Before discussing any risks children might undertake by running, a strong statement of perspective is in order: The dangers of children not participating in sports—athletics in general or running specifically—far outweigh the dangers of participating.
Children in the United States are overweight and underexercised. Obesity has become an epidemic; in fact, it’s the number one health concern facing our children today, according to numerous health organizations. In turn, as overweight children grow up to be overweight adults, obesity-related health problems such as high cholesterol, heart disease, and diabetes are reaching record proportions.
The problem stems from myriad causes, first and foremost atrocious nutrition practices and the insidious popularity of sedentary pursuits such as video and computer games. The solution must target the numerous causes. In other words, we need to overhaul our societal attitudes about what we eat and how we fill up our spare time. Meanwhile, as part of the solution, encouraging children to participate in sports and exercise can go a long way toward addressing the weight problems they face.
Sports get kids outside and moving around. The physical activity burns calories, but it does more than that. Sports foster discipline and teamwork. They build self-esteem and positive body image. Studies have shown that even the dangers of drugs and early sexual encounters are less of an issue for youngsters who take part in sports. Finally, getting into the habit of exercising early in life translates into good health habits later on.
The best way to get your child interested in sports is to set a positive example yourself. Toddlers are masters of imitation—they’ll often mimic Mommy or Daddy stretching, running, even icing their legs. If children grow up knowing that athletics is something their parents do every day, then chances are they’ll believe it’s something they should be doing, too. And that’s one of the best things you can do for your child’s health.
If your child has shown an interest in running, your mission now is to keep him or her enthusiastic and healthy. The best way to accomplish that is not to go overboard by encouraging intense training or competition. Make your child’s running goals fun-based, rather than performance-based. Achieving maximal gains in the sport should not be a priority. In fact, most experts agree that youngsters should not engage in serious training until high school. And even then, long-term health and fitness should be the primary driver, not high school stardom.
Experts suggest that the best athletic program for youngsters through the middle school years is one that allows them to experiment in many areas. Ideally, children should participate in several sports throughout the year, perhaps one each season.
The renaissance approach is recommended for all children, but for young runners in particular. Running does not require prodigies of tender age, unlike gymnastics or figure skating, which demand a tremendous degree of flexibility, skill, and fearlessness, abilities that tend to peak during or shortly after childhood. Running skills typically develop over time—years, even decades, of conditioning the body. In fact, runners who have competed at the world-class level have picked up the sport at all ages, including well into adulthood.
Here are five specific reasons children should avoid specializing in one sport to the exclusion of others.
Burnout. Children who engage in a sport earnestly can rapidly use up their well of excitement. Even if they show talent and enthusiasm early on, their motivation can quickly flag. They run the risk of growing bored or even starting to dislike their sport before reaching their potential. Research has shown that children who specialize in a sport before puberty tend to have shorter sports “careers” than those who wait until after puberty to focus.
Injury. The American Podiatric Medical Association, in its statement on children and sports, says that children who specialize in a single sport at a young age are more likely to develop foot and ankle injuries. In running, in particular, the injury rate for youngsters is directly related to the number of hours they devote to the sport. Injury is not only a health issue for children but also a psychological risk, since it can quickly dampen their enthusiasm.
Variety staves off injury by reducing trauma and stress to any one particular area. Throughout middle school, children shouldn’t engage in anything that could be construed as “training.” Rather, children should treat running as play. In high school, training should be moderate and approached with caution. For more on appropriate running levels for different ages, see the sidebar on pages 164 and 165.
Broad athletic skill development. Youth is the best time to develop and master a variety of physical skills—throwing a curveball, for example, swimming the butterfly stroke, or dribbling a soccer ball. Just as there is a window of opportunity for learning language when a child is young, sports that involve specific coordination requirements are best served by an introduction at a young age when the body is most accommodating to learning new movements. Remember, there’s no hurry for running. Running is something children and adults can always discover or return to, since little to no technique is involved. And since serious training is best reserved for later years, your child will enjoy greater health benefits by participating in other sports.
Peaking too soon. Runners who train seriously will naturally improve. Then, after several years, the gains stop coming so easily. If your child shows potential and hopes to be a star in college or even go on with hopes of a professional career, patience will be her greatest attribute. The number of “years on your legs” clearly takes a toll for runners later in life. And the running world is filled with anonymous former “bright, young hopefuls” who were never heard from again after high school. This is not to say that youngsters can’t run and even race, but the level of intensity should be moderate.
Changing body types. Before puberty, it’s impossible to tell how a child’s body will develop. A youngster who says, “I’m going to be a distance runner” ultimately might be disappointed as large muscle mass develops that makes him more adept for shot putting, football, or triathlons. By maintaining an interest in a variety of sports, children are less likely to become disappointed in their sports—and their bodies. They are also more likely to discover the sport that they enjoy most or at which they are most successful.
Running ranks high on the list of sports that induce injuries. One notorious Seattle-area study conducted over many years delivered the sobering news that girls’ cross-country produced the highest injury rate of any high school sport—higher even than traditional contact sports such as football and wrestling. Boys’ cross-country came in fifth, behind these three sports and girls’ soccer.
In almost any sport in which girls and boys both participate, girls suffer more injuries. So it should come as no surprise that girl runners suffer injury at a rate that is estimated to be anywhere from two times to eight times that of boys. The reason may be due to several factors, including poorer presports conditioning, wider hips that lead to greater knee troubles, and weaker bone density, sometimes caused by menstrual irregularities.
Why does running take such a toll on young runners? “The thing to understand is that running is a contact sport—between you and the ground,” says Stephen Rice, Ph.D., the pediatric sports specialist who conducted the groundbreaking study.
The impact forces of running are a compounded problem for children, whose bones are not yet fully developed. Soft cartilage growth plates, which don’t close until the age of 15 or so, are more susceptible to the tremendous forces of running. Also, bone growth tends to occur in spurts unrelated to the elongation of connective tissue, which often lags behind, resulting in imbalances and inflexibility. The soft, developing bones become particularly vulnerable to these imbalances, making them an easy target for injury.
At the base of it, though, many children’s injuries are preventable, just as injuries in adults are preventable. That’s because the reason for injury at any age is basically the same: too much stress on a body that is not conditioned for it—in other words, overuse. Because children have the added vulnerability of growing bones and connective tissue, they have to be that much more careful not to overdo it.
To avoid injury, then, parents and children must exercise caution and pay close attention to early warning signs of trauma, such as soreness and muscle tightness. “The threshold for getting a child investigated should be slightly less than for an adult,” says Jordan Metzl, M.D., medical director of the Sports Medicine Institute for Young Athletes at the Hospital for Special Surgery in New York City. In other words, while an adult might wait a week and self-treat to see how an ache progresses, 2 to 3 days is the limit before getting medical attention for a child.
Early intervention is especially important at a young age because running injuries tend to become chronic, and one injury is a strong predictor of future injury. Proper treatment can prevent injuries way down the line, Dr. Metzl says. An Achilles tendon that becomes tender during childhood can bother a person well into adulthood.
Most overuse injuries occur when kids reach high school, the time they start training in earnest for track or cross-country. Three of the most common injuries suffered by young runners are:
Shin splints. This is actually a general, nonmedical term that refers to pain in the shin area. According to Dr. Metzl, the problem can be either muscular or bone-related. In either case, microtrauma occurs, causing pain in the shin area. In some cases, it’s because of overpronation, which places excess stress along the tibia. The bone can become inflamed, and the condition can eventually cause a stress fracture. Muscular pain on the outside of the shin might instead be due to compartment syndrome, in which the muscle does not have adequate room to expand.
No matter what the source, the key is to address shin pain in young runners immediately. “In almost every case, this is not only treatable but also fully preventable,” Dr. Metzl says. He recommends a visit to a sports medicine physician, who can analyze the runner’s biomechanics, training, and diet and determine a proper course of action.
Some reduction of training might be necessary until the pain disappears. And the doctor might determine that a good pair of motion-control running shoes is required or an over-the-counter arch insert to control excessive pronation.
Osgood-Schlatter syndrome. Felt as pain just under the kneecap, Osgood-Schlatter syndrome is caused by a disparity in the growth rate of bone and tendon (see above). The tugging that occurs at the bonetendon attachment during periods of bone growth can cause trauma to the soft cartilage growth plates.
A temporary reduction of training might be necessary until the tendon-bone imbalance works itself out. This would be a good time for cross-training (see chapter 6); limiting the amount of running will alleviate the trauma in the knee area. Meanwhile, ice can reduce some of the associated pain.
Stress fractures. Children are more prone than adults to stress fractures, because they face a double whammy with every step they take. First, their still-developing bones are soft and vulnerable to impact forces. Second, because children are smaller and have a shorter stride, they must take more steps to cover the same distance—thus multiplying the repetition of stress and impact.
Stress fractures require time off from running until they are healed. An injury of this nature should also be considered a strong invitation to review and improve the young athlete’s diet. A susceptibility to stress fractures might be an indication of poor nutrition. Children today consume fewer dairy products and more soda and caffeine than previous generations, both of which hamper the development of bone mass. Young athletes should be sure to consume sources of calcium, including dairy products, calcium-fortified juices, leafy green vegetables, and fish.
All these injuries—and most others that strike young runners—are primarily due to overuse. The key to avoiding them is to train within reasonable limits and take some preventive measures.
Always increase training gradually. Children must be especially careful to follow the laws of proper training, first gradually building a base and only then adding faster, more intense running. Like adults, they can use the 10 percent guideline, increasing training distance or intensity by only 10 percent in any given week.
Youngsters are especially prone to injury when they begin training at the start of cross-country or track season, particularly if they have not been running much over the summer or winter break. Be sure they communicate their current level of conditioning to the coach and then work together to develop an appropriate program. Track and cross-country camps in particular are notorious for placing heavy training loads on unconditioned athletes; youngsters should prepare with some running and other activity in the weeks or months ahead of time.
Following is a sample training schedule for a high school freshman or sophomore preparing for fall cross-country season. Upperclassmen who run year-round and are more likely to be conditioned can start this schedule at a base of 30 minutes, 4 days a week. This training should be conducted in the 6 weeks leading up to the start of formal practice.
Monday: 20 min.
Tuesday: 20 min.
Wednesday: rest
Thursday: 20 min.
Friday: rest or swim/bike
Saturday: 20 min.
Sunday: rest
WEEK 2
Monday: 20 min.
Tuesday: 25 min.
Wednesday: rest
Thursday: 20 min.
Friday: rest or swim/bike
Saturday: 25 min.
Sunday: rest
WEEK 3
Monday: 20 min.
Tuesday: 25 min.
Wednesday: rest
Thursday: 20 min.
Friday: rest or swim/bike
Saturday: 30 min.
Sunday: rest
WEEK 4
Monday: 20 min.
Tuesday: 30 min.
Wednesday: rest
Thursday: 20 min.
Friday: rest or swim/bike
Saturday: 35 min.
Sunday: rest
WEEK 5
Monday: 20 min.
Tuesday: 30 min., plus 3 or 4 strides slightly up-tempo for 50–100 yards
Wednesday: rest
Thursday: 20 min.
Friday: rest or swim/bike
Saturday: 40 min.
Sunday: rest
WEEK 6
Monday: 20 min.
Tuesday: 30 min., plus 5 or 6 strides slightly up-tempo for 50–100 yards
Wednesday: rest
Thursday: 20 min.
Friday: rest or swim/bike
Saturday: 40 min., with last 5 min. slightly up-tempo
Sunday: rest
Pay attention to early warning signs. Aches and pains should be heeded and treated, not ignored or “run through.” Traditional PRICE (protection, rest, ice, compression, and elevation) treatment can help reduce inflammation and pain early in the course of many injuries. (See chapter 8 for more details.) Training levels should be reduced before the injury becomes severe. And a sports medicine specialist should be consulted if pain persists. If your child tends to be uncommunicative, you might not be aware of the warning signs, even an outright injury, unless you ask. In addition to obvious signals like limping or swelling, signs that something is amiss include a loss of enthusiasm for training and making excuses for missing a workout.
Make sure your child eats a wholesome diet with adequate calcium. Because of bone vulnerability, calcium intake is particularly important. Studies show some grim trends. It’s estimated that only one in five children consumes the recommended daily amount of calcium, which is 1,300 milligrams for children ages 9 to 18. (Children ages 4 to 8 should consume roughly 800 milligrams.) Meanwhile, bone fractures in children have increased markedly in the past few decades.
“The amount of milk that kids drink has decreased over the past 15 years, and the amount of soda they consume has increased,” Dr. Metzl says. The two simultaneous trends spell trouble for kids who run. “I never used to see kids with stress fractures, and now I do,” he says. Not only that, but children with already low bone density are setting themselves up for osteoporosis later in life. That’s because the body builds bone only during youth; after age 30, we are incapable of boosting bone density.
Low-fat milk remains the best source of calcium. It’s fortified with vitamin D, which is necessary for the absorption of calcium, and it also contains fat and protein. Fortified juices, while they do provide calcium, generally lack these other essentials—although some juices now contain D. Additional sources include other dairy products such as cheese and yogurt. Tofu, dark leafy vegetables, and canned salmon and sardines also contain calcium. Children who are picky eaters can take a supplement as insurance that they’ll get enough calcium.
Cross-train, particularly with strengthening exercises. Since children are often interested in many activities anyway, cross-training is a natural way to prevent injuries. Allow or encourage your kids to participate in numerous sports. The variety your child engages in when younger needn’t stop in high school just because she’s on the track team.
Cross-training can accomplish several things.
Stretch regularly after running. Stretching is particularly important for adolescents. While younger children are extremely flexible, this tends to decrease in adolescence, when rapid skeletal growth leaves muscles and connective tissue shorter in relation to bone and therefore tight and inflexible. Junior high and high school runners should stretch regularly after runs as part of their conditioning. The stretches in chapter 4 are appropriate for young runners. Youngsters should be cautioned not to turn stretching into a competitive exercise—the goal is not to see who can stretch the farthest but to stretch only to the point of mild resistance.
Invest in running shoes for your child. It’s not a lot of equipment, after all, and will cost you far less than outfitting a child for, say, ice hockey. Buy running-specific shoes, since general tennis shoes do not offer adequate protection. And plan to buy new ones every year or even twice a year—kids’ feet grow fast! Many running specialty stores and large sporting goods stores now carry running shoes for children.