Playing with pain: How doctors can spot red flags with youngsters and athletics

As kids get more serious about sports at ever-younger ages, physicians must rethink ways to prevent, as well as treat, injuries.

By Kathleen Phalen Tomaselli, AMNews correspondent. Feb. 2, 2004.

Stacy Maxwell is 18. And on the surface, she is the picture of health.

She usually lifts weights, runs cross country three times a week and plays soccer on two different teams six out of seven days. For 15 years she's been running around soccer fields, basketball courts, baseball diamonds and tracks. Like many young athletes, Maxwell has been playing her favorite sport -- soccer -- since she was 3. And it's paid off. The University of South Carolina recently recruited this Atlanta high-school senior to play at the college level next year.

But there are some problems.

During an end-of-summer tournament, Maxwell's knee gave out as she ran down the sidelines. A torn anterior cruciate ligament and partial lateral meniscus tear meant surgery and no running or soccer. It's been several months, the crutches are gone and she's walking again. And she's nervous. She needs to play, to get ready for college. But she's still in therapy and still can't run.

"I've never gone this long without playing," says Maxwell, who desperately wants back in the game. "I was overdoing it, my legs were tired ... my hamstrings and quads should have been stronger."

This kind of sports injury has always been common among mature athletes whose bodies have faced years of wear and tear. But the fact that young people are increasingly sustaining severe sports injuries resulting from intense training schedules is raising some red flags.

Millions of young people play sports -- a dramatic jump from previous generations. In the 1950s, '60s and '70s, most organized sports were reserved for high-school boys. Few 3-year-olds had team tryouts or nightly games. And girls rarely played. Today, the number of high-school girls participating in organized sports has increased about 700%. "About 5 million kids participated in the 1970s," says Tim E. Hewitt, PhD, director of the Sports Medicine Biodynamics Center at Cincinnati Children's Hospital Medical Center. "Today it's over 30 million. But of those kids, in any one year, one-third will get injured. That's 3 [million] to 10 million sports injuries a year and $2 billion in costs. It's a huge problem."