Tag: life

Are We Sacrificing Our Kids on the Elite Sports Altar? Part III: The Reward?

practicingcatholicmedicine

A Catholic pediatric PA and former collegiate hurdler and Varsity Catholic missionary weighs in

PART III: THE REWARD?

This is Part III in a 3-part series on elite youth sports and early sport specialization. Read Part I here and Part II here.

Pope Leo XIV’s intention for month of June is for the values of sport, and that sports, “… May be an instrument of peace, encounter and dialogue between cultures and peoples, and may promote values such as respect, solidarity, and personal growth.”1 I fully believe that sport, at its best, does all these things.

The youth sports landscape has changed over the years, with increased emphasis on elite youth sports and early sports specialization. As a former collegiate athlete and Varsity Catholic missionary, and now in my role as a pediatric PA caring for many youth athletes, I was deeply curious what the evidence shows regarding these changes.

Follow along in this three-part series – The Gamble, The Risk, and The Reward?- examining what current evidence and Church teaching have to say around the physical, emotional, and spiritual aspects of elite youth sports and early sport specialization.

Photo by Ambitious Studio* | Rick Barrett on Unsplash

Do Elite Sports and Sports Specialization Actually Predict Long-Term Success?

From a purely athletic standpoint, I was curious to see if elite youth sports and early sport specialization actually results in playing collegiately or professionally. Interestingly, the data shows that for most sports, children benefit psychologically and athletically if they wait to later in life to specialize.2 There are outliers: athletes in individual sports like gymnastics, dance, swimming, and tennis do to specialize earlier.3,4 Overall, though, when it comes to sports specialization, the data is clear: play a variety of sports for as long as you can.

World-class athletes often didn’t specialize before age 13 and instead competed in many different sports.2 Growing up, these elite athletes gain valuable play time in unstructured activities.2 In one study of NCAA DI athletes, 45% played multiple sports to 16 years old. Even the individual-sports athletes didn’t specialize until age 14.5

Another study looked at the age of sports specialization in youth, comparing DI athletes to their non-athlete college peers. It was the non-collegiate athletes who specialized in earlier in youth sports. For my fellow science-minded friends, the average age of specialization was 15.38 ± 2.7 years for the DI athletes versus 14.30 ± 2.6 years for the non-athletes; P = .002.6

There are a lot of percentages and statistics thrown out (by me, in this post), like 11% of parents think their child can be a professional athlete.7 The odds are… not that. Let’s use high school boys’ basketball players as an example. There are currently 540,704 high school boys’ basketball players. The chance of playing in any division of the NCAA is 3.6% (1.1% D1 and DII each, 1.5% DIII).8 Of all NCAA basketball players, 1% will be drafted into the NBA. To put that in perspective, of all the 540K+ U.S. high school boys basketball players playing today, only 54 of them will go pro.

A lot of people may be thinking, well, why not my child? I too think, why not your child? There is so much that goes into the formation of an elite athlete, and a not-exhaustive list includes coaching, a child’s desire to play, financial support, time, genetics, muscle composition, ability to stay injury-free or at least career-ending injury-free, mental health, proper diet, adequate sleep, work ethic, teams available in the area, decent teammates and competition, the reputation of a club/team/school, which college scouts see a kid play, and a dash of pixie dust and luck.

Speaking specifically on genetics, DI athletes are also more likely to have parents who played either collegiately or professionally compared to their non-athlete college peers.6 My parents weren’t collegiate athletes, and I like to think that I just happened to fall in love with hurdling on my own. But I’d be remiss if I didn’t mention that my first pair of sprinting spikes were my cousin’s, and she had won State in the 100m hurdles and was an NCAA champion and Olympic trials swimmer. My grandfather hurdled. When I ran at Drake Relays, my dad shared that a few generations back another relative of mine had ran there. I’m part of a long lineage of long-legged folk. What I may have thought was a fun choice as a 7th grader was pre-destined by my genetics.

(This is a bit niche, but in the back of my mind I’m hearing Miranda Priestly in The Devil Wears Prada saying to me, “Oh, I see, you think this has nothing to do with you. You think you chose hurdling because it you thought it was fun, however hurdling represents generations of runners, and it’s sort of… comical… how you think you’ve made a choice that exempts you from your genetics, when in fact, you’re doing a sport that was selected from you by the ancestors on your family tree.”)

At the end of the day, a child becoming a professional athlete is possible. But if you look out at a court of high school basketball players, even those who really love playing, only one out of 100 will go DI. I say that practically, statistically, medically. That doesn’t mean your child won’t. It’s just the way the math maths. We all know kids and have friends who made it big. It’s nowhere near impossible! We just need to have perspective.

Where Does This Leave Us?

From a strictly data-driven viewpoint, I would advise parents to think of a year-round baseball league for their 9-year-old as more of a short-term performance boost instead of a long-term plan. Early specialization and elite level playing increase risks for injury, abuse, and burnout, and the likelihood of becoming a world-class athlete goes down. There are outliers in everything, and I don’t know your family or children. However, as a PA, I’m trained in evidence-based medicine. While I try to tailor my advice to patients as individuals, I can’t avoid the piles of papers arguing against early sports specialization.

I empathize deeply with parents trying to make the best decisions for their kids, especially with outward pressure recommending private lessons, a special training session, another camp, or a coach growing annoyed at the recovery time for a concussion. Here’s the warm, beautiful truth: In most cases, no one cares more about a child’s long-term physical and mental health than the child’s parents. Not coaches, not teammates, or college recruiters. At the end of the day, anyone making money in the sports world has quotas to fill and games to win and a job to keep. Short-term success gained by pounding out hours on the pitching mound may benefit the team this year, but will your son need Tommy John surgery on his UCL a few years down the line because threw too much on a developing elbow?

Before I go on, I do want to say on the record that there are so many good coaches and people in the sports world. Thank you to all of the kind leaders out there. I have been abundantly blessed by some really excellent coaches who taught me not only in sport but were great mentors. One of my coaches literally saved my life and drove me for hours across rural South Dakota to a major medical center while I was in kidney failure after a race with an IV jabbed in my arm as I stuffed my face in a pillow and tried not to vomit. I am not arguing that your child’s coach doesn’t care about your kiddo; in fact, I hope their coach is excellent and is a trustworthy source of information and guidance. I just want to encourage parents to feel empowered to make the decisions they feel are best for their child. I’m hoping these kids will gets to play the sport they love for life, not just for a few years.

It’s hard out there, and there can be a lot of not-unrealistic fears of being left behind if kids aren’t in the leagues everyone else is, especially as high schools cherry-pick kids from feeder elite youth teams. I don’t know what decisions my family will make in the coming years. I’m curious to see how demographics shift in the NCAA and beyond as graduates of hyperintense youth sports make their way into the collegiate and professional world. Even with this movement, I’m still hesitant to say that we will see more elite adult players specialize early. The risks for injuries and burnout will still drive a lot of would-be great athletes to leave their sport, though with the current climate of needing to be in elite clubs early just to make it on to school ball teams, maybe we really will see a change. If I were a betting woman (and I’m not, I bring about $20 when I once-in-a-blue-moon go to a casino), I’d bet that us pediatric providers will see an increase in overuse injuries, sports-career ending injuries, and burnout in the coming years.

Called to be Saints

Most parents taking their Catholic faith with some level of seriousness move through the world with their eyes heavenward. Memento mori and all that jazz. All the statistics and studies matter, but at the end of the day, do elite sports help form our children into saints?

This is obviously not a question I’m going to be able to answer for anyone else besides maybe my own family, and even then, it is one that I’ll be re-evaluating over the coming years. Certainly, we are called to achieve the greatness God places on our hearts. We are given the gift of friendship with God, knowledge of our children and their hearts, the ways our family operates best, the discernment of spirits, and holy spiritual guides.

An Alternative

I want to acknowledge a youth sports group in our area that, in my opinion, is doing youth sports well and could encourage other cities to put something similar into practice. This is not an advertisement. The organization has no idea I’m writing this, but I’m so impressed by their approach I had to share. Highlight Catholic Ministries in the Denver area has two branches for boys and girls, Frassati and Badano Sports, respectively. They offer camps, clinics, in-house teams and leagues that play city-wide in the Catholic Schools Athletic League as well as against other leagues. Prayer, testimonies of saints, and encouragement to seek God’s glory in sport are integrated seamlessly into practices and games. Prices are affordable, and most coaches are volunteer. This exact model may not be feasible for smaller towns (thinking of where I’m from, rural Minnesota, where I was practically the lone Catholic in a sea of Lutheran kids), but I’ve been so impressed by the sports we’ve done through their league. My daughter has come home from their tennis camp every day this week excited to share a new story of a saint who loved Jesus through strength and sport.

Pope Leo XIV and His June Intention

If you’ve made it this far, you probably don’t need this reminder, but I’m going to give it anyways: this series specifically focused on elite youth sports and early sport specialization. Me = still big fan sports. When it comes to the hard decisions in sports and life, I often remind myself that we were never promised it would be easy this side of heaven. As an athlete, I get excited about that. Give me a challenge and I’ll rise to it, coach! As a parent, my kids aren’t in any elite leagues, but they have played many rec league sports. Sure, registration can be a headache, my daughter never learned to swim with private lessons at our local rec center, and I’m not sure she knows to not guard her own team in basketball. But! We’re having so much fun. We’re making friends. We’re learning virtue. Praise be God.

I’ll end with Pope Leo’s video message1 that went along with his intention for the month of June, sport:

In the name of the Father, and of the Son, and of the Holy Spirit. Amen. Lord of life, we thank you for the gift of sport, for those who glorify God through the exercise of their bodies, for the friendships born on the field and the joy of playing as a team. You teach us that in life, as in the game, no one is saved alone. We need others to grow, to learn respect, to overcome our limits, and to celebrate together the victories we achieve. We ask that sport may always be a school of fraternity, not of empty rivalry, a space of encounter, not exclusion, a path of peace, not violence. May those who play, train or cheer discover in sport a universal language that brings cultures together, unites peoples, and sows respect, solidarity and personal growth. Lord Jesus, may every sport become a parable of life lived with you, working with joy and effort, living with humility in defeat and with gratitude in the victory you offer in your Resurrection. May your Spirit never be lacking in us, making us one team, united with you to build communion and fraternity in history. Amen.

This is what sport can do. Consider the unifying delight it has been watching American host the FIFA World Cup this summer, deep in the midst of the United States really ticking off every nation worldwide politically. Norwegians doing the Viking Row on the floor of a New York subway, Scotts in kilts singing along to bagpipes in Boston, the French discovering how great air conditioning is.

I reminisce on the Olympics earlier this year. Athletes competed next to allies and “enemies”, athletes represented themselves individually because their nations were war-torn, the U S of A kicking old Canada’s behind back to the frigid North, all the heroic stories of redemption and love and families supporting each other. Sports are something that can rally us, encourage us to be more than we thought possible, and honor God.

I pray we each pursue God’s will for us, whether that’s on a fancy international soccer team or kicking a ball in the backyard.

St. Sebastian, patron of sports, pray for us!

The views are not necessarily those of my employer, and this Substack is not meant to intended to replace medical advice from a licensed provider. Please see your healthcare provider for any medical concerns.

References:

1. Holy See Press Office. Bulletin. Published June 2, 2026. Accessed June 20, 2026. https://press.vatican.va/content/salastampa/en/bollettino/pubblico/2026/06/02/260602e.html

2. Jayanthi N, Pinkham C, Dugas L, Patrick B, Labella C. Sports specialization in young athletes: evidence-based recommendations. Sports Health. 2013 May;5(3):251-7. doi: 10.1177/1941738112464626. PMID: 24427397; PMCID: PMC3658407.

3. Pasulka J, Jayanthi N, McCann A, Dugas LR, LaBella C. Specialization patterns across various youth sports and relationship to injury risk. Phys Sportsmed. 2017 Sep;45(3):344-352. doi: 10.1080/00913847.2017.1313077. Epub 2017 Apr 10. PMID: 28351225.

4. Guettler JH, Chrumka A. The fallacy of falling behind: the realities of early sports specialization. Sports Medicine Update. Fall 2024. Published 2024. Accessed June 18, 2026. https://www.sportsmed.org/membership/sports-medicine-update/fall-2024/the-fallacy-of-falling-behind-the-realities-of-early-sports-specialization

5. Swindell HW, Marcille ML, Trofa DP, Paulino FE, Desai NN, Lynch TS, Ahmad CS, Popkin CA. An Analysis of Sports Specialization in NCAA Division I Collegiate Athletics. Orthop J Sports Med. 2019 Jan 28;7(1):2325967118821179. doi: 10.1177/2325967118821179. PMID: 30729145; PMCID: PMC6350152.

6. DiFiori JP, Quitiquit C, Gray A, Kimlin EJ, Baker R. Early Single Sport Specialization in a High-Achieving US Athlete Population: Comparing National Collegiate Athletic Association Student-Athletes and Undergraduate Students. J Athl Train. 2019 Oct;54(10):1050-1054. doi: 10.4085/1062-6050-431-18. PMID: 31633415; PMCID: PMC6805068.

7. Solomon J. Project Play survey: 11% of sports parents believe their child can go pro. Project Play. Published May 28, 2025. Accessed June 21, 2026. https://projectplay.org/news/project-play-survey-11-of-sports-parents-believe-their-child-can-go-pro

8. National Collegiate Athletic Association. Probability of competing beyond high school. NCAA. Updated April 2024. Accessed June 21, 2026. https://www.ncaa.org/sports/2013/12/17/probability-of-competing-beyond-high-school.aspx

Are We Sacrificing Our Kids on the Elite Sports Altar? Part I

practicingcatholicmedicine

A Catholic pediatric PA and former collegiate hurdler and Varsity Catholic missionary weighs in

This post was originally posted on my Substack, which you can read and follow along here.

Pope Leo XIV’s intention for month of June is for the values of sport, and that sports, “… May be an instrument of peace, encounter and dialogue between cultures and peoples, and may promote values such as respect, solidarity, and personal growth.”1 I fully believe that sport, at its best, does all these things.

The youth sports landscape has changed over the years, with increased emphasis on elite youth sports and early sports specialization. As a former collegiate athlete and Varsity Catholic missionary, and now in my role as a pediatric PA caring for many youth athletes, I was deeply curious what the evidence shows regarding these changes.

Follow along in this three-part series – The Gamble, The Risk, and The Reward?- examining what current evidence and Church teaching have to say around the physical, emotional, and spiritual aspects of elite youth sports and early sport specialization.

person in white and red soccer jersey kicking soccer ball
Photo by Md Mahdi on Unsplash

PART I: THE GAMBLE

My WNBA Dreams, Crushed.

A few weeks ago, I watched my daughter play basketball, a new-to-her sport. Boy, did I surprise myself as I struggled to not coach from the stands. My daughter had an absolute blast. Meanwhile, I watched the WNBA dreams I had for her dissolve into the ether. I had no real reason to think we’d be a basketball superstar family, though my illustrious career as a middle school B-team guard and the single basket I made over two years make an argument for the perseverance of a professional athlete.

My daughter’s team was rec-league basketball. Two girls on the team were accidentally given the same number jerseys. Trips to the drinking fountain and after-game snacks were just as important as winning. The final game was cancelled because why not? My husband and I have been successfully intentional about not signing our kids up into the intense youth sports leagues that are rampant in the suburbs where we live, but it’s getting harder as our children get older. It was easy to ignore the pressure when our eldest was an infant and “she can’t walk yet” was a great excuse for not enrolling her into a technical soccer day camp. We are insulated somewhat by our Catholic school and community because for the most part, our circle of friends are on the same page. As my children age, and perhaps if they find some level of success in sport, I know these decisions won’t be as clear.

Not a Hater

Let’s start here: I love sports. I love playing sports, watching sports, and cheering my kids on in sports. I was a child of the ‘90s in a rural area, and I played all the sports the local community education catalogue had to offer. My parents said no to club teams because they didn’t want to spend all our time and money just so I could be somewhat mediocre at softball (as it was, I was already mediocre at softball, so who needed to throw more money at that?). I did get to go to an overnight summer camp for tennis hosted by a local-ish college and loved getting to play all day, every day. I was first singles on varsity tennis, and while my parents did invest in some private lessons, I got better mostly by playing with my friends at the school courts for hours every day. In the spring I hurdled on the track team, but I really only joined the team to stay in shape for tennis. Shocking everyone including myself, suddenly my junior year I was, like, fast. I went to State, and then I went to State again my senior year. College recruitment letters came in, and in the end, I chose an NCAA DII school that offered a scholarship and great competition while staying in a city I loved with the programs I wanted. After running in college, I joined FOCUS and served with Varsity Catholic as a missionary to collegiate athletes. Grown-up-me still works out almost every day because it’s fun for me and helps me not burn down everything in my path when I’m overstimulated. I dabble in local races, mostly aiming for PRs and placing in my age group, but I’ll admit I drank a beer handed to me by a kind Boulder local cheering from the roadside halfway through my last 10K race.

I’m currently editing this article while my daughter is at tennis camp. The benefits of sport for children are incredible. Friends! Teammates! The chance to meet and work with people who look and act different than you! Bravery! Hard work! Leadership skills – did you know 94% of women in C-suite positions played sports?2

The Church has also spoken on the good of sport, especially for young people.3 Pope Leo XIV’s intention for month of June is for the values of sport, and that sports, “… May be an instrument of peace, encounter and dialogue between cultures and peoples, and may promote values such as respect, solidarity, and personal growth.”1 I fully believe that sport, at its best, does all these things.

Not every kid is going to be a standout basketball player (see: my one basket), and not every kid wants to be a standout basketball player (I did want to be a super awesome basketball player, mostly because I thought the jerseys were cool). As a pediatric PA, I care for kids across the sports spectrum- those who have never tried to get their heart rate above resting to superstar kiddos competing at elite levels. From a health standpoint, I frequently encourage adolescents to find a way to move their body that is fun for them. I am such a big fan of all the creative ways kids find to be active in ways they enjoy- fencing, roller skating, walking their dog, taekwondo, jujitsu, dance, jumping on their trampoline. Physical exercise strengthens our muscles, bones, and heart. It improves our mood and decreases our risk for chronic disease. The mental health studies on sport are incredible, too, and this needs to be sung from the rooftops at a time when depression in kids is skyrocketing. Increased physical activity improves mental health, and this holds true even at high levels of performance.4 Even NCAA DI college athletes reported improved mental health compared to their non-athlete peers.5

And yet…

You Gotta Know When to Hold ‘Em

Anyone born in a year that starts with 19–, ye olde nineteen hundreds, will likely have felt the rapid increase in early sport specialization and elite youth sports compared to the podunk sports leagues we grew up with. By some accounts there has been a 70% increase in kids specializing on sports by age 13.6 Sometimes the way I hear parents talk about their kids in sports sounds a whole lot like gambling, and I can’t blame them. If I bet $20,000 over the course of my child’s adolescence on training camps and high-level teams and private coaches, what are the odds they will get a full ride? Us fun millennial parents were flooded under the housing market crash and were left to either enter the workforce with no jobs available, or we watched our college savings tank to poo poo butt (my middle son’s current favorite curse phrase). A college degree is outlandishly, disgustingly expensive these days. If a parent could give their child a leg up on life, to graduate with less or no debt, would they not be interested in that option? Add in NIL deals, and your child could do well financially in college as an athlete.

My question isn’t if elite youth sports are right or wrong. What I’m wondering is if elite sports and early sports specialization are actually helpful for reaching a child’s and parents’ goals? And what are the goals? Are we letting our kids play a sport they love at an elite level to fine-tune skills and improve long-term performance, or are we gambling with their bodies? Or both? If they don’t get a scholarship going DI or DII, if they don’t get an NIL deal, if they don’t go pro, if they get hurt their senior year of high school… Was it worth it?

I know a lot of people who would emphatically say yes, it would all still be worth it. Elite youth sports have benefits outside of just a college scholarship. Competitive sports challenge kids to be their very best and become mentally tough. There’s the opportunity to form solid community among team families and to travel the nation. Sometimes, the only way kids can continue on in sports is specializing early and playing in the “right” leagues.

Depending on local offerings, there might not be access to rec league sports or opportunities for children to play unstructured sports in the neighborhood. It’s a different era now, one where kids can’t run out and play freely without CPS being called. Last summer, a concerned neighbor knocked on our door because my eldest was playing on our front lawn while I watched on from the window.

In the metro area where I live, there are elementary feeder programs for the public high school teams. It breaks my heart to know that to be on the school team as a freshman, a child better have played with the $5,000-a-year travel team before they knew how to tie their own cleats. With these rising costs, equity in access to sports differs across gender, race, and geography, and unfortunately the fees of these competitive teams are shutting out entry to sports.7,8

Big Youth Sports

Speaking of finances, adults kind of ruin everything fun, don’t they? There’s a lot of talk about “Big Pharma”, but what about “Big Youth Sports”? An insightful article from the New York Times detailed a myriad of investment groups and private equity firms chomping at the elite youth sports bit.7 Retailers like Dick’s Sporting Goods and others are buying into youth sports clubs as investments, which makes sense considering the youth sports market generates $40 billion annually.7,9 American parents spent 49% more in 2024 compared to 2019 on their child’s primary sport, up to an average of than $1,016 annually, twice the rate of inflation during that time frame.8 The costs increase with age, with families spending nearly $2,000 a year for their teens.9 That may sound expensive, but I’m sure there are plenty of families reading this saying, “I wish it were that cheap.” Mid-level competitive soccer leagues can cost up to $6,000 annually, with elite youth leagues racking up a total cost of over $15,000 per child.10

With the high percentage of parents who think their child could be an Olympian, or at the very least use who want to use their child’s membership in an elite sports club as bragging rights and a status symbol, of course investment groups are going to follow the trend. Can you really put a price on raising an Olympian? (Yes, you can, and private equity is taking notes.) It’s the like peer pressure to smoke in high school, but now it’s dance moms in matching bedazzled jackets telling you everyone who’s anyone is on the hyper-elite dance team.

Elite Youth Sports- Good, Bad, or Ugly?

What to think of the push towards elite youth sports and early sports specialization? Is this a positive trend, helping our kids be the best they can be at something they love? Is this a way out of generational poverty and into a free ride for a bachelor’s degree? Or are we pouring a lot of time and money into a greedy youth sports machine that is going to leave our kids injured and burned out?

This is a delicate topic for a lot of families, both for those who choose elite youth sports and those who don’t. The pressure to specialize young is intense; there are not-unreal threats of kids being left out.

My goal is to provide the data, discuss the risks and benefits of elite youth sports and early sports specialization and give wiggle room for families to decide what is best for them. I’ll be using the term “elite” broadly in this series but think of “elite” as an intensity beyond community ed and rec league. Think year-round and early sports specialization, cross-country travel for games, politics and angry parents, $$$, intensive camps, private lessons with former pros, true Olympic hopefuls and the kids coaches tells parents could become Olympic hopefuls if they just spent more time and money.

As typical for this Substack, I will bridge the medical evidence with our Catholic faith and our vocations as children of God and, for many of us, as spouses and parents. And I’ll try my darn hardest to make it interesting and maybe a little funny, kind, and not overwhelming. Easy peasy.

My impetus for writing this article was twofold. Our friends are all feeling the squeeze and pressure of elite youth sports, some choosing to go that direction and others trepidatiously declining. Providers are seeing a lot of overuse injuries in clinic related to hours and hours a week of repetitious singular sport activities on young bodies. I was curious if this was just a fluke, or if there is real data to back up what I was seeing.

A word of caution before we begin: I was not expecting the level of risk and the lack of benefit for early sport specialization and elite youth sports that I came across. Honestly, I thought I was going to write a quick 1,000 words and call it good. Joke’s on me (and now you, dear reader), because we’ve got a three part series ready to go.

I worry we might have overshot our landing and are aiming for something far more dangerous when it comes to youth sports.

To be continued.

Subsribe to my Substack to receive post updates here.

The views are not necessarily those of my employer, and this Substack is not meant to intended to replace medical advice from a licensed provider. Please see your healthcare provider for any medical concerns.

References:

1. Holy See Press Office. Bulletin. Published June 2, 2026. Accessed June 20, 2026. https://press.vatican.va/content/salastampa/en/bollettino/pubblico/2026/06/02/260602e.html

2. Mai A. From athletics to the C-suite: why sports shape stronger leaders. Medium. Published February 26, 2025. Accessed June 21, 2026. https://medium.com/@andrea.maillardtouche/from-athletics-to-the-c-suite-why-sports-shape-stronger-leaders-9362eeb9f7f9. (medium.com)

3. Holy See Press Office. Giving the Best of Yourself: A Document on the Christian Perspective on Sport and the Human Person. Bulletin. Published June 1, 2018. Accessed June 21, 2026. https://press.vatican.va/content/salastampa/en/bollettino/pubblico/2018/06/01/180601b.html

4. Guddal MH, Stensland SØ, Småstuen MC, Johnsen MB, Zwart JA, Storheim K. Physical activity and sport participation among adolescents: associations with mental health in different age groups. Results from the Young-HUNT study: a cross-sectional survey. BMJ Open. 2019 Sep 4;9(9):e028555. doi: 10.1136/bmjopen-2018-028555. PMID: 31488476; PMCID: PMC6731817.

5. Snedden TR, Scerpella J, Kliethermes SA, Norman RS, Blyholder L, Sanfilippo J, McGuine TA, Heiderscheit B. Sport and Physical Activity Level Impacts Health-Related Quality of Life Among Collegiate Students. Am J Health Promot. 2019 Jun;33(5):675-682. doi: 10.1177/0890117118817715. Epub 2018 Dec 26. PMID: 30586999; PMCID: PMC7213817.

6. Healio Orthopedics. Risks outweigh benefits of early sports specialization in young athletes. Published November 7, 2025. Accessed June 21, 2026. https://www.healio.com/news/orthopedics/20251107/risks-outweigh-benefits-of-early-sports-specialization-in-young-athletes

7. Drape J, Belson K. Youth sports are a $40 billion business. Private equity is taking notice. New York Times. Published July 9, 2025. Accessed June 21, 2026. https://www.nytimes.com/2025/07/09/business/youth-sports-private-equity.html

8. Project Play. Challenges. Project Play. Accessed June 21, 2026. https://projectplay.org/youth-sports/facts/challenges

9. Maddox C. What families are really spending to keep kids in sports. Kiplinger. Published May 28, 2025. Accessed June 21, 2026. https://www.kiplinger.com/personal-finance/family-savings/what-families-are-really-spending-to-keep-kids-in-sports

10. U.S. Soccer Parent. Costs of youth soccer. US Soccer Parent. Accessed June 21, 2026. https://ussoccerparent.com/costs-of-youth-soccer/