In New Zealand, like many Western countries, our major physical activity problem is a physical inactivity problem. This applies to our kids as well as adults. The Ministry of Health and the World Health Organisations tell us that our kids should be accumulating at least 60 minutes of moderate to vigorous intensity physical activity daily. They should also be limiting screen time to no more than two hours a day. At a population level, these are the key targets we should be aiming to meet. That s a clear mandate to get out there and enjoy our beautiful outdoors doing what kids love to do, and that s play.

However, globally (and there is no reason to think that we are any different), we are seeing a trend where a small proportion of children are specialising in one sport, especially at an early age. The driver seems to be a belief that the likelihood of achieving sporting success as an adult is increased if you specialise in one sport from a young age. This not only incorrect but in fact, the reverse is true. Athletes who maintain a broad sporting base until an older age and then specialise in one sport are more likely to become elite athletes in adulthood than those who specialise early. In addition, there are a number of mental and physical harms associated with early specialisation and the associated training volumes.

When it comes to the harms associated with sport specialisation and training volumes we have to be precise. This means we must be clear about what sort of injury risk comes from sport specialisation and training volumes. The current available evidence shows an increased risk of overuse injury with sport specialisation. There is no evidence to support an increased risk of acute injury. This means, for example, that we cannot say that the risk of ACL rupture, or shoulder dislocation is increased in those who are sport specialised.

However, the major area where the message around training volumes gets misinterpreted is where play (or informal activity), is confused with training and competition. We want kids to play as much as they like because it's random, varied and self -limited i.e. kids stop when they want to. There is no suggested cap on playing, so get them out running around, climbing trees and kicking balls and shooting hoops with their friends. Training is different as generally, it s more repetitive in terms of movement, possibly even more repetitive than competitive games. It is the total hours of training and competition, not play, that should be kept less than the age in years to help reduce the risk of overuse injury. But that means exactly that - it reduces the risk, it doesn t mean that sticking to that guideline eliminates the risk, nor does it mean that disregarding that guideline will guarantee that a child will get injured.

Going back to play, one of the other metrics that the evidence suggests could reduce the risk of overuse injury is ensuring that the ratio of organised sport to play does not exceed 2:1. One good way to preserve this ratio could be to get kids to play more! I wonder as our lives get busy, and as our built and social environments are less conducive to informal play, if some of our naturally athletic kids are inadvertently having informal play replaced with formal training and sport.

Let s not attribute every harm to sport specialisation, it s likely to be a small piece of a big puzzle. And let s not confuse play with formal sport.

Reference: Axis Sports Medicine Specialist - By Dr Dan Exeter on 24.06.2019