Although some young athletes attempt to gain elite skills early on, they would be better served if they delayed intensive training in a single sport until adolescence. That is the advice of sports medicine physician Chris Liebig, M.D., with Akron Children’s Hospital, Mahoning Valley, Ohio. “If you are becoming too specialized too soon you are actually doing more damage. You have a 32% to 46% increased risk for injury and the likelihood of going into an elite status as an athlete is smaller, ” he said.
Children Athletes Should Slow Down, Have Fun

Kate Keller, Healthy Living reporter, quotes Liebig as saying that of the 38 million children who participate in sports, 10% end up receiving treatment for a sports-related injury. Liebig says, “Half of those injuries should not be taking place. Most could be preventable.”
Liebig continues to state: “The three factors that contribute to overuse injuries are beginning a sport too early, spending too much time participating in a sport and playing in an environment that is too structured.” He recommends that children delay specializing in a sport until they are 15 years old. By that age boys typically have three years left to continue growing and girls are closer to having completed their growth spurts.
Liebig told Keller that “During the growth spurts, the growth plates are at a higher risk for injury, more so than even when they’re not growing when they are younger. But when they are in that active stage of growing these growth plates are a lot weaker.” A common growth plate injury is Sever’s Disease that occurs when the heel growth plate becomes inflamed.

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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