05 March 2018 - dreicast GmbH

Dan Exeter: Early specialisation for the younger athlete

This month's '11 in 11' session is with Dr Dan Exeter on the subject of early specialisation for the younger athlete. Dr Exeter is a Sport and Exercise Physician ...

hi my name is Mike vulture and it's my

pleasure to introduce dr. Dan Exeter in this 11 in 11 talk Dan is a Sport and Exercise medicine physician based at the FIFA medical centre of excellence in Auckland New Zealand and he's going to share his experiences working with young athletes and talk a little bit about beauty specialization so thank you very much for joining us down thanks mark good to be so then I guess if you can start by maybe just telling us a little bit about what early specialization is and how its come about and and what the impact implications are for young players your Lilly specializations broadly defined as intensive year-round training in a single sport at the exclusion of other sports and later in the talk we'll come to three key parameters that can be used to stratify that degree of of specialization but that's the definition that most people tend to use with the medes we've discussed that there are a few ways to stratify that and I think we'll come to that later on and it talks about how therefore you can put an athlete into a box to say that they are low specialized moderately specialized or highly specialized and there's some

tools that people have been able to use to do some research in this in this interesting area okay and why why are we interested in specialization well it's happening more and more and we're seeing more and more young children always saying young we're talking about kids before the age of 12 to 13 starting to focus on one sport at the expense of others and it's come about because there's some misinformation and what we're also seeing as some of the downsides of taking that approach okay if we look at some key sports where it was thought that early specialization might be helpful and we look at sports like rhythmic gymnastics and diving but it's really interesting because even if you delve into those sports there's real little evidence to suggest that early specialisations beneficial and it's only really been shown one small study of rhythmic gymnastics and if you look at those sports they're very very different to football they're sports where we've been successful before full physical maturation is important they tend to be technique based sports with an aesthetic component it's very very different to football so it's very

difficult to see how this approach could be applicable it's certainly not transferable from an evidence point of view and what we've sort of seen is that as that has sort of bubbled to the surface we've had a couple of key reasons on a day-to-day level what kids are specializing more and more and it often comes down to an interaction between parents and coaches so what we see is that the parents will often be the ones to initiate early specialization they're the ones who might push a child in a particular direction but it's actually in the coaches who have the ability to ramp up their training intensity and to reinforce that message so it's but it's a bit of a key in the lock scenario you need both to generally see this develop and the coach might have other reasons why they want the athlete to be to be early specialized and would like to think all parents have got their it kids best interest at heart but they're often not really aware of of the upsides or lack thereof inside the significant downsides of making their 10 11 or 12 year old focus on one sport and in this case football so you think

parents want their kids to be an excellent or messy or Cristiano Ronaldo yeah and I think they just generally subscribe to them more as better and they get the lose opportunities thrown of them academies and training camps and and that sort of thing and they see that as an opportunity for their child to do something and they also get a bit concerned that I want to deny their child those opportunities and it becomes a bit of a vicious vicious cycle and it's come off the really off the back of a couple of things would have become quite topical again and the first is this concept of 10,000 hours which was a concept raised by Ericsson back in 1993 and Ericsson essentially said that you needed 10,000 hours of practice in any given area to become an expert but it was actually something shown in musicians it's never been applicable to it to athletics or athletic bastes pursuit he could show that 10,000 hours of training for a musician meant that someone was more likely to become a maestro than someone who needed 7,000 hours but but that's never been shown to work in sport and then that concept got picked up and run

with I guess by authors such as Malcolm Gladwell in his book outliers where we he talks about how do you get to success and raises 10,000 hours concept again so you get this perfect storm where it becomes very topical and and parents latch onto that and coaches then facilitate that process and next thing you know we've got a problem with young kids doing too much of one sport too often and so what I think is really interesting is that this because they think it's the right thing to do they think it's gonna make the their child or they're actually better at football there's a stick to football early but not only did the evidence does IVA don't not show that that that's the case evidence potentially shows that you actually beat her off to play a number of sports when you're younger so if you want to be successful in one sport it may it should be better to have a broad range of sports when you're younger and there's certainly a couple of studies out of Denmark and one out of Germany that shows and in some of the Olympic sports that people were more likely to get to the elite level rather than just B sub

elite if they had a broader range of sporting pursuits and if you look at some of the sports that are talked about in those studies we see sports like tennis rowing track and field cycling skiing so sports that are probably more similar to football they're not ball sports of course but very different to those other sports that were very much aesthetic and we're peaking before physical maturation might be important for that sport so potentially what we should be saying is if you really want to be successful forget this early specialization actually stay broad and then once you get into your mid-teens then then pursue football as Adam walks exclusive level so we're talking generally about early specialization we're seeing more kids playing more football than perhaps ever before and perhaps if we're trying to develop players it sounds like that may not be the best way to develop players I think you're going to talk a little bit more about some of the risks or problems associated with we're the only specializing yeah that's right Mac so that we've already shown that there's no real upside to doing it certainly in a

sport like football there's actually quite significant downside and and this is a nice slide that talks about the three key questions that some researchers from the United States and and I've got to give credit to Joe anthe and colleagues here for some excellent work you some three key questions that they've used to risk stratify a degree specialization does a does a earthly train more than eight months of the year do they choose a main single sport and the question that really discriminates between moderate and high risk specialization do they quit other sport to focus solely on that sport and what they've been able to show is that kids who get overuse injuries are more likely to be in that high specialized group so that is answering yes to all three questions yeah it's yes to all three questions your highly specialized if you if you ask answer used to two then you were in a much lower or moderate risk and if you answer yes to none or one then again that's that's even lower so if you're answering yeast to all three questions then we know that you're more at risk of overuse injuries in the odds ratios they

arranged from from two to three with respect to lower limb injuries so it's reasonably relevant so we've got zero to one as low as two is moderate risk and three is a high risk that's correct here we've done more with it slide anyway the other thing to look at is just overall training hours and this is another great graph which shows that you can put a line of best fit really through increasing hours per week of training and watch that watch that with a nice curve marry up to the injury risk odds ratio but as soon as you jump over 16 hours a week that risk of injury doesn't fit that curve it jumps ahead rather rapidly and there's some nice research in 2008 that's been able to to demonstrate that that playing more than 16 hours of a sport when you're young puts you at risk of overuse overuse injuries and there's a positive correlation there the other thing I used to talk about is is this concept of burnout and I think we're increasingly aware of that the importance of the mental health of our athletes and just the reason that we want kids to play sport and to play footballers because there wasn't to

enjoy it and this is a good position statement from the American Medical Society for sports medicine and it shows that these specializations associated with some things that a renal what we want to associate with sport when other early specializations associated with spending less time on national teams deciding to quit sport earlier enjoying sport less which which is just a thing we really want to try to avoid and actually lower health outcomes so if you look at some of the you know broader implications of early specialization beyond injury it also could be detrimental in other areas as well so just more and more we're seeing that this is just not the right way to go not only if you want to be successful in the sport but actually if you want to enjoy sport and avoid injury so did some what we what we're hearing is that nearly specialization potentially doesn't make you into a better player there's an increased risk of injury if you play more and you're less likely to enjoy the sport and participate life long if you specialize to really yeah everyone needs some specific advice for when we see that

player come into our rooms or we see those periods what can we talk to them about these are the three key parameters I look for and I make I make young footballers total up their training in game hours each week we'll ask them ask them questions about how much they do and it's particularly relevant where we're from marking that we've got players often playing for a number of different organizations club school with Academy for example so the three key issues or the three key parameters that put you at risk of overuse injury is greater than 16 hours a week of training or gameplay a ratio of organised sport to free play we'll just play which is greater than two to one so if you're spending more than double the amount of hours that you are just running around having a good time as a kid an organized sport that also puts you at risk of injury and a nice really simple one if the number of hours you spend an organized sport is greater than your age that's a very very simple one could people know how old their kids are and if you're spending more time than that training or playing you've got an increased risk of injury and so that

things I try to disseminate to everyone I deal with coaches athletes parents other health providers because they're nice and simple and we could all ask them yeah there's some great take-home messages or take home tips that we can all use their practices on Monday so look bet really the gist of it I think what we've been able to show today markers that early specialization was never really intended for sports like football there's no evidence base to support it not only does it not make you more likely to be successful that potentially makes you less likely to be successful you may be better off to be broadly involved in sport and then specialize and finally it puts you at risk of injury burnout not enjoying sport and that those are things that we just don't want to our youth Leitz to be exposed to we want them that will enjoy football and if they're successful on top of that and that's an added bonus right so look thanks very much then for for that excellent summary of what is a very interesting and kind of topical topic and one of the key things with the 1111 is the opportunity for our network users to interact with our experts and

so for those of you listening who may want to pose a question to one of our experts in the future log on to the groups and have a look to see who is going to be speaking next and how you can ask them a question we do a few questions for Dan today so from the network we have a Christian at what age does it become appropriate to start specializing if we talk about early specialization being those parameters we talked about before occurring before the ages of 12 to 13 so really it's about 14 15 you can start to choose one sport over the other so when you really come into that post pubertal adolescence period that that's when you can start to focus on on one sport very good the next question is about bio bending I've heard about bio bending what is this I might keep you and your toes here Mack because you know a fair bit more about by bending than that than I do with your a lot of your work and football and why don't you explain that one so in general so a nice way to think about is the average 13 or 14 year old and we know that the average is not what all 13 or 14 year olds look like so for any given age we could have a six foot tall player

and we could a four-foot five-tool player and so obviously and this chronological age but there's also physiological age so what what does the player look like how close to squid or maturity are they and by abandoning is essentially a way of trying to group kids together by the physiological age and by maturity rather than by their age so looking at the appearance heart looking at rates of growth and development and using some other measures and a formula to try and estimate the the physiological age rather than their chronological age so by Manning a something and trying to group players together so that they're more on an even playing field so it is it's something I think that we're going to see more of and it is a way I think of trying to prevent some of these overuse injuries you're talking about next question and I country the best young players often play for multiple teams do you think that this is a problem potentially and the reason it's a problem is it's very very easy to start to exceed the training parameters we talked about before so if you have a scenario where a player has where a

footballer has to play for this school a place for their club and in his academy commitments you can see very quickly that by having two trainings in a game for each of those three organizations it'd be very easy to exceed 16 hours per week of training it'd be easy to exceed a organised sport to FreePlay ratio of two to one and if you total up those hours it'd be very easy to be doing more training than your chronological age and and the other thing is is that kids who tend to be good enough to be involved in multiple teams all all those teams want a piece of them and team a is not talking to team B or team C about the overall load for for that young athlete and knowing has ultimate responsibility and they're often very good so each of those organizations wants that kid to be playing for them and so a bit of oversight is really helpful you like the parents to play that role but often they feel a bit a bit subservient I guess they feel that they don't unempowered enough to confront someone and say I think my my child's training too much again for the reasons we talked about before they want their kids to be successful they don't want anything to

stand in the way and that they they think this is the right way to do it I've got their kids best intentions at heart okay well thank you very much Dan for what's been an excellent talk I think for those of you listening if you have any questions or this has stimulated your thinking please feel free to log on to the network and interact with your peers and some of the experts so thank you can Dan thanks mark

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