Childhood obesity has become one of the most widespread public health problems in the United States, and it has received tremendous media attention in recent years. Obesity in children and adolescents has also been thought to be a significant risk factor for cardiac disease, diabetes, and high blood pressure later in life.

Do American children meet the Guidelines?

Does much of the childhood population engage in 60 minutes of physical activity, and does that activity level increase or decrease over time? Laura Basterfield et al. published a study in the January 2011 edition of Pediatrics that showed that the physical activity levels of children are low. They found that the children averaged 26 minutes per day of moderate-to-vigorous physical activity at an average of 7 years old and 24 minutes per day at an average of 9 years old. Only 6.4% of children averaged the recommended 60 minutes per day of moderate-to-vigorous physical activity at age 7 and 5.7% did age 9.

A Proposed Solution

As gloomy as this data seems, there might be a fairly simple solution. Russell Jago et al. published a study in the February 2011 edition of Medicine & Science In Sports & Exercise looking at the influence of best friends on a child's physical activity level. The authors determined that the physical activity levels of 10- to 11-year-old children were closely related to physical activity levels of their best friends.

Encouraging children and adolescents to get outside with their friends and play will largely meet the Physical Activity Guidelines. It really isn’t that complicated. There are numerous examples of activities that kids can do together that are both fun and also have aerobic, muscle-strengthening, and bone-strengthening properties.

For example, riding a bicycle or walking a dog can serve as moderate-intensity aerobic activity. Games with friends, such as playing tag, or more formal sports, are terrific ways to get vigorous-intensity aerobic activity. Likewise, playing on playground equipment, playing tug of war, or climbing a tree are muscle-strengthening activities, while push-ups, sit-ups, or more formal resistance training can be used by older adolescents. Impact sports and activities, such as running, jumping rope, and formal sports like tennis and volleyball can help strengthen bones.

It is important to remember that children and adolescents should meet these Guidelines with a variety of activities. Engaging in activities that stress different body parts will avoid overuse issues and decrease the chance of injury. The STOP Sports Injuries campaign aims to keep kids active in sports and exercise while decreasing injuries that can occur. There are a variety of resources available to parents, coaches, and physicians to educate them and promote safety in sports and other activities.

Patterns of low levels of activity and high levels of sedentary activity are established in childhood and only get worse as they get older. Let’s work to get kids outside playing with their friends, exercising, and playing sports to keep them healthy for life.

What are some other ways that each of us can work with our community, schools, employers and our own families to  get kids outside and active more frequently?

There is nothing more discouraging to a young athlete than an injury. Keeping young athletes safe is critical to fostering enjoyment from sports and developing a lifelong active lifestyle.

Many children and youths participate in organized athletics, either through school or community leagues. These athletes can be challenged both physically and mentally from this activity and may formulate lifelong relationships with organized sports. Unfortunately, injuries do occur. Among the roughly 7 million high school scholastic athletes, approximately 2 million injuries occur annually.  Sports like soccer, basketball, and football are commonly participated in and injury research has led to some preventive measures to help make these sports safer for kids. Preventive measures may take the simple form of equipment or rule changes. But how do we get the word out about just the simple activity of safely participating in athletics and marketing to those groups who need the information the most? (parents, coaches and athletes themselves.)

The American Orthopaedic Society for Sports Medicine and its partners, including the National Athletic Trainers’ Association, American Academy of Pediatrics, American Academy of Orthopaedic Surgeons, National Strength and Conditioning Association, SAFE Kids USA, Sports Physical Therapy Section and the American Medical Society for Sports Medicine along with many individual hospitals, sports medicine practices and sports leagues are stirring up a grass roots movement to teach and market safe sports participation. The initiative called STOP Sports Injuries, is engaging community leaders by asking them to send out press releases to local media, giving talks on safety issues to parents and coaches, placing specialized logos of participation on websites, releasing public service announcements and have local individuals follow up with radio and TV stations and interacting on social media sites such as Facebook and Twitter.  Slowly but surely the word is getting out and the campaign is really starting to create a buzz in the sports medicine community. This type of marketing and education effort takes a lot of time and persistence but our hope is to make an impact and keep kids active and participating in sports so they can enjoy the benefits of exercise for a lifetime.

For more information or to get involved, visit our STOP Sports Injuries Web site and help share our commitment to keeping kids in the game for life.  We would love to hear your suggestions for additional outreach or ways to enhance our educational efforts.

How can your organizations get involved and help market injury prevention to multiple audiences (coaches, parents, athletes and healthcare providers?

Participating in sports is a great way to stay active and develop a multitude of skills from teamwork and discipline to self-respect.  However, playing safe is critical to not only staying in the game today, but also throughout life. While athletic participation is on the rise, so is the incidence of youth and childhood sports injuries. Most are aware of a sports injury when it occurs to a professional athlete, but few understand the life ramifications when a child gets a major athletic injury at an early age.  Lifelong and ongoing issues can ensue that may lead to a lack of physical activity and an increase in the chance for obesity and other health problems in adulthood.  

First, let’s take a look at the facts: more than 7 million high school students participate in athletics, resulting in an estimated 2 million injuries and 500,000 physician office visits.  An estimated 30 million children participate in sports resulting in 1.8 million emergency room visits for athletic injuries annually.

While certainly many of these injuries are traumatic, it has been estimated that close to half of these injuries are overuse in nature. The reasons for this trend have yet to be determined, but are likely attributable to the increase in children and youths specializing in specific sports and even positions – without allowing the usual rest gained during cross-training or an off-season.  These overuse injuries can often have long-term consequences well into adulthood, including tendinitis, arthritis and chronic pain.

It is not surprising that the sports with the most injuries are the contact sports: football, rugby, wrestling and hockey. However, sports like soccer and basketball are more commonly played – resulting in a large injury load as well. The majority of injuries are to the lower extremity: knee and ankle. The knee accounts for 30% of serious injuries and more than 50% of injuries resulting in surgery.⁴ These injuries, such as an anterior cruciate ligament (ACL) tear, can result in significant cost to the individual as well as the health care system.

As you can see, if we can prevent kids from getting hurt or burned out during athletic participation then they are more likely to remain active throughout life and achieve the Physical Activity Guidelines for Americans. In addition, research has shown that kids who participate in sports are more likely to stay in school and receive better grades.  It is for this reason that the American Orthopaedic Society for Sports Medicine and several other organizations, including the American Academy of Orthopaedic Surgeons, SAFE Kids USA and the National Athletic Trainers’ Association are launching the STOP Sports Injuries campaign. STOP, or Sports Trauma and Overuse Prevention is a campaign designed to educate coaches, parents, athletes and healthcare providers on the importance of sports injury prevention while keeping kids active and involved in sports and physical activity for a lifetime.  Do you want to learn more about this program and how you can get involved in your local communities? Visit http://www.sportsmed.org/stop  and help keep kids in the game…for life.

What else needs to be done to make sure that physical activity is safe for children and adolescents?