My friend Nancy went for physical therapy for her back pain the other day, and was really surprised by what she saw there: the place was full of kids.

“Yeah, it’s like this now,” said the therapist when Nancy asked about it. “It’s the sports.”

It’s not that kids are getting clumsier or having more accidents. The injuries that are sending kids to physical therapy are overuse injuries. Kids these days are specializing in a sport as early as elementary school, and spending many more hours a week in practice than we ever did as kids—and we’re seeing the consequences.

In a newly-released study authored by Children’s Hospital Boston’s Mininder Kocher, MD, and Alison Field, ScD, researchers found that girls engaging in eight or more hours of high-impact activities (especially running, basketball, cheerleading and gymnastics) per week were twice as likely to have a stress fracture as those engaged in such activities for four hours or fewer. These stress fractures, if not detected and treated early, can lead to worse fractures, deformities and growth problems. Some may need surgery.

“We are seeing stress fractures more frequently in our pediatric and adolescent athletes,” says Kocher. “This likely reflects increased intensity and volume of youth sports. It is not uncommon to see young athletes participating in more than 20 hours of sports per week.”

My older son, Zack, stopped doing any other sport except swimming when he was 9 years old. A big part of the reason—really, the biggest part—was that he loved swimming. But there was also the reality that in order to be successful at it—make even the lowest level of championships, be in the top half at USA Swimming meets—he had to spend a lot of hours in the pool. That’s what all the other successful swimmers were doing, and Zack wanted to be successful. It didn’t leave time for other sports.

We were lucky; he didn’t have any injuries. He broke his wrist once, but that was in gym; as a swimmer, he didn’t know that you were supposed to overrun first base, not slide into it. But he did burn out. He hit a plateau in high school, and got really frustrated and discouraged. Swimming became a source of anxiety and exhaustion for him, not fun. He didn’t want to quit the team, but when he graduated from high school he left the sport behind.

Swimming fewer hours a week, and not swimming year-round, would have meant many fewer ribbons and medals for Zack. It would have meant being a recreational swimmer, not a competitive one. My husband and I would have been fine with that, but the coaches would have given him a hard time. He would have had a lesser status on the team, and that would have been hard for him. He wouldn’t have been chosen as captain, and he loved being captain.

See, that’s the thing. To decrease the number of overuse injuries, we will need to change the culture of youth sports. We can encourage parents to limit the number of hours their children practice and compete, and make sure they know that specializing early is dangerous. We can educate coaches. But unless we can get our culture to take a collective deep breath and let go of the idea that kids need to not just play sports but achieve in them, we will get nowhere.

This emphasis on achievement in sports is just one facet of the achievement culture problem in our country. It’s understandable and commendable to want the best for our children, but somehow we’ve gotten it into our heads that in order to have the best they have to be the best—in school, in sports, in everything. And it’s just not true. In fact, pushing to be the best can be bad for kids, physically and emotionally.

I think we need to start early with our kids and ourselves. We need to set different expectations and different goals. Don’t talk Harvard—talk college. Don’t talk A’s—talk trying their best. When it comes to sports, don’t talk winning—talk playing. I have a 5-year-old, so I have another chance at all this; I will do it with you. We’ll buck the trend together. We’ll be rebels, fighting for a cause.

And one by one, bit by bit, we will take back childhood for our children.

Claire McCarthy is a primary care physician and the medical director of Children’s Hospital Boston’s Martha Eliot Health Center.  She blogs at Thrive, the Children’s Hospital Boston blog.

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