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No Substitute
for FREE -PLAY

By Jorge Gómez, MD

This is the sedentary generation. Consider how young people dress: baggy pants held up miraculously at the level of the pubic symphysis; shoes worn untied.

Compare this to how kids dressed in the 50’s & 60’s (those of us who are old enough to remember): comfortably fitting pants, held at the waist by a belt, sneakers, tied. In this kind of dress, youngsters could easily go from sitting to running, jumping, playing. How can children move instantly into running and jumping if they’re coming out of their shoes with their pants falling down?

Not that it’s their fault. Young people today live in families in which both parents work (if they’re lucky enough to live with both parents), often long hours that preclude the parents playing with their children.

Many kids live in apartments where they can’t just run outside and play. Many parents don’t feel comfortable allowing their children to play outside unattended. For similar safety concerns, many of San Antonio’s parks, playgrounds and green spaces are under-utilized.

Some children live in neighborhoods without sidewalks where they can walk or bike. Other children live in neighborhoods with sidewalks next to the street, often obstructed periodically by a mailbox or parked car, forcing them to move onto the street. Whether because of lack of supervision, no one to play with or lack of safe playing areas, most of today’s children are not getting enough free play.

Why is free play so important? Free play is critical for physical, gross motor, fine motor and social development. Through the 15 years I’ve been practicing sports medicine, I’ve seen a dramatic increase in the number of young patients with serious knee and ankle injuries and back pain.

Researchers have thus far been befuddled by the dramatic increase in ACL ruptures, particularly among girls. Many studies looking at differences in hormone levels, quadriceps and hamstring strength, notch width, ACL diameter and knee valgus between injured and non-injured girls, and between males and females, have failed to account for the increase in ACL injuries.

The explanation may lie in the lack of free play. Coaches talk about the importance of a quarterback getting “snaps” or repetitions. A quarterback who has just a few snaps under his belt will not be able to respond as quickly or effectively as one who has had many snaps.

The same is true for movement: many ACL injuries are non-contact injuries. The athlete succumbs because
he or she does not have the repertoire of movement skills for the muscles that stabilize the knee to be able to respond to novel dynamic situations.

Many youngsters have back pain that is likely the result of poor “core strength,” i.e., strength of the trunk and pelvic muscles that help stabilize the spine. As a result, they strain the muscles in the back, often while doing routine activities.

Play activities like tag, leap frog and climbing are great for developing core strength. How many children are doing those kinds of activities these days? Participation in organized sports is a poor substitute for free play. Watch any given youth league soccer, basketball or baseball practice and you’ll see that the movements are relatively constrained when compared to what is seen on a playground when children simply “play.”

I see just as much back strain among athletes as non-athletes. Pediatric health care providers and parents can help fight this trend by encouraging parents to play with their children, even if they come home from work tired.

Children should be allowed time and space for free-play. Free-play is much more important for the longterm
physical and mental health of children than participation in competitive sports.

We all need to advocate for improvements in the built environment, specifically safe places to walk, run, bike, and accessible green spaces for children to play.

Dr. Jorge Gómez is a pediatrician who specializes in sports medicine. He is the medical director for youth sports treatment and fitness for CATZ Sports. He also serves as a professor in the department of pediatrics and director of the fellowship program in pediatric sports medicine at the University of Texas Health Science Center at San Antonio. Currently, Dr. Gómez serves as the Medical Director of Athletic Medicine for the University of Texas at San Antonio and is the team physician for the Edgewood and Southwest Independent School Districts.

Dr. Gómez graduated from Stanford University where he participated in track and field as a triple jumper. He was a Robert Wood Johnson generalist physician faculty scholar from 1996-2002. He also served on the committee on Sports Medicine and Fitness of the American Academy of Pediatrics from 2000-2006. Dr. Gómez is a native of San Antonio, father of three children and has been practicing medicine for 15 years.

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