Children and Exercise: How Much Is Too Much?

Many children and young people are playing and training for organized sports with an intensity once reserved for top-level athletes. Consequently, doctors are learning more about the lasting impact overtraining injuries can have on youth. We must take care to harness the potential of young athletes for long-term wellness and healthy development to maturity.

We have all heard the recent reports about childhood obesity rising 30% in the last decade and we all would agree on the need to encourage most young people to exercise more. But there is another trend at the other end of the spectrum among children and youth: overtraining. Is there such a thing as too much exercise for children?

In the United States, approximately 35% of children and young adults between the ages of 6 and 21 years participate in sports. Team sports are a great way for children to improve physical coordination, boost self esteem, maintain physical fitness and foster self-discipline. However, increasing numbers of young children are becoming sports-specific and training year-round to compete at a competitive level of play. This puts them at risk for overuse injuries.

"As adults, we can work ourselves to a higher level of performance by adding miles or add pounds lifted," says Dr. Elizabeth Szalay, a paediatric orthopaedic surgeon at Carrie Tingley Hospital and an associate professor of paediatric orthopedics and paediatrics at the University of New Mexico. "But in children there is a finite point, which can't be exceeded without permanent damage, and there's no way to get around that."

Overuse syndrome, playing the same sport constantly instead of participating in a variety of activities, can result in injuries such as swimmer's shoulder, Little League elbow, runner's knee, jumper's knee, tennis elbow, Achilles tendonitis and shin splints-conditions that can develop into chronic problems later in life. In some cases, the damage of overtraining is permanent, increasing the risk that the athletes-some of them as young as 9-will suffer crippling arthritis or require extensive surgery as they get older.

Paediatric Injuries Due to Overtraining Up 50%

In June 2007, the American Academy of Pediatrics released a report stating that up to 50% of all injuries seen in pediatric sports medicine are related to overuse ("Overuse Injuries, Overtraining, and Burnout in Child and Adolescent Athletes," Pediatrics 119: 6, June 2007, 1242-1245).

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