Whether on a court, in a pool, on a field, or in a gym, more children than ever are competing in sports. Sports help boys and girls keep their bodies fit and feel good about themselves. However, there are some important issues that parents need to be aware of if their children participate in organized sports.

The following are answers to common questions parents have about sports and children. Talk with your child's doctor if you have other questions or concerns.

Q: At what age should my child get started in sports?

A: Before school age, children should stay physically active and healthy through unstructured "free play." For preschool-aged children, "sports" classes that emphasize fun are a great way to introduce athletics without competition. Most older children are ready for organized team sports when they are about 6 years of age. This is when they can follow directions and understand the concept of teamwork.

Keep in mind that all children are unique individuals. They grow and mature at different rates. Age, weight, and size shouldn't be the only measures used to decide if your child is ready to play a sport. Emotional development is also important. Children shouldn't be pushed into a sport or be placed in a competition they are not physically or emotionally ready to handle. Consider allowing your child to participate only if his interest is strong and you feel he can handle it. Remember, most children play sports to have fun.

Q: Should boys and girls play in sports together?

A: Until puberty, boys and girls can play sports together because they are usually about the same size and weight. After puberty, most boys are stronger and bigger than most girls. At that point, boys and girls should no longer compete against each other. However, if there is no team for girls in a certain sport, girls should be allowed to try out for a spot on the boys' team (in fact, it's the law in some states).

Q: What are the risks of injury?

A: All sports have a risk of injury; some more than others. In general, the more contact in a sport, the greater the risk of injury.

Concussions occur after an injury to the head or neck. They are most likely caused by body-to-body contact, body-to-object (like a ball) contact, or body-to-ground contact.

Most sports injuries involve the soft tissues of the body, not the bones. Only about 5% of sports injuries involve broken bones. However, the areas where bones grow in children are at more risk of injury during the rapid growth phase of puberty.

The main types of sports injuries are sprains (injuries to ligaments) and strains (injuries to muscles). Many injuries are caused by overuse. Overuse is when a child overdoes it (by pitching too many innings, for example). This places stress on the tendons, joints, bones, and muscles and can cause damage.

Q: How can the risk of injury be reduced?

A: The following are ways to help reduce the risk of injury:

• Wear the right gear. Appropriate protective equipment may include pads (neck, shoulder, elbow, chest, knee, shin), helmets, mouthpieces, face guards, protective cups, and eyewear.
• Increase flexibility. Stretching exercises before and after games can help increase flexibility of muscles and tendons used in play.
• Strengthen muscles. Conditioning exercises during practice and before games can help strengthen muscles used in play.
• Use the proper technique throughout the season of play.
• Take breaks. Rest periods are important during practice and games to reduce the risk of overuse injuries. During the year, a 2-month break from a specific sport is recommended to prevent overuse injuries.
• Play safe. There should be strict rules against headfirst sliding (in baseball and softball), spearing (in football), and bodychecking (in ice hockey) to prevent serious head and spine injuries.
• Stop the workout if there is pain.
• Prevent heat injury or illness. Rules for safe exercise in the heat include the following:
  • – Drink plenty of proper fluids before, during, and after exercise or play.
  • – Allow athletes to gradually adjust to exercising in hot, humid weather by increasing activities slowly over the first 2 weeks of practice.
  • – Decrease or stop practices or competitions during periods when the combination of excessive heat and humidity approaches dangerous levels.
  • – Wear lightweight clothing.
• Stop play if lightning is detected within a 6-mile radius (follow the "5 seconds per mile" rule).
• Play on safe fields. Inspect fields before practices and games. Clear all debris and repair holes and uneven surfaces.

It's also important to make sure your child has a complete physical exam by her doctor before participating in any sport. Most organized sports teams require an exam before a child can play. These exams are not designed to stop children from participating, but to make sure they are in good health and can safely play the game.

Q: What if my child wants to quit?

A: Sometimes a child will lose interest in playing a sport, find another sport more interesting, or follow his friends to a new activity. If your child wants to quit, get as many facts as you can. Talk with your child to find out the reasons for quitting. There may be a simple reason, such as not getting along with a coach, or the frustration of being "benched" and never playing in any games. If this is the case, talk with your child's coach to try to solve the problem.

Base your decision on what your child says and what you see. While it may not be wise for your child to make a habit of quitting when things get tough, "sticking it out" may not be the answer.

Q: How can sports-related stress be prevented?

A: The main source of stress in sports is the pressure to win. Sadly, many coaches and parents place winning above everything else. Young athletes should be judged on effort and not just winning. They should be rewarded for trying hard and for improving their skills rather than punished or criticized for losing. Remember, children would rather play on a losing team than sit on the bench with a winning team.

Reduce stress in your child's sport with the following tips:

• Look for positive programs. Avoid placing your child in a "win at all costs" program or intensive programs for elite players that play 4 to 5 times each week.
• Get to know the coaches. Stay away from coaches who are abusive toward or overly demanding of any child.
• Find a good fit. Make sure your child plays with and against other children in the same age range and ability.
• Get help. Help your child improve her skills with extra practices, sports camps, or outside help during the off-season.

If your child is under too much stress, either from the sport or from other sources like school or home, withdrawing from the sport may be necessary. Some of the signs of stress include recurrent or repetitive injuries requiring time off from the sport, loss of appetite, headache, vomiting, or depression. The signs of depression include sleeping more often than usual and acting tired or withdrawn.

Learning to cope with stress is an important part of growing up. In many ways, sports can help children cope with stress. This is one reason why pediatricians encourage children to play sports.

Q: Should bad grades keep a child from playing sports?

A: In most cases, the answer is no. A child having trouble in school still needs all the benefits of exercise, competition, and a sense of accomplishment. Sports may be the only place a child feels successful, and it could be harmful to take away a source of achievement.

If your child is not doing well in school, make sure other things are not the cause, such as conflicts with a job, other duties, or too much TV. If you feel that your child is simply not studying enough, you may want to tell him he can only play if his grades improve. Ask your child what you can do to help him do better in school.

Copyright © 2010 American Academy of Pediatrics