Athletic Training and Sports Health Care

Editorial Free

Where Have All Our Youth Athletes Gone?

Thomas W. Kaminski, PhD, ATC, FACSM, FNATA

In the words of U.S. Olympic Committee member Anita De-Frantz, “Sport is a birthright.”1 From combatting the growing obesity epidemic to promoting camaraderie and confidence, sport plays a pivotal role in helping children become healthy on all levels—physical, social, emotional, and cognitive.2 As a boy growing up, I spent almost every waking minute outside playing sports—going from football in the fall, to basketball in the winter, to baseball in the summer; no cell phone or videogame distractions to contend with!

Unfortunately, as I begin a new year, some disturbing statistics have emerged that caught my attention. According to the Sports and Fitness Industry Association (SFIA), the number of children who played a team sport on a regular basis decreased from 44.5% in 2008 to 40% in 2013.3 As I pick myself up after reading these startling statistics, I can only think that the growing obesity crisis our nation faces is going to become more bloated—pardon the pun!

The report continues, indicating that sports participation and fitness have significantly dropped and that nearly 3 million fewer children have played basketball, soccer, track and field, baseball, football, and softball, and less than 1 in 3 children between the ages of 6 and 12 years participated in a high-calorie-burning sport or fitness activity three times a week, according to SFIA data.3

Why the downward trend? I contend that it is related to two primary things: “the machines” and “fear of injury.” First, “the machines” are killing the American sports culture. Kids now grow up with cellphones in their hands instead of basketballs and baseballs! Distractions like these have disinterested children, making them “homebodies” not willing to step outside for a little recreational fun and activity.

Second, the American media has created a fear among parents that some team sports are unsafe and unhealthy to participate in. This fear primarily stems from issues related to concussion and subconcussive impacts to the heads of youth in contact/collision sports such as American tackle football, ice hockey, lacrosse, rugby, and even soccer. Although there are inherent risks with most sport activities, in my opinion the physical, social, emotional, and cognitive benefits of participating in sport and activity far outweigh these risks. This is where I believe the role of certified athletic trainers as qualified health care professionals trained in athletic injury prevention and management is the key element in reversing the downward trend in sport participation and countering any fears brought on by a misinformed media enterprise.

Two other recent developments in the youth sport arena caught my attention as the new year commences and involved significant rule modifications in youth soccer and football. As a researcher in the area of sport-related concussion (primary focus on soccer) over the past 25 years, I applaud these rule changes and the recommendations put forth by each governing body and advocacy group in trying to make the respective sports safer. I gain even greater satisfaction from hearing that both advocate for the use of certified athletic trainers to be on hand for sanctioned competitions.

Let me speak first about the ensuing rule changes affecting soccer. The United States Soccer Federation recently settled a class-action lawsuit brought on by a group of parents in California and as a result settled out-of-court, agreeing to make significant rule changes with regard to safety in the sport, especially at the youth level. One such change was the rule that bans heading in children 10 years and younger (intuitively this makes perfect sense). From a practical sense it was a no-brainer because outside of the fact that there are probably a few rogue and sadistic coaches out in the world who would institute soccer heading drills to this age group, the ball is rarely in the air in matches involving this age group so there is no real need to teach the heading skill.

On the other hand, the rule change goes on to state there is to be a limit on the amount of heading in practice for children between the ages of 11 and 13 years. Again, I like the spirit of the new law because repeated subconcussive impacts to the brains of developing children are not healthy, but I do argue that coaches MUST become properly trained so that the soccer heading drills they do implement in practice are rendered safe and follow a logical progression for skill acquisition. I contend then that if done properly in practice situations, this will render the athlete safe and less susceptible to head injury during match play. Stay tuned on this front as the rule changes play out in the near future.

Almost simultaneously, the American Academy of Pediatrics Council on Sports Medicine and Fitness Policy Statement on Tackling in Youth Football was released to provide recommendations to make the sport of tackle football safer for America's youth.4 Of note are the recommendations for (1) reducing the number of impacts to the head during practice and games, (2) proper enforcement of the rules, (3) expanding non-tackling leagues, (4) proper tackling instruction for coaches, (5) neck strengthening (I personally advocate for this with all youth sports athletes involved in contact/collision sports; strong necks can help limit head accelerations!), and (6) efforts to have the services of certified athletic trainers on the sidelines of organized football practices and games.

The Youth Sports Safety Summit is an annual event hosted by the Youth Sports Safety Alliance and the National Athletic Trainers' Association (NATA) to educate key stakeholders about current issues in youth sports safety and effective measures to keep young athletes safe. The NATA has been on the forefront of this youth sport safety advocacy program since its inception. This year's event slated for March in the Washington, DC, area will focus on “Stay Ahead of the Game: Preventing Catastrophic Injury in Youth Sports.” I can think of no better, well-suited, and equipped professional than the athletic trainer to be leading these discussions. More on this year's summit can be found at

Although all of these initiatives and activism call for athletic trainer involvement to help stop the growing downward trend in sports participation, the decision to participate or not rests with parents. Making available information that is relevant and evidence-based with the real facts about all of the positive benefits gleaned from youth sport participation, despite some controllable risks, is justified. The statistics don't lie and prove that children who are active and participate in sports live longer and healthier lives and are less likely to become obese, more likely to go to college, and more likely to be productive adults than children who do not play sports.

I came across this quote by Shakeel Syed, Executive Director Islamic Shura Council of Southern California, who said, “The pervasive malaise of TV is robbing our children and plaguing their innocence. Should we care to turn our future on, turn off the TV today.” We need to send a message to today's youth to get up and get moving!


  1. Elliott H. London Olympics organizer emphasizes women's roles. Los Angeles Times. February17, 2012. Available at: (
  2. Lee A. 7 charts that show the state of youth sports in the US and why it matters. The Aspen Institute blog. February24, 2015. Available at: (
  3. The Sports and Fitness Industry Association. 2015 Participation Report. Silver Spring, MD: Author; 2015. Available at: (
  4. American Academy of PediatricsCouncil on Sports Medicine and Fitness. Policy Statement: Tackling in Youth Football. San Francisco: Author; October2015. Available at: (

The author has no financial or proprietary interest in the materials presented herein.


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