The Grind Never Stops: How Modern Youth Sports Affect Athletes

Players line up for a drill at a tryout for Long Island Elite Football. Photo by Ryan Toohill.

As youth sports have become more specialized, the demands on athletes’ bodies and minds have increased as well.

Hours-long daily practices year-round and weekend travel tournaments are the norm in many sports now, leaving children to juggle these commitments with their schoolwork and social lives.

“Nowadays, if you're trying to play a sport at the highest level, it's really going 365 days a year,” said Jesse Winter, the president and CEO of Level Up Long Island, an Amateur Athletic Union (AAU) basketball team. “You have to separate yourself by putting in a lot of extra time.”

A 2023 paper published in the journal The Physician and Sportsmedicine found that 21 percent of youth athletes self-reported spending more time playing sports than guidelines recommended. The researchers also found that these children were likely to agree that they had played more games than they should have before college.

Overuse Injuries

A 2018 meta-analysis published in the journal Pediatrics showed that youth athletes who were highly specialized in a sport had an 81 percent higher risk of sustaining an overuse injury than those who were less specialized.

Graphic by Ryan Toohill.

 According to the American Academy of Pediatrics, overuse injuries are the result of small wounds accumulating on muscles, bones or tendons as a result of repetitive stress on the area without sufficient recovery.

“You see a lot of those kids that specialize [have] overuse injuries, which can really impact the ability for them to excel,” said Harry Jacobs, the North Atlantic regional director for USA Lacrosse.

You have likely heard of some of these afflictions, which are often colloquially associated with the sports that cause them: gymnast’s wrist, tennis elbow, swimmer’s shoulder, to name a few.

Graphic by Ryan Toohill.

Joel Brenner, a doctor and head of the sports medicine program at the Children's Hospital of The King's Daughters, said that he’s seen the rate of overuse and overtraining rise over the past decade in youth athletes.

“It persists despite educational efforts and acknowledgment by professional and college athletes about not specializing early,” said Brenner.

Mental Health Effects

A 2021 study published in The Physician and Sportsmedicine found that highly specialized athletes experienced more fatigue, anxiety and symptoms of depression than their less-specialized peers.

More niche papers have not completely replicated these findings but still offer valuable insight.

A study published last year in the journal Sports Health reported that among a cohort of youth softball players, the more specialized athletes scored more favorably on depression and anxiety questionnaires. However, the researchers also found that the players who received private training showed more signs of depression and anxiety than those who did not.

Volleyball players who tied up more of their personal identity with their sport showed higher rates of total anxiety, depression and social phobia, according to a study published earlier this year in Frontiers in Psychology.

This is all without mentioning the elephant in the room for many contact sports: head injuries and the impact they can have on athletes down the road.

A 2023 study from the Journal of the American Medical Association (JAMA) screened 152 athletes who were younger than 30 at their time of death for chronic traumatic encephalopathy, or CTE. The disease is found in people who experience repeated head injuries, causing progressive nerve cell death in the brain.

The JAMA study found that more than 40 percent of the athletes they looked at had CTE. Those that did for the most part never played past the amateur level in contact sports like football, soccer, hockey and rugby.

Because CTE can only be diagnosed after death, it is impossible to know in real-time how the disease might be impacting youth athletics as a whole.

The Adult(s) in the Room

Grown-ups are perhaps more invested than ever in youth sports, which can lead to some ugly scenes, like the recent case of a Floral Park, New York, dad who is facing an assault charge for allegedly slapping an 11-year-old at a soccer game.

“In most cases, the adults have no idea what they're doing, and kids are just responding to that,” said David Thorpe, an NBA player development coach who has worked in the space since the early '90s.

While his clients have included elite professional players like Udonis Haslem and Corey Brewer, Thorpe works with high-level prep prospects, as well.

“AAU coaches in basketball tend to stress how many games are you playing, without thinking about the players’ bodies,” he said.

Indeed, the relationships children have with their parents and coaches are often one of the deciding factors in whether they enjoy their sports at all.

A 2016 paper, published in the Scandinavian Journal of Medicine & Science in Sports, showed that athletes who think their parents wanted them to win more than just try their best experienced higher levels of burnout.

Joel Brenner, the head of the sports medicine program at the Children's Hospital of The King's Daughters. Photo by CKHD.

Brenner, in a 2024 clinical report published in Pediatrics, emphasized that the way to avoid this is to help the athlete set goals and motivate themselves, something Thorpe agrees with.

“The players have to want to do it, and most parents don't get that,” he said.

Coaches play a key role in athletes’ overall enjoyment of their sports, also.

How a coach supports an athlete, both directly and in the player’s perception, has a measurable effect on an athlete’s self-confidence and psychological well-being, found a 2024 study published in the European Journal of Sport Science.

In the aforementioned report, Brenner noted that coaches who are controlling, perfectionistic and emphasize results over enjoyment are more likely to cause burnout in their athletes.

“We have kids at 11, 12, years old quitting, saying, ‘I'm not playing anymore, because I got some jerk coach over here screaming and yelling at me,’” Jacobs said.

Making it Work

Given all this information, it’s tempting to condemn early specialization for youth athletes across the board. If done right, though, this path is one many children do not mind being on. 

“Every kid's different,” said Benjamin Carey, the president and co-founder of Long Island Elite Football, which runs travel teams that compete in New York and across the country. “Some kids want to play checkers or chess, but my son first said he wanted to be an NFL player when he was five.”

Carey’s son, Preston, a senior at IMG Academy in Florida, is committed to play defensive line at the University of Georgia next year.

 Austin Irizarry, a freshman at Long Island’s Massapequa High School who plays on Winter’s Level Up AAU team, was complimentary of his coaches and parents. Despite much of his life revolving around basketball, he said that he finds a healthy balance and feels supported by those around him.

“I think it's good,” said Irizarry. “It's preparing me for the future.”