Children and extreme sports: a parent’s perspective

Adventure and extreme sports (AES) have gained enormous popularity over the past two decades and are now performed not only by adventurous elite athletes, including youth, but are very common amongst weekend warriors and relatively inexperienced active individuals. Social media tools and global spread of the World Wide Web, connecting people at real time, 24/7, without geographical, age or time-zone boundaries have resulted in an ever-growing inspiration and motivation for, especially, young generations to participate in AES. This, alongside dedicated media outlets (with their financial interest), fuelled by impressive film footage of breath-taking stunts, has created a young generation that is up for the game. The “bring it up, step it up” generation is like nothing before, willing to go higher, faster, stronger, with 10 camera angles and live feed.

AES, by definition, involve an element of increased risk and are usually performed in beautiful, exciting and remote locations or in extreme environments, where timely and experienced medical assistance is not always readily available. A wide variety of sport and recreational activities fall into the category of the ever-expanding AES field. New disciplines are invented and developed regularly, thanks to a rapidly evolving creative and financially stronger industry, improved technology and the fast-paced idea-to-market era we live in.

The American Ninja Warrior and X-games cultures are also helping to navigate teens’ energy and spare time into healthier and confidence-building lifestyles, which open new doors and opportunities. Football and basketball are considered All-American sport outlets, which carry the opportunity for college education and a better life. Today’s young extreme sports heroes jump straight into the centre of the media stage, inspiring and building up huge fan bases, attracting sponsors and generating economic benefits. In the past, a landlocked individual had to follow where the swell and the remote reef breaks led them to learn and improve their surfing skills, requiring significant financial capacity and time. In the near future, by contrast, wave pools and indoor ski domes may be the place where new champions are born, similar to what has happened in the rock-climbing world. During the last 20 years, adolescents have become the best climbers in the world, developing their skills in the indoor climbing gym during years of dedicated practice. Making these sports accessible to the crowds, eliminating the financial barrier, geographical proximity and culture or the “second-generation” factor are all changing the way young adventure superstar athletes are born.

Unfortunately, as more and more children and adolescents are enjoying AES, increased numbers are becoming injured as a result. Social media postings and readily available footage of extreme sports events frequently show spectacular crashes and near misses but rarely show the actual injuries or fatalities. This may generate a false confidence in some young athletes who, at times, may lack a realistic understanding of the implications associated with these pursuits as well as dedication to mastering the skills required to perform them safely and consistently.

Epidemiological research is progressing alongside the sports’ development to create a better understanding of the distribution and determinants of AES injury. However, this research is still at its infancy, considering that youth participation in some AES is relatively new. We all hope to make these sports safer for young athletes without detracting from their adventurous nature. The risks involved in AES and the way youth handle those risks help to develop their character and confidence and is one of the main reasons they are attracted to them.

Injury epidemiology of many traditional sports is being increasingly understood, with national surveillance databases, injury-reporting programmes and evidence-based countermeasures implemented to prevent injuries. In traditional sports, the mechanism of many injuries has been established, and when sustained, young athletes tend to follow a management algorithm featuring non-operative care or surgical intervention and rehabilitation before returning to play. By comparison, the epidemiology of AES injury is far less researched and understood, which makes the diagnosis, treatment and rehabilitation more challenging for the healthcare provider, the athlete and his/her family.

It has been shown that many adult extreme sports athletes self-select for their sport (Monasterio et al., 2016; Monasterio, Mulder, Frampton, & Mei-Dan, 2012). They are more capable of responding appropriately in an adverse situation and do not perceive the situation as dangerous compared to the perception of the non-participating population. This may be slightly different with adolescent athletes where accessibility to a type of sport, or family direction, may play a stronger role in the activity performed. We should be open and sensitive to how children respond to the hours of training and the stress of competition and make sure they are participating because they truly enjoy it and see the yield rather than fulfilling their parents’ will. This is even more relevant in AES when suboptimal “fit” can result not only in the athlete’s being sidelined by the coach or by self-confidence challenges or by lack of joy, but also as a result of significant injury.

As a lifelong extreme sports athlete, a father of three active children (Figure 1) and an orthopaedic sports medicine surgeon, I carry an inherent passion for the topic and a well-established personal approach regarding child and adolescent involvement in AES. Participation in AES is a way of life in our family, with all the implications and consequences associated with it, both good and bad. My wife and I have learned to live in acceptance, have embraced and have become accustomed to the physical price that is associated with the love for these sports. It is a different thing altogether when this price is borne by your children. We try to raise them without inhibitions or limits to their sports pursuits, but as every parent, this does not come easily. Sharing with my 10-year-old son the love for backcountry skiing, multi-pitch climbing or downhill mountain biking is a huge privilege that results in pure happiness, but also comes with a valid share of concerns. Following him as he rides quickly down a steep rocky mountain bike trail, for example, is scarier for me than jumping off a cliff with a parachute. Understanding the risk involved, from all aspects, how fragile the human body is and how fast things can flip flop on you with the slightest mistake is not an easy thought to consider. However, as parents we eventually need to let go and trust that we provided our children with the appropriate protection, tools and ability to make the right decision, even if this relates to a split second call on how to avoid an avalanche in the backcountry. The grin on their faces is worth it, even if occasionally it comes with a few scratches and bruises.

Figure 1. Three active kids, plenty to be worried about, lots of joy. Image © Dr Omer Mei-Dan. Reproduced with permission.

A – Airborne, Vail’s terrain park, age 9.B – Ready for cruising down the slopes, age 3.C – Surfing Hawaii, age 6.D – Scuba with dolphins, Red-Sea, age 10.E – Ski racing in Vail, age 11.F – Dropping in, Whistler bike park B.C, age 9.G – Downhill MBK in Crested Butte Co, age 9.H – Climbing the 1000 ft route up the 1st Flatiron, Boulder Co, age 6.F – Ice climbing Vail falls, age 10.

Dennis Caine and Aaron Provance assembled a comprehensive theme issue on the epidemiology of youth injury in AES in a very unique cohort – children and adolescents – that is rarely studied or discussed. Each article is authored or co-authored by an expert in paediatric and adolescent sports medicine, including many who themselves are actively involved in AES. The public health model is used by the authors to describe the scope of the injury problem and associated risk factors in a variety of popular child and adolescent AES and to evaluate the research on sport-specific injury prevention strategies. This special issue delivers valuable information to healthcare providers treating or interested in better understanding the young AES athlete and their parents.

Disclosure statement

No potential conflict of interest was reported by the author.