problem, according to the orthopedic surgeons called upon to fix our injured over-played youth, is that today’s style of play is taking a toll on our children’s bodies.

Overdoing It

“Our children are getting overworked,” says Richard Reff, M.D., a Kensington-based pediatric orthopedic surgeon. While there are some recreational players out there who are enjoying games for the sake of a game, for the most part, the kids Reff sees are enjoying the games but just aren’t getting a break. There are the single-sport players who are overdoing the same repetitive activity for years at a time with no off-switch; those doing multiple sports from one season to the next never take a break.

On any given Saturday or Sunday in the D.C. metropolitan area, orange cones and white lines adorn fields from elementary schools to public parks, and children as young as 3  can be found dribbling balls and learning skills, from lacrosse to field hockey to football, baseball, basketball and hockey. 

It’s not just the contact sports where overdoing it is a problem. Swimmers and dancers, too, practice repetitive skills for countless hours each day, often more than seven times a week. “This is sort of the essence of the Beatles Song, Eight Days a Week,” says Reff. “And parents are wondering why little Suzy or little Johnny has knee pain or leg pain. Take a look at their schedules. Even professional athletes don’t have these kinds of schedules; they train hard, but they have days off.”

The toll on the body, not even counting the injuries, according to Reff, is extreme. From the feet to the shins to the head, parents need to understand what happens when they launch their children into a variety of athletic adventures, whether it’s many sports or one  they do repetitively for more than a decade.

Why Do Children Get Injured?

There are a number of reasons our children get injured.

The Greatest Athlete/The Wrong Sport

Part of the problem is the parent. “There needs to be parental acknowledgment that every child is not a champion,” says Reff, “that every child has strengths and  weaknesses, and that while you can try to enhance the strengths, and you can try to lessen the weaknesses, not every child will be a champion. By driving them, [parents] are supporting—condoning even—overly intense training schedules.”

Often, children are built for one sport but are doing another. It may be that a long-distance runner experiencing pain should actually be a sprinter. “Sometimes the selection process happens naturally, sometimes it doesn’t,” says Reff. “If an individual is being pushed into a sport where explosive power is required but she is loose jointed or ‘floppy,’ then she is not going to excel at that sport. The parent may believe it’s about desire, but it’s that the child physically can't do it.”

The Wrong Equipment

Too often, “cool” rules on the field and the result is injury. Richard Landis, a Washington Area Girls Soccer (WAGS) coach for more than a decade, says the wrong type of cleats or poorly fitted cleats lead to falls and injuries. Landis says the cleats worn by top line pros are not “healthy” for children because they are “paper-thin.” Yet they are popular with kids because of the stars who wear them. “They are made for pros who want lighter cleats and comfort in order to run faster,” says Landis. “But they are not good for foot protection. After a game, the kids wearing these thin cleats have bruises on the tops of their feet.” The average player, says Landis, should consider padded shoes for protection of the foot as well as cushioning to ease the pounding that legs take.

Mike Wilson, who played high school and college basketball, then professional ball for 10 years with the Harlem Globetrotters, learned a lot about the right equipment, especially the right shoes, when he played 250 games a year with the Globetrotters. “It didn’t take me long to learn that just because they look nice didn’t necessarily mean they were the right shoes for my feet.”

“It’s a sign that a shoe doesn’t fit properly when it flies off when the ball is kicked,” says Landis.

Ed Jurgrau, founder of Shoe Train in Cabin John Mall, has been fitting children in shoes for more than four decades. He says it’s key to bring the socks and shin guards to the shoe store when making a shoe purchase. “If a cleat is tried on without the proper foot attire, the child will usually be buying the wrong size. Improperly fitted footwear can affect gait movement, stamina and mobility.”

With all the playing kids are doing, it’s also important to make sure athletic shoes and cleats are in good condition.

“We got a new pair of shoes every two weeks,” says Wilson. “A veteran Globetrotter told me to take care of my feet. That was one of the most important things we learned. But when I was a kid, the bottom of my heel would hurt so badly, and now I always use orthotics. Plus, I have to wear long narrow shoes, size 14. Even on my basketball team, not everyone could wear the same shoe.”

“Right fit is important,” says David Stein, a Potomac parent of two young athletes. “Fit avoids injuries. I go where the staff is very experienced about fit. I could save money by going somewhere else, but I only trust an expert.”

“Many first time footwear purchases will be athletic sneakers,” says Jurgrau. “If little children are not fitted properly and wear multiple pairs of misfitted sneakers, they will begin drawing up their toes to relieve the discomfort of the misfitted shoes. Eventually this repetition can cause children to develop a habit of walking on their toes, which can eventually translate to tight heel cords.”

Poor Coaching

There are thousands of coaches in the D.C. area teaching our kids how to play a variety of different sports. As with anything, some of these coaches are good and some are not so good. Reff points out that one way to avoid sports injuries is to find an intuitive coach rather than a mechanical coach. 

“Basketball coaches, for example, may have kids run two miles as a warm up, but what do you actually do when you are on the court? Do you run two miles?” asks Reff, “No, you sprint. If you want to go out on the track and run short distance sprints, sprint-walk, run-recover, run- recover, that’s coaching because that’s what you are going to do on the court. Yes, it’s important to have endurance during basketball, but endurance for doing what? Running backwards, running sprints, stopping.”

“I had the knowledge,” says Wilson, “and so I never got injured too badly.”

Most Common Sports-Related Injuries in Children:

  • Sprains and Strains
  • Growth Plate Injuries
  • Repetitive Motion Injuries
  • Heat-Related Illnesses

Overuse:

Younger athletes can recover faster from activity than older athletes. But it is possible to “extend your ability for use so that it doesn't become overuse,” says Reff. There are four basic tenants of fitness: strength, power, endurance and flexibility. When you are younger, flexibility is the glue that pulls the rest of the “pieces” together.  As an adult, you can overcome your flexibility-decrease with an increase in power, endurance and strength.


Cari Shane is a freelance writer and has published in a variety of national and local media outlets. She lives in Montgomery County where she is raising three children and a dog. She and her business partner, Julie Schumacher, own sasse agency, a PR, marketing and social media company.