Does Your Athlete Have an Off-Season?
During the 2018 NCAA Division I Men’s Basketball Championship game, Donte DiVincenzo scored 31 points off the bench and was named the Most Outstanding Player, recognizing a pivotal performance to lead Villanova to their championship win against Michigan. This is the ideal many parents and athletes hope to achieve. Countless hours are put toward the goal of a college scholarship, performing well, and athletic success.
While Donte’s performance was impressive, the announcers mentioned the interesting fact that Donte never played organized basketball until he was a freshman in high school. In a day and age where sport specialization and year-round, club team, travel team competitions are the focus, it was a refreshing reminder that athletic performance and success are not based on the requirement of early sports training.
While the athlete success stories and great scholarships inspire us to push through the hours of practice and games, sore muscles, endless travel, and weather extremes, there are consequences that often get overlooked. When looking at the goal of youth sport participation, what it should be and what it often is don’t always match. The goal should be to introduce physical activity, inspire healthy habits to promote lifelong exercise, have fun, interact with peers, learn teamwork, and teach skills commensurate with age and development. (1,2) What often happens is the focus shifts to adult goals of measures of success and performance, without an understanding of the potential physical and psychological consequences.
With overtraining, repetitive stress cannot be absorbed/adapted by the body without adequate rest. Overtraining can trigger a lower injury threshold, meaning that it takes less stress, activity or loads to create favorable injury conditions or cause an injury. This over-conditioning can result in an overuse injury. Pediatricians have noticed an increase in the early onset of more serious musculoskeletal injuries in the adolescent population. For the developing athlete, growth plate structures are weaker than surrounding tissue leading to an increased risk that overtraining or overstress may cause injury to the growth plate, instead of the nearby structures. (3) Cognitively, a younger athlete may not associate vague symptoms such as fatigue and decreases in performance with the beginning of an overuse injury. (2) Injury risk from overtraining can be further compounded by lessened recovery time if they athlete is involved with more than one team, particularly if it is the same sport. Pause for a moment and count how many sports or organized athletic events you or your athlete are involved with in a week.
The increased hours of practice and games during a week can contribute to overuse conditions and affect the growth and nutrition of a young athlete. Caloric intake may not meet the caloric output demanded of the hours of sports participation, especially during growth when minerals like iron and calcium are key to development. I have met athletes who were already “retired” from a sport by high school or who had to stop playing that sport during high school due to a long history of injury.
Another consequence that is sometimes overlooked is the effect of sport specialization on an athlete’s psyche, which can result in burnout. The mental fatigue from hours upon hours of a single sport can be draining after weeks and weeks with little break. Add years of the same grind, and it isn’t surprising that burnout becomes a real problem. This mental exhaustion can cause a decrease in performance and lead to anxiety and depression in addition to burnout. I have come across athletes with immense talent who have lost the joy of their sport and no longer participate. Whether it was the countless hours of practice, the endless travel, or the pressure to perform and succeed, the bottom line is unchanged: they no longer have any desire to play the sport they used to love or that used to define them. It is estimated that as many as 70% of youth athletes discontinue playing organized sports by age 13. (1,4)
The words “off season” have become a sham of what they used to mean. I can remember on more than one occasion evaluating an athlete’s musculoskeletal injury and recommending a treatment plan, which included rest, only to be stumped as the injury or condition continued to worsen, despite the prescribed treatment and rest. The majority of the time, the truth would finally emerge… The athlete would have rested from their high school sport but would have participated in several club practices or games during the same time frame, thus continuing or exacerbating the injury pattern. Rest and recovery become undervalued as we continue to cram our already busy schedules with more and more athletics, on top of other activities and homework loads. Taking a break from a particular sport can let the athlete’s injuries heal, allow rejuvenation of the mind, and give time for focus on injury prevention training through strength, conditioning, and proprioception. (2)
What about the multi-sport athlete? Researchers use common terminology to help understand best practices for young athletes. “Early diversification” encourages young athletes to participate in a variety of sports without the performance pressure. Social, physical, and psychological development occur in these types of settings and foundational skills begin to grow that have cross-over to many sports, including a single sport that they may choose to focus on in later adolescence. A couple studies cited in the updated 2016 Pediatrics article (1) looked at NCAA D1 athletes and found their current sport was different than their first sport and many played multiple sports in high school. Another study looking at the 2015 NFL Combine reported 87% played multiple high school sports. Ryan Casey, CHSAA Director of Digital Media, recently re-tweeted USA Football’s post from April 26, 2018: 29 of 32 First Round Draft Picks in the NFL Draft, 91% were multi-sport athletes in high school. “Later specialization” encourages athletes to wait until after puberty to start sport specialization and intense training. Additional cited studies found better success potential for long-term athletic goals, elite status, and fewer injuries with later specialization than those who began sport specialization earlier. For those who do participate in multiple sports, the risk for overuse injuries occurs if rest and recovery isn’t sufficient between seasons or between daily activities. (2) Athletes going from one sport to another should communicate with both coaches as to their training load and current injury status. Overuse injuries are especially likely in sports that use the same body part, such as a throwing sport and swimming. (2)
What do we do with this information about sport specialization and overtraining? This has become a growing concern for healthcare providers, and large governing bodies have proposed performance models to help educate parents and athletes. Two examples are below as reported in the 2016 Pediatrics Clinical Report1:
Long-term athlete development (LTAD)
- FUNdamental (6-10 years)
- Fundamental movement, ABCs of athleticism
- Training to Train (10-14 years)
- Ratio: 75% training, 25% competition
- Training to Compete (13-18 years)
- 50% technical and tactical skill, 50% competition-specific training
- Training to Win (ages ≥17 years)
- Optimize performance, 75% in competition or competition-specific training
- Retirement/Retraining (when athlete stops competing permanently)
American Development Model (2014)
- Discover, Learn, and Play (ages 0-12 years)
- Develop and Challenge (ages 10-16 years)
- Train and Compete (ages 13-19 years)
- Excel for High Performance or Participate and Succeed (ages ≥15 years)
- Mentor and Thrive (for Life)
Here are the guidelines and recommendations proposed by the American Academy of Pediatrics Committee on Sports Medicine and Fitness: (1)
- Injury Prevention: At least 1-2 days off per week from a sport can decrease the chance for injuries
- Recovery: Taking 1 month off from a sport at least 3 times per year allows for physical and psychological recovery
- Early Diversification & Later Specialization provides a great chance of lifetime sports involvement, lifetime physical fitness and possibly elite participation
Here are some general take-away points: listen to your athlete, it’s okay to say no, seek medical care for injury, pay attention to the warning signs of burnout and overuse injuries. A great resource on Overtraining Syndrome and Burnout can be found on The Children’s Hospital Colorado website (https://www.childrenscolorado.org/conditions-and-advice/sports-articles/for-parents/overtraining-and-burnout-in-young-athletes/).
Editor’s Note: Since this article was written, the New York Times published an article on May 7, 2018 titled “How to Avoid Burnout in Youth Sports.”
1. Brenner, JS and AAP COUNCIL ON SPORTS MEDICINE AND FITNESS. Sports Specialization and Intensive Training in Young Athletes. Pediatrics 2016;138(3):e20162148.
2. Brenner, JS. Overuse Injuries, Overtraining, and Burnout in Child and Adolescent Athletes. Pediatric 2007;119;1242.
3. Committee on Sports Medicine and Fitness. Intensive Training and Sports Specialization in Young Athletes. Pediatrics 2000;106;154.
4. Jayanthi N, Pinkham C, Dugas L, Patrick B, Labella C. Sports Specialization in Youth Athletes: Evidence-Based Recommendations. Sports Health. 2013;5(3):351-257.