A physician's recommendations concerning athletic activity for normal, healthy children must take into account a wide range of individual differences in size, age, coordination, stage of maturation, and level of physical and mental development. However, when the child has a skeletal abnormality, the physician must also consider the broad spectrum of variations of the disorder itself. For example, a child with rheumatoid arthritis may be in acute pain with systemic symptoms, may have no evidence of activity, may have mild monarticular arthritis that terminates after two or three years, or may have every joint involved without let-up for ten years.
The following principles will serve as a guide to the physician as he discusses athletic competition with the child and his parents.
It is important to distinguish between participation in athletic activities and participation in competitive sports. Competition is often highly motivating and may be a means for promoting self-satisfaction and developing muscles and coordination. But, this is so only if the child is successful in his competitive efforts. If a child is condemned to constant failure because of limitations in strength, endurance, range of motion, coordination, or for any cause, participation in competitive activities can be destructive to his self-image. A child with limited ability should be guided to an appropriate level of activities with no competition or with a goal of competition against one's previous performance. A child with a serious handicap usually recognizes that he has no opportunity to succeed; however, the child with a mild handicap which keeps him from ever being first or causes him always to come in last may experience considerable frustration and discouragement.
- Copyright © 1973 by the American Academy of Pediatrics