Just a few decades ago, a child tearing their ACL would lead to years of reduced activity and inability to participate in sports. Surgical reconstruction was not an option, given that the procedure required drilling through the growth plate, and would disrupt future growth in the child’s affected leg.
But in 1976, Lyle Micheli, MD, director of the Sports Medicine Division at Boston Children’s Hospital, pioneered a new growth plate-sparing ACL reconstruction procedure for growing children. Known as physeal-sparing ACL reconstruction, the procedure has been used to reconstruct ACLs in prepubescent kids at Boston Children’s ever since.
This is the procedure that Nate — a 12-year-old star baseball player at the time — underwent in 2013, after tearing his ACL playing football. Rather than rush into an ACL reconstruction surgery in their home state of Maine, Nate’s family researched the best ACL surgeons, and were ultimately referred to Mininder Kocher, MD, MPH, associate director of the Sports Medicine Division at Boston Children’s. …
In recent years, sports specialization has become a hot topic amongst both parents of young athletes and medical professionals. There are a lot of questions swirling around early specialization: When should my child begin to focus on just one sport year-round? Are there injury risks associated with specialization? Does specializing in one sport provide a significant benefit for their skill development?
While answers to these questions aren’t always straightforward, in a recent study Dr. Mininder Kocher, an orthopedic surgeon and associate director of the Boston Children’s Hospital Sports Medicine Division, found some compelling evidence of the risks of early sports specialization.
Many parents recognize there are tremendous benefits to youth sports participation, such as building relationships with peers and coaches and developing a healthy lifestyle. But for some kids, focusing on one sport at a young age can be too much of a good thing.
Sports specialization — intense training for a single sport with exclusion of other sports — has become increasingly popular at younger and younger ages.
Researchers suggest this specialization period occurs between the ages of 6 and 12. At these ages, some common overuse pediatric injuries, such as patellofemoral pain syndrome and Osgood-Schlatter disease, are four times greater in sport-specialized athletes. Diversified sport participation promotes the development of motor skills and limits repetitive stress on kids’ growing bones.
This is why pediatric sports medicine professionals recommend athletes delay specialization until late adolescence (16 to 18 years old) to minimize risk for injury and psychological stress.
Here are some pointers to keep young athletes healthy and in the game.
Take part in recreational play.
It is important for young athletes to enjoy neighborhood games such as tag, capture the flag, kick-the-can, wiffle ball and other games. These keep kids active and promote healthy living. Performing movements that differ from a specific sport are more likely to reduce the young athlete’s risk of injury.
Even switching from ice hockey, which can focus on repetitive drills, to street hockey, which is recreational play, may lessen injury risk.
Take advantage of the off-season.
Usually there are a few weeks between the conclusion of one season and the beginning of the next. This is a great time to hang up the equipment. The athlete can focus on recovering, taking a few days off to rest and then working on some easy strength, flexibility and other modes of cardiovascular activity, including recreational play.
Participate in one sport a season.
Often young athletes participate in more than one sport a season. Before the ages of 16-18, youth should participate in a variety of different sports throughout the year and limit organized participation to one sport a season. Kicking a soccer ball differs from shooting a basketball and offers the body a variation in movement. This benefits kids because not only does the risk of injury decrease, but it also gives the athlete the ability to develop different motor skills.
Begin strength training.
Parents and coaches believe young athletes are strong from the sports they play. Sports develop strength to a certain degree, but a well-rounded strength program corrects imbalances and promotes proper movement to reduce injuries in sport. Ultimately, the stronger the athlete, the more likely she is to reduce her risk for injury.
A common misconception is that strength training means lifting heavy weights, but strength training can be as simple as a plank or a bodyweight squat. Any uniform exercise performed correctly with repetition that allows children’s muscles to respond and produce a movement will create strength.
There is no minimum age requirement to beginning strength training, but athletes should be able to follow directions and demonstrate balance.
Talk to a sport psychologist if your child seems stressed about sports participation.
A sports psychologist can be a great resource for an athlete to voice concerns about the mental components of a sport, such as preparing for tryouts, overcoming a tough loss and setting personal goals. Psychological stress can lead to an injury or burn-out. It also may result in some athletes quitting their sport at a young age.
From marathon volunteer to injury prevention pioneer—it’s all part of Dr. Lyle Micheli’s mission to keep runners and athletes of all types on the field.
Sore quads. That’s one of Lyle Micheli’s memories from the 1975 Boston Marathon. But Dr. Micheli, Director of Boston Children’s Sports Medicine, wasn’t sore from running. As a medical volunteer at what was a “very informal” event in 1975, Micheli spent the day ducking and “limboing” under the ropes marking the last feet of the 26.2-mile run and making sure the athletes were OK to proceed beyond the finish area.
Since that day, running has gained tremendous popularity. The Boston Marathon has increased from a mere 1,000 runners in 1975 to 30,000 in 2015. Micheli has been at the finish line year after year as a way to give back to his beloved city and the historic race.
The medical tent has matured from an informal crew stocked with Bands-Aids, beef stew and water to a highly sophisticated organization, comprised of multiple teams of medical professionals with designated assignments.
Still, nothing prepared Micheli and other volunteers for 2013. “We weren’t equipped with life-saving equipment.” Forty years earlier, as a member of the U.S. Air Force, Micheli had received evacuation training. It kicked in—he jerry-rigged a tourniquet from a runner’s jacket and triaged injured spectators.
Micheli will be on hand at the finish line again in 2015. While his primary motivation is community service, Micheli and Boston Children’s Sports Medicine staff and patients reap plenty of benefits from their commitment to the race. “We encourage all of our fellows to attend. It’s a model for mass casualty training.” Plus, the doctors learn by observing elite athletes.
In the last 10 years, for instance, the science of injury prevention has emerged. “We’ve learned how various running techniques and different shoes contribute to injury risk. We’re using this information to guide our Injured Runner’s Clinic at The Micheli Center for Sports Injury Prevention in Waltham.”
For more on Micheli’s other accomplishments in the 1970s, learn how he improvised an innovative solution to solve the challenge of reconstructing a torn ACL in growing children.