Focusing on mental health issues among athletes (copy)

Sport specialization refers to a young athlete participating in one sport and excluding all other sports, leading to year-round participation and increased training in that one activity. File/Stuart Villanueva

I’ve written many columns discussing the negative physical effects of kids specializing in one sport at an early age, namely a higher risk of injuries and missing out on the development of a wide range of skills that actually increase the chances of later collegiate and professional athletic success.

There’s another aspect of sport specialization we need to recognize if we want the best for our kids in sports and in life — the mental health of these young athletes.

Sport specialization refers to a young athlete participating in one sport and excluding all other sports, leading to year-round participation and increased training in that sport. Frequently these young athletes and their parents believe that focusing on only one sport is the path to future college scholarships or professional paydays.

A new review study published in the Journal of Athletic Training suggests there are a number of effects this specialization has on mental, social and psychological well-being. Possible effects include increased anxiety and stress, social isolation, less family time, insufficient sleep  and burnout.

Unfortunately, research into the mental and psychosocial effects of early sport specialization is only now being performed in the U.S. Most of our evidence in these domains comes from European studies. But there are three key areas we should examine: mental well-being, sleep and burnout.

Generally, it has been assumed for years that playing sports is beneficial for kids’ mental health. There might be a threshold, however, at which the volume of training might start to negatively impact kids. In a study of elite young Swiss athletes, mental well-being peaked at around 14 hours of sports per week. Above 17.5 hours, though, the odds of poor mental well-being more than double.

Certain aspects of sports clearly improve kids’ mental well-being, and coaches and parents should focus on them. The mental health of young athletes improves when training and competition in sports are fun for the kids, when coaches teach life skills, and when coaches and parents motivate kids positively instead of critically.

Another key aspect of mental health is sleep. While the American Academy of Pediatrics recommends 9 to 12 hours of sleep for children ages 6 to 12, and 8 to 10 hours per night for adolescents ages 13 to 18, young athletes often get much less.

Elite athletes in team sports average seven hours per night. Top athletes in individual sports average 6.5 hours of sleep per night.

It’s too soon to truly tell the toll insufficient sleep takes on young athletes. But one study found that female athletes with clinically diagnosed depression or anxiety were less likely to meet sleep recommendations.

Decreased mental well-being and poor sleep lead to the most worrisome potential effect of early specialization — burnout. As it relates to sports, burnout has been defined as a “response to chronic stress in which a young athlete ceases to participate in a previously enjoyable activity.” The three main components of sports burnout include emotional and physical exhaustion, decreased sense of accomplishment and sport devaluation.

Burnout is hard to quantify, as little data exists on burnout in youth sports. Overreaching, however, has been studied. This is the condition of decreased performance and negative psychological symptoms due to intense training. Studies have estimated that between 30 and 35 percent of adolescent athletes experience overreaching. Multiple studies have shown that kids who specialize in one sport at an early age more often withdraw from that sport due to burnout.

Kids who try to be perfect in sports are at greater risk of burnout, especially when their parents emphasize winning or failing more than doing the best they can.

Other risk factors for burnout include excessive time commitments and training, demanding expectations from coaches and parents, negative evaluations and little control over decision-making with sports.

The American Academy of Pediatrics and American Medical Society for Sports Medicine have published recommendations to prevent burnout among young athletes. I’d argue these tips are critical not only to decrease burnout and keep kids playing, but also to improve their overall physical and mental health.

• Keep training fun.

• Take one to two days each week off from the sport to rest or participate in a different activity.

• Take 2 to 3 months each year off from that sport and play another sport or focus on strength and conditioning.

• Focus on skill development rather than winning and losing.

Finally, I would encourage parents to allow their kids to play multiple sports until high school. Watch their attitudes and behaviors in whatever sport they play. And make sure they’re having fun so they don’t quit sports altogether.

David Geier is an orthopedic surgeon in Charleston and author of “That’s Gotta Hurt: The Injuries That Changed Sports Forever.”

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