Children and Sport

Sport is a very popular pursuit for children, providing opportunities to increase physical activity. Clinicians need to be aware of the physical, physiological and psychological capacities of children in sport  has an impact on mechanism of injury. Children develop at different rates  physical activity needs to be appropriate for the stage of physical, social and psychological development of the child. Sport for children has been shown not to be “character building”, but could be more accurately described as a situation in which character may be displayed rather than developed .

Benefit of sport for children:
• have opportunity to develop self-discipline, self-confidence, independence, inter-personal skills, communication skills, team participation, leadership skills
• active lifestyle in kids  assume that it is continued as adult  less risk for disease
• increased self esteem (children with low self esteem can gain greatly from a good sports experience, but also be greatly harmed by a negative experience)
• development of coping and social skills
• healthy outlet for energy and expression

Risks of sport for children:
• injury
• fear of failure  anxiety
• greater risk of heat stress (thermoregulation is not as well developed)
• “voluntary” dehydration
• parental pressures, criticism, inappropriate expectations
• negative peer interactions
• seductive fantasy of ‘stardom’
• potential maladaptive psychological effects (promotion of aggressive behaviour?; development of pathologic eating disorder; physiological manifestations of stress)
• compromised academic performance

Organised sport for children should complement and not replace regular physical activity and strategies are needed to be put in place to optimise the benefit to risk ratio .

Recommended sports activities for children :
Infancy (0-2 years) – free play in a safe, unstructured environment; structured exercises do not enhance development; swimming programs offer no advantage.
Early childhood (3-5 years) – play in a closed system (few variables, constant conditions); appropriate activities include walking, running, swimming, tumbling; use a flat playing surface; consider avoiding organised sport – they may not offer a long-term advantage and competition is so complex it may interfere with learning skills.
Childhood (6-9 years) – emphasise skill acquisition; appropriate activities include running, walking, swimming, gymnastics; may participate in recreational leagues of contact sports such as soccer; may begin organised sports with minimal, if any, emphasis on competition; football, basketball and hockey may be too complex.
Late childhood (10-12 years) – may begin competition in complex sports; consider participation in contact/collision sports based on maturation rather than chronological age to decrease injury risk.

There is no reason for boys and girls not to play sport together up until the age of puberty.

Strength training for children:
Despite initial earlier concerns, guidelines from a number of sports medicine organisations suggest that strength training for children is safe and worthwhile activity provided that the program is supervised and designed appropriately – it should be only a component of a wider program to enhance fitness and skills. In children strength training can increase bone mineral density, improve motor skills and enhance sports performance. Strength training must be at a level that is equated with their ability – the volume and intensity must not exceed their capability. Education as to safe lifting techniques is important at a young age.

‘Ugly Parent’ Syndrome/the ‘vicarious’ athlete:
Parental pressure is a common reason of children dropping out of sport. The child’s sport is used as an outlet for parental aggression or reliving past glories – the ‘achievement by proxy’ behaviour. A negative influence on children is the imposition of a “professional sporting model” on what should be a “recreational model” of sport by the parents  the over emphasis on winning. The child may feel trapped with the only way out being to have an ‘injury’. The incidence of parental ‘rage’ or ‘violence’ at children’s sports events appears to be on the increase. Sports have to be a positive experience for the child and adolescent if they are to develop, with positive support from parents. The child needs encouragement and support from parents and has difficulty understanding the need to argue with coaches and officials. Positive ‘sideline’ behaviours of parents include providing support for children to enjoy themselves, putting the emphasis on skill acquisition rather than winning, showing self control, valuing the contribution made by each child, advocating fair play, allowing all children to participate equally, keep all comments positive, be a good role model and congratulate/thank the referees and umpires.

Sports Injuries in Children:
• up to 40% of all accidents reported in children occur during sports participation
• child’s bone can absorb more energy before fracture than adult bone
• unique injuries in children include overuse and traumatic injuries to epiphyseal growth areas of bone

Bill of rights for young athletes (American Alliance for Health, Physical Education, Recreation and Dance):
• Right to participate in sports
• Right to participate at a level commensurate with each child’s maturity and ability
• Right to have qualified adult leadership
• Right to play as a child and not as an adult
• Right of children to share in the leadership and decision making of their sport participation
• Right to participate in safe and healthy environments
• Right to proper preparation for participation in sports
• Right to equal opportunity to strive for success
• Right to be treated with dignity
• Right to have fun in sports

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