Play As Many Sports As You Can

Where kids get hurt
Children's bodies are not fully developed and are susceptible to injuries to the musculoskeletal system - muscles, bones and associated tissues like cartilage. Here is a look at the common injury areas

GROWTH PLATE INJURIES
• The growth plate Is the area of developing tissues at the end of the long bones in growing children and adolescents. The long bones in their bodies include those in the hand and fingers, forearm, upper leg, lower leg and foot.

• During a growth spurt, the risk of getting injured is higher because the bones grow first and faster, compared to the muscles and tendons. This results in decreased flexibility and muscle strength imbalances.

• Girls tend to experience growth spurts between the ages of seven and 12, while boys tend to have them between 10 and 14.

HEAD
Dehydration and other heat-related illnesses like dizziness and nausea. Children do not adapt to hot conditions as well as adults. Their bodies produce more heat and they perspire less. They are vulnerable to dehydration because they tend to forget to drink water when they are playing. This is a concern in almost any
outdoor sport.

SHOULDER
Baseball, rugby, softball, swimming and tennis are common sports where such injures are suffered.

ELBOW
Baseball, basketball, Javelin, shot put, softball and tennis.

WRIST
Common in gymnastics and racket sports

LOWER BACK
This is a vulnerable spot for those Involved in diving, gymnastics, martial arts, rowing and tennis.

KNEE
Sore spot for children In activities like basketball, football, gymnastics, jumping, netball and volleyball.

FOOT
Often suffered in football, as well as jumping and running activities.

ANKLE
Perennial problem area for those in basketball, football, jumping and running.

Don't let kids or youths specialise in a sport too soon, warn the doctors

TOO much exercise for children may not be a good thing. In fact, it may be bad for them.

This is what doctors are increasingly concerned with in light of the growth of youth-level sports in Singapore.

That is not all. Doctors are also cautioning against allowing children to specialise in a sport at an early age.

The Straits Times reported recently that an increasing number of young Singapore athletes are putting their studies on hold in favour of training full-time for their sport.

And with Singapore set to host the inaugural Youth Olympic Games next year, and the government providing a warchest of $5 million to prepare the Republic's athletes for the Games, the emphasis on youth sports has never been stronger, noted Swimfast Aquatic Club head coach David Lim.

He said; "People's minds have started to change. Compared to five years ago, the number of children participating in sports has increased significantly."

The increase in the number of participants in the junior categories of mass participation events is a clear sign of such a boom.

For example, the recent Osim TriathIon saw 500 children and teenagers participating in three age-group categories. They had to complete a 100m swim leg, a 5km bicycle leg and a 1km run.

This is a significant increase from 128 kids when the categories were first introduced in 2003.

While all this suggests a growing youth sports scene, parents, coaches and athletes must balance the desire to excel in a sport with the need to protect young muscles, bones and joints.

"Children are not just smaller versions of adults," said Dr Jason Chia, consultant sports physician at the Changi Sports Medicine Centre.

"Their skeletal structures are not mature and cannot withstand impact and sheer forces as well as adults."

A clinical report published in 2007 in Paediatrics, the journal of the American Academy of Paediatrics, also noted that children are less able to recognise fatigue or poor performances as signs of injury.

Constant close observation by parents and coaches will be key to the prevention of such injuries.

Dr Ong Wee Sian, head and consultant sports physician at the Sports Medicine Service at KK Women's and Children's Hospital said: "Weight gain, height gain, appetite, school performance, sports performance, and fatigue level are all indicators of possible problems."

While there are guidelines to help prevent overuse and burnout, it is important for parents to ensure individual monitoring.

Dr Chia explained: "Young athlete mature at different rates. So two young athletes of the same age at different stages of physical development may respond differently to the same training programme."

Injuries are most commonly suffered by youths training in running, swimming, badminton, basketball and football. Commonly- affected areas are the knees, heels and shoulders.

Repetitive stress and overuse injuries are also concerns if a child specialises in a sport too soon.

Dr Ong is advising parents of children aged nine and below to expose them to a wide variety of sports. They should also emphasise the importance of having fun instead of letting their kids specialise in a sport.

This will enable them to pick up a range of motor skills. It will also result in their all-round development a they will use different muscle groups.

"Most parents believe that specialising early will give their child an edge, but there is no evidence to support a definite advantage," she said.

"In fact, the drop-out rate among those who do so is very high. Only a few will reach the top."

How much is too much?

Based on the International Olympic Committee's guidelines, Singapore Sports School sports physiologist Dr Taisuke Kinugasa recommends:

• For strength training: Two to three sessions a week, with three sets at an intensity of 50 to 85 per cent of their maximum strength.

• For endurance training: Three to four sessions of 40 to 60 minutes, at an intensity of 85 to 90 per cent of their maximum heart rate each week.

Based on The American Academy of Paediatrics Council on Sports Medicine and Fitness guidelines, Or Ong Wee Sian recommends:
• Children should vary the sports they play. Using different muscle groups will help prevent over training injuries and burnout.
• For older children who have already specialised in a sport, they should perform this activity to a maximum of five days a week.
• Athletes should have at least two to three months off a year from their particular sport.
• Training goals should not increase by more than 10 per cent a week.

Other recommendations:
• The maximum competition distances at different ages should be as follows:
Under nine years old: 3km
Ages nine to 11: 5km
12 to 14: 10km
15 to 16: Half-marathon (21.1km)