Karen Langone, DPM:

Hi. Thank you everybody for being here today. Thank you to HMP for having me. I'm Karen Langone. I'm a practicing podiatrist in Southampton, New York. I am a past president of the AAPSM, current president of the AAWP. I'm a trustee for NYSPMA and I'm board certified by ABPM.

So it's very interesting. When I first started in practice more than several years ago, I never saw athletes with injuries until they were in high school. And now what I'm finding is a younger and younger group is sustaining these athletic injuries. Yesterday I had an eight-year old in the office and that's becoming a lot more typical of what we start to see. And the biggest change seems to be that everyone has chosen one sport and they are playing this sport five to seven days a week and they are playing it year round. So the difference is really that kids years ago moved from different sport to different sport. There weren't so much association with a travel team and a high level of competition. And now even young children are playing, as my patient yesterday was, basketball year-round with a club, with another travel team, and then at home to the elimination of virtually any other kind of recreation, not really riding a bike, not jumping around with friends, not on a trampoline, but solely involved in this one sport. And that I think is the biggest challenge that we face right now.

Like so much of what we do, education is really a huge part of working with these athletes and their parents. An eight-year old cannot ferry themselves to practice seven days a week. So it requires some parental involvement and acceptance and approval of the practices that are going on. So it's really important to try to emphasize with the parents that what we're seeing now is when we think of injury, we think of these traumatic injuries, but 80% of the injuries that these athletes are sustaining are really overused injury. And we are seeing them primarily with foot and ankle leading the way. And so it's really important both to discuss with the athlete and with the parents that being a little more multi-specialty, multi-disciplined is going to be a big benefit for them by not overworking the same body parts repetitively over and over. It's that cycle of overuse in an immature body that's really not allowing the body the opportunity ever to recover and to move on.

And that's really what we're starting to see. You know, hear stories now of kids having Tommy John surgery at 14. There's definitely something wrong with what we as parents are encouraging our children to do and are accepting. It's also an interesting thing that kids who tend to do that have the highest level of burnout in those sports. And so children who specialize when they're in elementary school or middle school tend to be the kids that by the time they're 15 or 16, are fed up and are burnt out mentally from the stress and strain of the sport and start to realize that there's more to life than this one sport. So I think that's a big factor. When we look at children who receive college scholarships, we tend to find that those are the ones who did sample multi-sports through the years. It's also better for the developing body. It's also better for long-term bone health to really have been involved in multi-sports and multi-directional sports rather than focused on one sport entirely.

That's a really tough question. I think it comes down again to education more than anything else. I think that most people, most parents who encourage their children to do this, think they're doing the right thing. They're thinking their child is going to be able to excel. Their child has a love for a particular sport, they're supporting that interest and they feel that their child will be more successful that way and perhaps be able to compete at a higher level, have a greater level of self-esteem, find their way, find their passion, and find their love. But statistically, what we're seeing is that really is exactly the opposite of what is playing out. So if we can really help parents to understand that, that while what they're doing is with the best interest of their child at heart, it really is being counterproductive at this point. And that would be our best option.