February 2017

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Editor Message


Sports in the tiger-parenting era

It doesn’t surprise me that focusing on achievement in a single sport at a young age substantially raises the risk of overuse injuries and can lead to other physical and developmental issues.

But experts quoted in our current feature (See “Early athletic specialization: Misconceptions and hazards,” page 15) brought up some less intuitive points about the increasingly common practice of intense concentration on a single sport at a young age.

Many children who specialize are trading the slim hope of elite achievement—and often, parents are the driving force behind these hopes—for the benefits and pleasures of the noncompetitive play that used to characterize childhood. Not only did such varied play promote the fundamental mastery of many motor skills, playing different sports allowed children to find their athletic niche naturally, rather than be routed onto a narrow path.

Greg Myer, PhD, associate professor of pediatrics and director of research and the Human Performance Laboratory in the Division of Sports Medicine at Cincinnati Children’s Hospital Medical Center in Ohio, said his biggest concern about early specialization is that it probably means many kids aren’t playing the sport for which they’re best suited.

Lower extremity practitioners can help their young patients by schooling parents on the facts, both obvious and subtle, starting with the data showing specialization can expose children to significant risks for injury now and in the future, and to issues ranging from emotional burnout to eating disorders.

And, in an era of tiger moms and dads, reminding parents, as does a longtime coach and athletic director in our feature, that despite the elusive allure of college scholarships and elite-athlete status, fun and a love of the game are perhaps better—and certainly less risky—reasons to play.

By Emily Delzell, Senior Editor


  • Shoes add to energy cost of gait compared with barefoot walking

    Footwear should allow dynamic activity – A recent study of the metabolic costs of barefoot versus shod walking found walking in shoes required a higher energy expenditure and had a poorer economy than barefoot walking. These outcomes suggest going barefoot may be preferable for children whenever it is deemed…

    By Greg Gargiulo

  • Sensor data quantify clubfoot patients’ reported, real brace use     

    Parents overestimate wear times – Researchers who used temperature-sensitive devices to measure brace-use adherence in children with clubfoot found parents overestimate brace wear time when reporting to clinicians and that children are not in their braces as long as their doctors recommend.

    By Peaches Yeilding

  • Martial arts students at risk for lower extremity injury, sequelae     

    Traumas increase with age, skill level – Martial arts participation has numerous benefits for children and adolescents, but it also has its risks—including lower extremity injury, according to a recent clinical report and literature review published by…

    By Chris Klingenberg


  • Flatfoot questions: Risk factors and assessment

    The proposed association between obesity and pediatric flexible flatfoot (PFF) may depend more on the reliance on subjective, 2D footprint-based assessments than true correlation. And recent research has identified another potential risk factor, whole body and joint hypermobility.

    By Hank Black

  • Early athletic specialization: Misconceptions and hazards

    Most elite athletes didn’t concentrate on one sport as adolescents, and there’s a strong link between early sport specialization and physical injury and emotional burnout. Yet, many parents think this risky path is the only route to high achievement and college scholarships.

    By P.K. Daniel