Prominent surgeon's insight youth sports parents can't ignore

Prominent surgeon's insight youth sports parents can't ignore


By Greg Bach

Dr. Lyle Cain, world famous surgeon at the renowned Andrews Sports Medicine and Orthopaedic Center, met with a patient recently who had torn his ACL.

That patient was 9-years-old.

And his injury is indicative of an alarming national problem that shows no signs of slowing.

“He had essentially been playing soccer for a full year and was probably fatigued,” Cain says of that youngster. “And for a 9-year-old that’s a joint-changing event that you can never really get back. It’s not something that will ever be a normal knee again, even though we construct the ligament again and we can make it heal. The knee itself is probably going to have trouble as he ages.”

Personal training sessions.

Travel teams.

Year-round participation in a single sport.

The problems with specializing in sports at young ages are well documented – but continue to be ignored by many parents blindly pushing their children in a sport at insanely young ages, and well before they’ve even had a chance to explore and decide for themselves which one they truly enjoy.

And they’re having them play it, and train for it, 12 months a year.

“What we’re seeing now is that young kids as young as t-ball age – 6-, 7- and 8-year-olds – are having year-round training,” Cain says. “They’re having professional instruction during the offseason. So instead of playing a three or four-month season they’re playing a seven or eight-month season and they really have no time off to allow their joints and their muscles and their tendons to heal and to rest.”


The reality is that most children who step on a field or court will never earn an athletic scholarship or reach the professional ranks – and that’s difficult for many parents to accept.

“I think what happens is that parents tend to do more training and more instruction and more specialization thinking that it’s going to help their child become a better athlete,” Cain says. “And the reality is that most athletes that are elite athletes that make it to the Olympic level in certain sports or to professional levels in baseball or football and other sports – those kids probably have some type of special ability that no matter what their training is they’re going to be an elite athlete. Most kids don’t have that so I think it’s important to allow the kids to play for fun, not to play because you think you’re going to make them into a pro athlete or they’re going to make money someday playing sports.”

So how much is too much when it comes to kids and sports?

“Our general rule of thumb or feeling from many of the research studies that we have done here in Birmingham is that kids should probably have a minimum of four months off from the sport that they are participating in,” Cain advises. “If you’re a baseball player it doesn’t mean that you can’t play football or you can’t play basketball or you can’t play other sports, but baseball itself needs to be less than eight months out of the year. And you need to have at least four months off where your joints can rest and you’re using different joints and different motions and different mechanics when you’re doing those other sports.”


As the father of four, Cain can relate to what parents are thinking and how too many wind up driving their kids down this path that can veer into burnout or worse, a trip to the operating room.

“I have four children myself that are 21 down to 13 so I have been through this with all of my kids,” Cain says. “As a parent I think you feel neglectful sometimes if you don’t get your kid into that extra training because some of the other people in the community are doing it and you get encouraged, especially if your kid plays a sport, to be more active and to participate more because the feeling in a community oftentimes is that the more you train the better you are going to be and the better your opportunities are. And I would tell parents that I think in some cases that’s exactly the opposite.”

Many professional players have voiced concerns about specializing too early, as well.

“There have been a couple of good studies recently where Major League Baseball players were surveyed and asked when would they let their kids start pitching or when would they let their kids start playing year-round baseball and most of them said they wouldn’t, or they would wait until high school,” Cain says. “So, I think the guys who are elite players realize that playing year-round doesn’t make you elite, it just leads to problems.”


When a young athlete has surgery to repair a ligament, tendon or joint that’s a serious procedure.

And it’s accompanied with no guarantees once the child can return to action.

“I think there is a little bit of unrealistic expectations about surgical procedures in youth and adolescents,” Cain says. “We know that we can reconstruct a lot of these ligaments and fix a lot of the problems that happen at this age, but it’s a fix that gets them back into activities and into an active lifestyle. But that joint and that bone is forever changed and it won’t ever quite be the same as it was before surgery.”


Cain and his mentor, the renowned Dr. James Andrews, began seeing these injury problems related to kids specializing in a sport nearly 20 years ago.

And they are disappointed that little has changed as parents continue to push one sport in pursuit of those coveted scholarships or hitting the lottery with a professional contract.

“It’s really kind of disheartening,” Cain says. “We really haven’t seen a lot of success yet.”

So, as the seasons and training sessions and year-round play blend together, young athletes will continue to be forced to the sidelines with injuries.

And many of those still-developing bodies will never be the same until parents realize that they are doing more harm than good to their child.

“I think the key message is that kids need to be allowed to be kids and to have fun and to have free play time and not be doing year-round instruction for any type of sport, no matter what the sport is,” Cain says. “If your child is playing more than eight months in any one sport – and that includes private instruction – I think you are at high risk for some kind of problem.”

Specialization; Injury; Surgery Burnout Overuse

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