This is one of the most difficult questions I field from parents of children over 5. Every parent wants their child to receive the social, emotional and physical benefits from participating in sports. They also know that there are greater risks for hypermobile kids.
Kids with hypermobility fall on a very wide spectrum. Some are strong and flexible, allowing them to compete in gymnastics and dance with ease or even excellence. Some kids are prone to injury; they spend more time on the sidelines than on the field. And some need to have P.E. classes adapted for them or substituted with physical therapy.
Wherever your child lands on this spectrum of ability, it is likely that they want to be able to participate in sports, and you want them to be able to do so as well. Engaging in sports delivers a lot of positives: conditioning, ability to work in a group, ability to achieve goals and handle failure/loss, etc. Most therapists and doctors will say that being as physically active as possible enhances a child’s overall wellness and can be protective. But every child is different, and therefore every solution has to be tailored to the individual.
Here are a few questions to guide your assessment (and involve your child the decision, if appropriate):
- Is this activity a high or low-risk choice? High-risks would include heavy physical contact, such as football. Tennis requires hitting a ball with force and rapid shifts of position with lots of rotation of the trunk and limbs. I am going out on a limb, and say that ballet on-pointe is a high-risk choice for kids with lower-body weakness and instability. The question of risk in any activity has to be combined with what is risky for each child. Your doctor, PT, OT or other specialist can help you identify what the risks are for your child.
- Will endurance be an issue, or will there be flexible breaks? Activities that require a lot of continuous running, such as soccer and lacrosse, may be harder than dance classes. Swimming is often suggested as an easier sport, but think about the strokes. Competitive swimming is a lot of resistance work against the water with repetitive motions of the shoulders. Some strokes are more difficult than others, so examine each stroke as well as the frequency, duration and intensity your child intends to pursue.
- Are there ways to support performance, such as braces, kineseotaping or equipment modifications? A great pair of skis or shoes can help tremendously in sports. So can targeted exercises from a physical therapist or a well-trained coach that understands the needs of the hypermobile athlete. Your child may not be able to be on a travel team due to the intense demands and greater risk of injury due to fatigue/strain, but be very satisfied being on a local team. For the smallest kids, even changing your trike can make a difference Picking The Best Trikes, Scooters, Etc. For Kids With Low Tone and Hypermobility. To remain safe in a sport, many hypermobile kids need to keep working with a PT. Do you have the insurance or the cash to pay for this expense?
- Will your child report pain or injury and ask for assistance? Will your child accept limitations on their activity level? Some kids are very proactive, and some will try to hide injuries to stay in the game or on the team. Without this knowledge, no coach or parent is able to make the right/safe choices. Sometimes it’s an age thing, where young children aren’t good communicators or teens are defending their independence at the cost of their health. If you think that your child will hide injuries or push themselves past what is safe for their joints, you will have to think long and hard about the consequences of specific activities. Read For Kids With Hypermobility, “Listen To Your Body” Doesn’t Teach Them To Pace Themselves. Here’s What Really Helps. for more information about teaching your child to handle fatigue and pain better.
- Within a specific sport, are there positions or types of participation that are well-suited for your child’s skills and issues? Skiing wide green (easy) slopes and doing half-pipe snowboard tricks are at distinct ends of the spectrum, but a hypermobile child may be quite happy to be out there in any fashion without pain or injury. Goalies are standing for longer periods but running/skating less. Endurance running and sprinting have very different training and participation requirements. There may be no options for a child that insists on running cross-country when their body cannot handle it.
- Sadly, hypermobility can progressively reduce or alter safe participation in sports. Not for all kids, and not even for kids with current issues. Children can actually be less hypermobile at 12 than they were at 3. They build muscle strength as well as they grow. It can happen. Therapy and other strategies like nutrition and orthotics can make huge improvements for hypermobile kids who want to play sports. But too often, the child who is pain-free in dance class at 7 isn’t pain-free at 14. This doesn’t have to be a tragedy. Kids can be supported to adjust and adapt so that they are playing and working at their current maximal level. Your child may find that changing sports is easier than struggling or suffering in a sport that is now difficult for them. Good physical or occupational therapists can help you figure out how to make athletic activities fun and safe!
- Are you sad that they are losing their passion? Try to separate your sadness from their sadness. It is OK to feel your feelings. If your child has a heritable condition such as EDS, and you didn’t know you had it yourself until your child was diagnosed, you may be feeling a great deal of (unfounded) guilt. Even if you knew the you could pass on a HDCT, the truth is that you probably also are their greatest fan and supporter. Your child has someone in their life who really knows what they are going through. That is helpful, even though you might not see it right now. Think about how you felt as a child when you didn’t understand why you were dropping things or not as skilled as other kids. Your child knows that you know how they feel. Working through those feelings will help you see things clearly with your own child. Avoiding your feelings will keep you mired in them. Only after you come to terms with how you feel will you be able to help your child see that their passions are evolving and they can create new passions in many areas. The bigger issue is handling the feeling of vulnerability that come with chronic disorders and an uncertain future.
- Get your professionals to support your decisions and let them take some of the pressure off of you. Kids are often really good at blaming parents, and parents can be vulnerable to the guilt trips kids send out. If their doctors or therapists are telling them about the risks they face, you won’t seem like the only person that is trying to rob them of fun. The truth is that children, including teens, cannot imagine that the damage they do today could shorten their professional career in 20 years, or contribute to surgeries in 30 years. This is the sad truth of hypermobility: damage is often cumulative and what is only a small discomfort today can grow into a serious loss of ability later. No one will be able to predict your child’s future, but it is possible to identify a range of potential risks. When you understand the risks, you are able to make decisions with more confidence.
For more information regarding hypermobility, please read Hypermobile Kids, Sleep, And The Hidden Problem With Blankets , Can You K-Tape Kids With Connective Tissue Disorders? and Should Hypermobile Kids Sit On Therapy Balls For Schoolwork?.
Is your child not a child anymore? One issue for tweens and teens with hypermobility is looking at the future clearly in terms of jobs and careers. Take a look at Career Planning for Teens with JRA, EDS, and Other Chronic Health Issues and Teens With Chronic Illness Or Disability Need A Good Guide: Read “Easy For You To Say” for some strategies to help your child think clearly but positively about their future.