12 December 2013

The difficult question of sports injuries and disillusionment in youngsters

This good website has some interesting information on the size of the problem of young sportspeople getting injured. Injury rates are going up, to uncomfortably high levels. A serious sports injury is not just a short term issue for a young climber, runner or other sportsperson. It’s one of a few important reasons why so many youngsters drop out of sport before they even finish their teens.

It’s so obviously ironic that parents and coaches both take satisfaction from encouraging kids to take part in sport to foster a lifelong habit of activity and enjoyment. Yet overdoing that encouragement is one of the main reasons behind them ultimately dropping out or getting injured. The number one reason youngsters give for deciding to quit their sport is pressure from parents, coaches or the setup of their sport. So, whatever we are doing, it’s wrong.

Lots of coaches are still wrestling with the idea of whether formal competition in sport is a good idea for kids. There doesn’t appear to be any straightforward answer to that question. The best answer might be ‘it depends’. If the environment is optimal, competition in sport may be quite healthy, if unnecessary. However, it rarely is optimal. There are potential sources of problems everywhere. Therefore, being realistic, maybe no competitive sport until beyond adolescence is better? That is definitely still an open debate.

It’s difficult for parents even to realise how pivotal their role is. For instance, who can blame parents for subconsciously rewarding competition results instead of effort, balance, maturity, sportsmanship and science based training in sport? The very best coaches in professional sport can hardly seem to achieve this, even though they should know better. It’s a tough challenge for parents to assume the role of sports philosopher, role model, coach, sports scientist and sports medic. On the other hand, if you are going to invest time, effort and expense in encouraging your child’s path in sport, you might as well do it properly, in a way that doesn’t leave them either injured or disillusioned and out of sport for good at 13 or 14.

It’s difficult for coaches too. Reliable and useful information on training program design and injury prevention is extremely hard to come by. Moreover, coaches often don’t have enough time with youngsters to provide individually tailored training. In this situation, I think it’s important that they emphasise to both parents and youngsters that the advice they give has limitations, and if they want to make sure they are training safely, they should consider  training themselves to be informed self-coaches, or hire in some more personalised coaching.

In climbing, we are about to enter a dangerous period (in the UK at least) since some new coaching qualifications are coming on-stream. Qualifications, generally speaking, are of course a good thing. However, there can be problems if parents see the word ‘qualified coach’ and don’t think any more about what the qualification means. It’s possible to be a qualified coach in many sports on surprisingly little experience, and unfortunately, depth of knowledge. Parents should be careful to make themselves aware of the level of skill and experience of those coaching their children. Start from the assumption that the coaches are not suitably experienced or resourced to prevent injuries in youngsters, and that you’ll need to consult a range of sources to ensure the best chances of avoiding injury and ensuring youngsters have a good range of influences on their development in sport.

I must say, with my own child, I’d be equivocal at best about encouraging them to get involved in regular competitive sport before adolescence. Non-competitive sport offers so many of the benefits, if not more, without the inherent problems that competition brings. Taking injury risk in particular, non-competitive sports offer the opportunity for more variety and spontaneity in the yearly diet of training, important both physically and psychologically. They also push the focus of performance inwards, to messages coming from the body, rather than outwards, just doing the same training as your peers or trying to keep up with others unrealistically. In other words, they are often healthier all round.

I see advice for youngsters in competitive sport to take breaks in the year from competition. Good advice, although not if they simply stop training completely. Complete rest falls foul of one of the fundamental laws of tendon injuries: “tendons don’t like rest or change”.

I’m talking about parents, coaches and the youngsters themselves so far. They have the immediate responsibility to improve the outcome for the youngster as they move forward with their own life. But what about those higher up, who are in charge of leading sport, spending our money to make sure the potential benefits for all of us are realised? What is the point in promoting sport if it is so hampered by a massive early dropout rate and millions (3.5 million in the US) of injured kids? The idea is that we foster lifelong involvement in sport and physical activity and that sport is something youngsters enjoy over the long term. It’s pretty clear that it doesn’t nearly meet these aims for a big chunk of the participants.

This is a big, serious question, that needs leaders of sport to go right back to basics. When we promote sport, how should it be done? What sports, or sporting practices are healthy in the long term? Should we be promoting entirely different sports and ideas around sport? Probably. I’d like to see data comparing dropout rates between competitive sports and non-competitive sports, such as those based around the outdoors and training. My hunch is that if sporting culture was less centred around rankings or winning/losing and more centred around simple fun, effort, resourcefulness and dedication, that dropout rate would go down.

What specifically should change? It’s a deep cultural change, so no single or simple thing can be targeted. I’d certainly like to see that a session at the gym/leisure centre/sports facility should always be cheaper than a can of cider. Getting an exercise high should always be cheaper than a drug high like alcohol for so many kids who have limited money. Unhealthy goods like cigarettes and alcohol are taxed more heavily to take account of their effects. Why not services? It seems a shame that new sports facilities are not given a more favourable financial climate in which to flourish. At big multi-activity centres, the pizza and cinema tickets could be £1 more expensive so that the indoor snow slope or climbing wall can be cheaper. The many threads of enjoyment of exercise and training for it’s own sake should be promoted over winning and losing. More could be made of urban spaces. Good incentives should be set up for running, cycling, parkour, skateboarding etc clubs to use these spaces. Everyday exercise and sport should be as conspicuous as possible. ‘No ball games’ signs could be banned. If the NHS is going to save money by encouraging us all to be involved in sports, at least some provision is going to be needed to offer proper sports medical care, in recognition that sports injuries do happen and are career ending if left untreated. Surely it’s cheaper to correctly diagnose and repair the ACL tear now than treat the arthritic patient in a couple of decades?

Of course there are countless possibilities along these lines. The cumulative effect would be that youngsters who we do manage to encourage into sport will have enough variety in their activity, so they don’t grow to hate their own sports before they are 15. Moreover, they’ll be less likely to feel the need to enter into serious competition until later, when they are ready. Their parents will be less likely to ‘hang’ their encouragement on success in one sport as well as measuring that success along different lines. And, the youngsters might become more physically conditioned from a longer background in sports before they launch into serious training and hence lower their risk of injury.

Young climbers I’ve met who have been involved in the competitive side of climbing are the only ones I’ve ever seen stop climbing at a young age. I don’t think I can recall ever seeing a climber who was focused on the other aspects of the sport decide to give up. That’s not to say I conclude that competition is bad. It’s just that it can tend to drown out the other reasons for doing sport and become a demotivator after a while.

Whatever is suggested as solutions, the first stage is to really recognise that the injury and dropout rates among youngsters in sport means that what we are doing now is not enough.


OnSight said...

Hi Dave,
Interesting post.
In regards to the "Tendon's don't like rest or change" paper you linked, which section are you referring to? I can't get through the jargon!

Robin O'Leary said...

Hi Dave,

Very interesting reading.
I like the idea of seeing the difference in numbers for those that have left the competitive aspect of our sport (or any sport) vs the non-competitive aspect.
Are we just more aware of those that are competition climbers being injured?

I think educating the parents as well as the child is crucial. Under the guidance of a coach, it is very easy for a child to do what is correct (to make gains and avoid injury - to train safely). However, when they show enthusiasm, and see these gains, they tend to train outside of squad sessions, or 1:1s and then are encouraged by the "casual" wall users to try harder problems or to do something that will make them more prone to injury.
In the child's eyes, they are impressing (a good feeling), in the wall users' eyes, they are encouraging, but as you said - this has detrimental effects.

It is a hard line to draw, but a correct "education" in safe training is at the heart of it.
The child's maturity to do this without supervision is crucial...but a big ask of some children.
This, I do not think it is limited to competitive climbers - but perhaps the ratio is greater?
I also agree with the uninformed coach principle, or in fact the term "coach" being used perhaps unjustly in some places - a recipe for disaster.

I have got some questions to ask you about injuries etc, what's your current email?



Neal McQuaid said...

Really interesting post and especially apt for myself as I work on the Irish coaching awards. Your comments about the qualifications are constantly on mind as something to consider when trying to set the content, levels, and how to educate the coaches properly in the limits of their knowledge.
Relative to competitions: The Youth Climbing Series in the UK and Ireland is the most visible demo of youth competition. It's hard to say if it's commonplace but as I was the ex-organiser in Ireland, I can vouch that up until aged 12 (youth C), we essentially placed no emphasis on results - the whole point was to get kids together to hang out from different parts of Ireland.

I'll have to query the bits near the end however. Thinking of several friends (both Irish, UK, American and Mainland European), they were all competitive climbers as youths who are have stayed very active in the sport. On the flipside, I can also think of several adults (and kids) who climbed regularly (without competing) and dropped out. I remember meeting an Austrian friend who's brother had climbed from a very young age (non-competitive) but quit in early teens to take up other sports such as basketball. I suspect climbing is no different to other sports and drop-out rates?

Everything about youths and injuries should be well heeded, sad to see we all seem to be going down a path of learning the hard way - huge injury rates instead of never letting it happen. Let's just hope we never get to the point that this scary article of an ex-NFL athlete are 'normal'!

Great thought-provoking post.

Cinderella said...

Hi Dave,
first I'd like to say I enjoy reading your blogs very much. I decided to comment this time because this particular post struck a chord with me. Lately it has become a bit of a fashion statement to say that you are so focused on your goal, that nothing else matters. I have been told: anything worth doing is worth doing to an extreme. I don't do competitions, but I suspect that if this attitude has spread in the circles I'm in, it is probably even more prevalent in competition circles. It's an unfortunate attitude and it has the undesirable and even longlasting painful repercussions you've mentioned in your post. Thank you for addressing it. I like the idea of learning to reward care for nutrition and lack of injury as much as "winning".