Dr. Joseph Congeni knows and loves sports.
He's been Akron Children's Hospital medical director of sports medicine and the Hoban High School team doctor for 30 years.
He's also a father of six with 18 years of coaching experience, including football and basketball.
“I'm a sports guy. I love the benefit of sports,” said Congeni, who is this month's expert for my monthly Healthy Actions column.
“There's so many life lessons with competition and team sports. Everything I learned in school I learned in youth sports,” he said.
But over the course of his career and especially in the last few decades, Congeni has seen an increase in injuries among young athletes from overuse, overload or overstress to their young bodies.
Many of the overuse injuries are preventable with education, Congeni said.
His biggest concern is young or pre-teen athletes, those from age 8 to 14 or late elementary school to middle school. By high school, athletes' bodies have matured and can handle the training and play, he said.
Young athletes' muscles are tight and their growth plates are growing fast. The growth plates in younger and middle-school athletes are not as strong as the bone in a fully-matured kid, he said.
Training wrong or not taking care of your body can make a young athlete more prone to injury, Congeni said.
But first, Congeni has some general tips for all athletes, including high school athletes.
Research shows that injuries go down when athletes limit their training to five days a week, no more than 10 hours total (playing and training) and taking a season off. During that off season, Congeni said, “just do something else.” It's the repetitive nature of doing the same motion over and over again which can lead to injuries. “If you want to do some conditioning and training, even if you want to do another sport, yeah, we love that.”
To keep young athletes healthy, here are some topics to keep in mind.
Sometimes kids are encouraged to specialize in a particular sport so early that by the time they're in middle school or high school, the child is burned out, Congeni said. Some kids start to specialize in third and fourth grade.
“Wow, that's way too soon,” said Congeni. Junior high is still too soon, he contended.
Doing too much
Congeni said he gets it. Especially when the kids are young, you want to expose them to different sports. But layering too many sports at the same time can be a problem.
Layering of too many teams, like a recreational or school team, an all-star team and a travel team, is also concerning.
“It's not unusual in my office to ask how many games you've played in a sport in soccer or baseball where kids will tell me 60, 80, 100 games a year,” said Congeni. “At a position that's really high risk (for injury) like a goalie or pitcher, say particularly [a] pitcher: How many of those games do you pitch? Forty percent of the 80 or 100 games. Oh my gosh, we wouldn't do that to a professional pitcher by any circumstance and yet we do that to a younger player.”
Over-scheduling sports can also lead to what Congeni called “Frantic Family Syndrome,” where families are always on the run to practices, games or traveling for sports and they “give up valuable family time, which ends up leading to dysfunction that is the opposite of what we love about sports.”
For high-schoolers, weight-training on their own or with a coach is reasonable, Congeni said. But he does not believe middle-school students should be told to go to the weight room on their own.
Congeni will give the green-light to middle school students — both boys and girls — with some stipulations.
It must be one-on-one or directly supervised. Kids should also start with body-weight exercises for at least the first four to six weeks. Weight-training should be free weights at lower levels and “with more repetitions and no maxing out or working more than 50 percent of their max,” he said.
Congeni also said young athletes should not be in the weight room for more than 30 minutes, not on back-to-back days and no more than three days a week. “Try to mix it up and have a well-balanced program with upper body, lower body and trunk” with a good warm-up and stretching program, he said.
Congeni notes that younger male athletes won't see muscle gain because they don't have the testosterone levels yet, but kids can gain strength.
Middle school and high school athletes should be getting enough protein with a well-balanced diet that protein supplements are for the most part unnecessary, Congeni said.
“For people who are buying the big vats of protein, it's a pretty expensive insurance policy,” he said. “The body can only use so much ... you're basically peeing out your expensive supplements.”
Still, Congeni said supplements are not dangerous and are pretty safe. He does recommend staying away from anything with creatine, which he thinks has very little upside and can cause cramping.
Congeni said he is not opposed to a young athlete going to a certified strength and conditioning coach, as long as they still follow the weight stipulations above. It is important, however, to go when the athlete is not injured. An injured athlete needs to go to a physical therapist, he said.
Dancers are also athletes and are also prone to a certain set of injuries, said Congeni, who has worked with many dance patients.
Congeni would still like dancers to adhere to the same rules of no more than 10 hours a week, five days a week, nine months of the year, but he recognizes that for some advanced dancers, they are at the studio for 20 or more hours a week in order to perfect their art.
“They're inherently going to have overuse,” he said. “If that happens, I'll be here to help you.”
Overall, Congeni said “there's so many good things about sports. We just have to keep them in balance. A lot of times well-meaning adults push that out of balance. I can gently nudge them back to the balance world.”
Medical writer Betty Lin-Fisher can be reached at 330-996-3724 or email@example.com. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ and see all her stories at www.ohio.com/betty.