Crooked Toes are not Random

crooked-feet

 

Misaligned toes and bunions are fairly common, but there are numerous misconceptions about this. Most fail to realize that their crooked, calloused feet and their ankle and foot pain like achilles tendonitis and plantar fasciitis go –ahem– hand in hand

My patients often look down at their feet and blame the problem on their mom. But bunions, spurring, and drifting and overlapping toes are not random occurances like a cyst or a plantar wart. These structural issues are the body’s typical response to mechanical forces. What’s inherited is not the bunion itself, but a faulty foot or lower leg structure and gait pattern that causes repeated abnormal strain through the entire kinetic chain.

“Okay so it’s not just a bunion. The bunion is there because something else is misaligned or not working properly.”

Before giving me a”Who cares?” eyeball roll, please consider the relevance to deciding the best way to treat a structural toe or foot problem. You could…

A. See callousing and bunions primarily as cosmetic issues that need to be treated at the spa or through surgery.

-Or-

B. See them as biomechanical problems in need of biomechanical correction or at least some supportive work away from the actual bunion.

For example, treatment for someone with a mild to moderate bunion and/or hallux valgus (first toe migration) may include:

  1. Placing a splint or spacer between the first and second toes.
  2. Appropriate width footwear that doesn’t perpetuate the sensitivity with pressure on the area.
  3. Custom or semi-custom orthotics (shoe inserts) that correct for structural misalignment in the midfoot or rearfoot and allow for straighter forefoot (front of the foot) alignment as the patient rolls off the ball of the big toe.
  4. Stretching and select strengthening of the foot, and more likely, the ankle and the hip, which promotes a better gait patter which unloads the part of the foot that’s taking a beating.
  5. Gait training aimed at forming a “new groove” of walking that places more normal forces at the hip, knee, and foot and again, minimizing the biomechanical forces which cause the deformity.

Pain relievers help relieve pain and surgical correction is absolutely needed at times. But can you see how a toe splint and anti-inflammatory drugs is a short sighted fix for something that may be due to biomechanical forces all the way up at the hip? Orthotics and surgery are even of limited benefit if you walk like Donal Duck. Donald seriously needs some hip work.

crooked-feet-2

 

When your back “goes out”

I’m guessing that it went something like this:

You reached or twisted quickly.
You went to pick something light off the ground.
You lifted a heavy couch, sack of birdseed, or barbell, with or without good form.

Immediately or shortly thereafter, you experienced a dagger in or just below the spine. The pain went from nothing to searing. You held your breath. You swore that a bone or muscle must have cracked right in two. You didn’t want to think about moving.

You, my friend, as they technically say, have thrown your back out. I’ve been there. On more than one occasion. What exactly is going on in there? It’s difficult to say exactly what tissue is at fault. But we can make a few basic assumptions with some degree of confidence.slinky back

First let’s try to define what kind of injury we are dealing with:

-There was a relatively abrupt onset of symptoms.
-The quality of the pain was sharp and intense.
-There was no numbness, pain, or weakness down either leg.

When this is the case, we are most likely dealing with one of three things:

-Strained muscle, tendon, or ligament. With these you can almost always palpate (touch or point out) the site of injury. The pain is very consistent, just like when you pull a hamstring or hip flexor after sprinting in the cold. Maintaining a rigid brace of the spine when you move often increases the pain because this places demands on the stabilizing muscles that are in question.

-Stress fracture. This is fairly rare but it happens. This pain is also very consistent, increasing with almost all loaded movements (standing on your feet). Almost all unloaded movements (laying down and sitting) cause minimal pain, though transitions back to sitting and standing will be difficult.

Lumbar stress fractures are seldom related to forward bending activities. They occur more commonly from extension overload, over arching, where the spine repetitively or traumatically undergoes compression with backward rotation (as when running, jumping, and tackling with a weak anterior core and/or tight hip flexor muscles).

Disc derangement. As the years roll by and I manage hundreds of people with lower back pain, I’m certain this is the most likely culprit for backs that “go out” during and after flexion based activities. Keep in mind that not all disc herniations cause referred pain or numbness to the lower extremities. It is well known that tears within the disc, with or without an actual “slipping” of the disc, may produce a sharp or intense pain without pressing on the nerves that go into the legs.

The pain is almost always increased with forward bending and prolonged sitting because you are reproducing the mechanism of injury. But otherwise, the condition is fairly inconsistent. Sometimes there’s no pain at all and you’re like, “whew, smooth sailing!” Then, just when you let your guard down and go to put the milk back in the refrigerator, **BAM** you’re shot by the lumbar sniper.

With all things considered, here’s the ironic kicker. Whether your abrupt, severe, lower back pain is due to a disc injury or a muscle/tendon/ligament injury, you should treat it nearly the same way.

The absolute best things to do in the short term are as follows:

1. REST. Lay off it already! No, literally, lay flat on your stomach or on either side and take it easy. One way or another, you literally have injured tissue. There’s no manipulation or particular exercise that’s going to make it heal faster in the short term. Again, seriously, stop running for the manipulations and wiggling around when what’s most likely needed is REST. Try not to sit for prolonged periods. You can try some gentle press-ups and ice. Massage and modalities like electric “stim” and ultrasound may alleviate muscle pain for a short while. But the main thing you need to do is quit nagging it and give it a chance to heal.

Press-ups are often indicated in the instance of acute, flexion-based back injury.

The mullet is not necessary.

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..

2. Ice is usually best in the first few days. But truly, with back pain there are no hard and fast rules. When I experienced acute lower back pain, ice made me feel stiff and a hot shower was almost miraculous. If you tolerate anti-inflammatory medications, take them. Nobody is impressed with anti-medication heroics. Taking a moderate dose of Advil for a few days is usually worthwhile.

3. Avoid flexion/bending activities. I have found that in the acute phase of lower back pain, most people underestimate the importance of staying away from the type of movement that stirred up the issue in the first place. Avoiding slumped sitting and the recliner chair posture is critical. If you feel significantly shifted to one side, and it’s hard to straighten up, try laying on the floor and getting straightened out. Shift your hips to the side that leaves you in line with your shoulders, and simply lie there for a while then try to stand upright, without the lateral shift.
lateral shift   This type of lateral shift needs to be corrected ASAP.
To be clear, avoiding flexion means NOT standing and reaching to your toes. It means NOT kneeling and pushing your chest to the floor. It means NOT laying on your back and pulling your knees toward your chest. All of these stretches cause lumbar flexion and you should not do them! I’m amazed at how many people strain their lower back while bending forward or lifting, and then continue to stretch it by bending forward.

Yes, the bending forward movements do indeed stretch tight muscles. But it also reproduces the mechanism that got you into trouble in the first place! The relief of stretching those muscles will be temporary at best. At worst you will further aggravate or progress a disc problem to a full herniation.

So technically, these three things “to do” when your back goes out are actually non-doing things. And in the immediate short-term, that’s exactly what the doctor ordered to allow time for healing. But after 3 to 5 days, you need to get moving. You need to DO some things and still be careful to avoid doing others.

Prognosis?

By the numbers, you probably will get better with this simple advice. You will naturally take it easy, partly because you can’t go hard, partly because you will be more cautious. For a while. But did you know, also by the numbers, that chances are that after you improve and get back to what you like to do, you will experience a more severe episode of similar or progressive symptoms in the future? The last I read on this topic, there is a 90% chance that symptoms will return, and they are usually progressive in nature. What once was a disc tear will have progressed to a full blown disc herniation with sciatica, and you won’t be trying to call that a simple muscle strain.

Above all else…

Given the grim statistics on the natural progression of acute, localized lower back pain, let your personal episode of misery serve as a warning. Once you rest and ice and be very careful to avoid forward bending movements, it’s time to get active. There are plenty of things you should be doing to mitigate or altogether avoid the natural progression. But that’s another essay!

Abgnostics: The secret of ab secrets

Here you will find no fees, dieting or ab contraption gimmicks. I’m not even asking for your email!

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Are you struggling in pursuit of a solid mid section, wondering what secret knowledge lies hidden behind the “ab secret” ads floating all over social media? Or maybe you’ve considered the numerous benefits of physical training and figure that while you’re at it, you may as well do something for your core.

Maybe you could care less, and that’s perfectly fine too, so long as you’re active and healthy. But I do receive questions and see much misinformation pertaining to “sharp abs.”  Here’s the lean (not skinny) on what all the remarkably well advertised ab secrets should be trying to tell you.

                       Kung Fu Panda opens the sacred scroll

                                   “It’s you. The secret is you.”

exercise

It’s that simple. You can run, bike, swim, zoomba, scoot, crab walk, shuffleboard, rake, chase puppies, throw children, and so on. You can even do some crunches and leg raises if you like.

I’M TELLING YOU IN CAPS – THAT A LARGE PORTION OF HAVING ABS IS SIMPLY GETTING YOUR ENTIRE BODY STRONG AND FILLED WITH MUSCLE. Most of the above activities do not really achieve this. You need resistance training. Press weight overhead, squat, lunge, and pick it up off the ground. Rest well and make sleep a serious health priority. No, this is not a substitute for an intelligent diet. Forget the training machines and learn how to move some weight in good form, without doing anything stupid that will wreck your knees, back, or shoulders!

It’s muscle that sticks out – in a good way – in your midsection and other sections. It’s the loaded resistance exercises that cause all your trunk muscles to work hard in a functional manner. You don’t get that from just running, or swimming, or zoomba, or crab walk, or so on. Plus, muscle is functional, like making you useful outside of the gym. All of those injury prevention and functional benefits are mere side effects of being ripped ; ).

Please don’t worry about 7 minute abs, 4 minute abs, or any other minute abs. Sure, you should try to include a few “core exercise” variations after or as part of your real training. And yes, the fact that Hershel Walker and so-and-so do 15,000 sit-ups each and every night is dooly noted. And a waste of time! Doing that much of anything does risk developing imbalance and later injury.

eat

This side of the issue can be complex. What, when, and how much we eat has far more to do with behavioral science than food science. I mean, really, the formula is fairly easy to grasp:

Eat non processed foods (that are at or close to their natural form) most of the time.
But of course it’s never that easy.

The specifics probably vary and are highly dependent upon your starting point; whether you’re already relatively thin or 15 or 100 pounds overweight. Here are a few things to consider no matter where you stand.

No amount of training will make up for a crappy diet. But -the-perfect diet cannot do for your body and mind what intelligent training can.

If you feel like you don’t have time to be at the gym 6 days per week and prepare and tolerate broccoli and chicken every day, good because you don’t have to. You do not have to eat like a typical bodybuilder. On the other hand, you cannot eat like a “typical” American either.

Start with this: give up fried foods, add something green to every time you eat, and attempt to limit (but don’t overly restrict) healthy carbs. Try to find a weekly cycle of a few meals/foods that work well for you and simply stick with it for a while. Enjoy a moderate cheat day once per week, and otherwise remove your choices and eat on autopilot. You WANT to be bored with your food most of the time, but NOT hungry. Nobody said it would always be fun.

These secrets are all general. Please don’t put hope in any breakthrough supplements or ab machines unless you’ve tried at least 3 to 6 months of consistent total body resistance training along with boring, non extreme dieting with moderate amounts of mostly non-processed foods ; ) .

And here’s the kicker:

Around the time that you train strong and live strong and generally make solid choices with your diet, you tend to care far less about less than perfect abs. These things tend to help you become a solid -person-. And that’s truly a great place to be.

For detailed information specific to your needs and situation, please see David Drinks at Umed Gym in Carlisle. Also a plethora of legit and no b.s. top-notch dietary advice can be found at the Precision Nutrition and Examine.com websites.

Heel pain in soccer players



Heel pain is a common problem in any “cleated” athlete, and something often treated at my physical therapy office. This essay will focus on the most common cause of heel pain in young soccer players.
—–
Differential diagnoses includes Achilles tendinitis, stress fracture, recurring ankle sprain, nerve entrapment, and plantar fasciitis. Please do not assume that your Google degree has enabled you to reliably determine Severs disease from a stress fracture or achilles tendinitis.
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This problem is most often a condition known as apophysitis of the calcaneus (heel bone) or Sever’s Disease. This label describes a repetitive overuse injury, with inflammation of the growth area of the calcaneus which has not completely closed. It is most commonly seen in boys and girls between the ages of 10-15 who frequently participate in sports that involve running and jumping. The pain is usually present in the back and bottom surface of the heal.

Causes of Sever’s Disease Include:


1. Training Errors

The issue often occurs abruptly after a period of inactivity, when the athlete resumes running, cutting, and jumping activities too frequently or intensely. Other times, the condition develops gradually as the athlete continues to pound their joints with insufficient time for recovery between games and practices.

2. Footwear

Soccer cleats are intentionally created to minimize interference with foot feel and function. This is great for quick cuts and precision touches to the ball, but leaves very little between the foot and the ground. Cleats that are too small are often a culprit, as are shoes with less than four cleats in the heel area.

3. Foot Structure and Function

Biomechanical imbalances such as high or low arches, or very stiff or loose joints, can be the root cause of the abnormal strain across the Achilles tendon insertion point on the heel bone. The details are beyond the scope of this writing, but you should realize that the heel may be overloaded due to too much or too little movement in other areas of the leg.

Treatment: Beyond rest and heel cups

The most effective treatment usually includes measures to address some combination of the above problems.

1. Systematically apply stress to the body.

Plan ahead to gradually apply more stress to the foot and ankle before jumping into a lot of repetitive agility and sprint work. At least initially, apply a limited number of high impact activities to build resiliency in the foot and ankle.

Wear cleats around the house for “everyday life” and light skill work before using them for more intense training.

2. Address issues with foot structure

The details of foot structure and function are beyond the scope of this essay. This is highly individual, and demands a thorough orthopedic evaluation of the entire athlete (not just the foot). Not all “low arch” feet need orthotics. They may respond well to a few exercises and shoe modification. But some athletes certainly do require an appropriate off-the-shelf or custom orthotic device.

3. Modalities

Applying ice and massaging the calf muscles and the area around (but not directly to) the tender area often helps. I’ve found Ultrasound treatment to be worthwhile to decrease pain and inflammation. While these do indeed help manage the symptoms, they don’t address the root cause.

4. Taping Techniques

There are a few flexible- (aka kinesiotape) and traditional taping techniques that effectively reduce the overload of the heel bone. Sometime this is enough to get the athlete outside of the threshold of injury. Which technique and type of tape may work best depends on the static and dynamic (movement) patterns the athlete displays.

5. The quick fix. ***

I’ve hit upon a quick fix (of sorts), and will usually try this in combination with a few targeted exercises and temporary activity modification prior to considering an orthotic or other more intensive intervention.

The quick fix is a 1/4″ semi soft heel lift that runs from the heel and gradually tapers to the ball of the foot. This works far better than Dr. Scholls type insole because they don’t take up room in the toe box area where the athlete is accustomed to a form fitting shoe. And unlike gel “cushion” heel cups, they don’t slide around in the shoe. They also provide more lift than squishy gel. A quarter inch is usually enough to lift the back half of the foot and lessen the Achilles tendon pull on the calcaneus.

I make these in the orthotic lab and they often do wonders for athletes stuck in a rut of heel pain.

Try these tips and let me know if you have any questions.

Hell Week Survival Guide: Does standing tall help recovery?

tired sprints

 

This time of year finds nearly every athlete being pushed and tested by their coaches. There is nausea, gasping of humid August air, and bent over stances under blistering sun.

Tis the season! Hell Week is fine and well, to an extent. Team sport athletes need to bond and gain mental toughness. For coaches, interviews and tryouts provide little of the insight or natural selection process that comes respiration3from a few gut-busting conditioning workouts. Severe shock to the system can usually be minimized with a little off season training.

But here we examine the point in time immediately after the sprint, when the coach leans in to a small sea of dazed athletes and starts talking.

I’ve been there on more than a few occasions, utterly exhausted, trying to get my life together, when the coach delivers a nugget of inspirational advice or a scatterbrained diatribe. I’ve heard both. But one bit of barking from a particular coach stands out.

“Get your hands off your knees and stand up.”

“Stand up and breath, ya bunch of pansies.”

Yes, coach Painter repeatedly referenced pansies and advised rode us regarding standing tall when trying to recovery from strenuous activity. I’ve heard variations of this, minus the pansies, repeated by a handful of other coaches in the years since. Nobody ever questioned it. Does standing tall during recovery really achieve anything?respiration2

To say that recovering tall may score you a psychological victory over the opponent is one thing.  Feeling exhausted in a late-game situation and looking up to see the opponents showing no signs of fatigue can be mentally defeating. But what about the claim that standing upright is better for recovery because you can take in more air than leaning over?

It’s time for a lesson from Anatomy & Physiology 101.

The primary muscles of breathing (respiration) are the diaphragm, the internal intercostals, and the external intercostals. These muscle are active when you are resting and under light exertion. Some physical therapists and trainers go into great detail regarding the effects of spine position on the diaphragm, and this is true to a degree. But the leverage of the primary respiration muscles changes minimally with acute changes in torso position.

The accessory muscles of breathing do not play a significant role during normal breathing. These muscles around the upper neck and chest wall help move us around and generate significant forces on the neck, shoulder, and scapula. But when the neck, shoulder, and scapula are fixed, as when standing leaning forwardrespiration1 with hands on knees, these muscles essentially reverse their function, pulling the clavicle and ribs up- and outward. Viola, greater rib cage expansion and greater volume of air entering the lungs.

Side note: People with emphysema and other diseases of respiratory distress often sit and stand with hands planted on their thighs or a table. They naturally assume a posture that is most efficient for their struggling lung capacity.

The bottom line is that standing upright to recover offers no special physical benefits. When your legs are spent, it feels good to take a portion of your bodyweight through your arms. In fact, as compared to leaning forward, standing upright may effect a slight decrease in recovery and performance for the next physical effort. Coaches should consider, at least at times, allowing athletes to choose how they recovery. Slump, kneel, or lay down…let performance do the talking.

“I don’t care how you recover, let’s see who can complete a 3rd or 4th line drill in under 26 seconds.”

I have no doubt that coach Painter meant well. As much as I would like to go back and hand him a textbook or bouquet, I should also thank him. If you’re a team sport athlete, simply do as the coach says (within reason.) Stand on your head between sprints if he or she tells you to, with the understanding that optimal physical recovery may not be the main point.

 

Soccer: Save the knees

Today I learned that two players on one soccer team suffered ACL (knee ligament) tears in one day. The athletes will be having surgery and miss the fall season. This did not occur during intramural or middle-aged pick-up soccer, but in an NCAA D1 womens soccer team. Two major knee injuries in one day seems stunning. But according to the data, this truly is no surprise.

I have nothing against this university. In fact, I’m well aware that this particular university happens to be at forefront of teaching and research regarding musculoskeletal injuries. I understand that injuries in sports are inevitable. Accidents occur despite the most well laid out precautions and planning.

But I have some observations to offer. I’ve seen a fair share of collegiate soccer players over the years, in the clinic and around the house. Not hundreds of them, but plenty enough to notice patterns.

Fact#1: Soccer is a game of repeated cutting, sprinting, accelerating various directions, and even jumping.

Fact #2: Since the knee joint is the largest lever in the body, situated between the two longest body segments, the brunt of high stress tends to fall there. In soccer players, knees and ankles are by far the most common injured part of the body.

How are these athletes preparing for the demands of fall soccer practices and the upcoming season? They are jogging. Jogging long and slow. Jogging somewhat fast (yeah, I cannot run a 5-minute mile either). They are doing tedious interval sprints, mostly in a straight line. They are fearful of failing the timed mile, two mile, or other gut-busting tests of endurance and grit.

They choose not to do much in terms of plyometric or resistance training due to lacking the time, know-how, or means to build up gradually, and high intensity plyometrics and weight training leaves them too sore and tired for the running protocol. I don’t blame them. People are not machines. Who has the energy for resistance training, cutting, jumping, and quality-of-movement work, when they need to drop a minute off their timed mile?South Africa's Refiloe Jane, left, controls the ball challenged by Sweden's Fridolina Rolfo during the opening match of the Women's Olympic Football Tournament between Sweden and South Africa at the Rio Olympic Stadium in Rio de Janeiro, Brazil, Wednesday, Aug. 3, 2016. (AP Photo/Leo Correa)

For more than a few years, we have known many of the risk factors to look for, and specific interventions that have been proven to lessen the risk of ACL tears. We know the demands of a typical soccer match, such as those found here and here. 726 turns during a single match, and still we have athletes focused on jogging. There’s a better way to do summer!

 

5 KEYS FOR PRESEASON SOCCER PREP

  • Sprint and change-of-direction/acceleration training, beginning with moderate speeds focusing on movement QUALITY, and gradually increasing in speed, impact, and repetition.
  • Plyometric training, with jumps, hops, striders, tuck jumps, etc, focusing first on movement QUALITY and gradually building in speed, impact, and repetition.
  • -Intelligent- application of strength training, building a base of hip mobility, leg and core strength, with gradual transition to fairly heavy/low repetition total body exercises. We’re not talking about nauseating cross training with weights. Neither do we speak of the typical leg curls and power cleans, which are completed on no legs or two legs. Most high level athletic movements (and virtually every non-contact ACL tear) takes place with bodyweight on one leg. Most soccer players will drastically improve performance and decrease risk of injury when they focus on strength and power in single leg movements in multiple directions.
  • Proprioception training. The literature states that not all athletes are lacking in their ability to feel and control body movements. But the ones who are lacking in this regard stand to benefit greatly from a handful of activities that fine-tune balance and body awareness.
  • Movement Screen (Assessment) While not being predictive of who will suffer injury, this is invaluable for determining exactly what the athlete should be doing and where they can enter in to the consoccer cut 3tinuum of strength training and conditioning.

Truly, it’s not difficult to include these in a weekly and monthly training regimen. Keep it simple and abbreviated. Quality trumps quantity, so resist the temptation to simply add these components to the status quo running protocol. An athlete’s time and ability to adapt and recover is finite, so something has to go.

I’m still relatively new to soccer culture. But I would love to see coaches adjust their preseason conditioning tests to reflect lower body power, and short bursts of multidirectional movement. A grueling test of endurance is absolutely called for in the preseason to use as a gauge of work ethic and grit. But this should not be the emphasis. Do not let the demand for running endurance rob the entire team of time and energy better spent elsewhere.

And the few high level players who show up to fall practice “out of shape?” Let them run distance with a ball, after practice. That’s the time to tack a mile or three of endurance work on to the athletes who need it. It should only take 15 minutes or so ; ).

soccer cut 2

 


Here are a few of the risk factors for ACL tear

  1. dry weather and surface
  2. artificial surface instead of natural grass
  3. generalized and specific knee joint laxity
  4. small and narrow intercondylar notch width of the femur (ratio of notch width to the diameter and cross sectional area of the ACL)
  5. pre-ovulatory phase of menstrual cycle in females not using oral contraceptives
  6. decreased relative (to quadriceps) hamstring strength and recruitment
  7. muscular fatigue by altering neuromuscular control
  8. decreased core strength
  9. decreased proprioception
  10. low trunk, hip, and knee flexion angles, and high dorsiflexion of the ankle when performing sport tasks
  11. lateral trunk displacement, hip adduction (collapse), increased knee abduction moments (dynamic knee valgus
  12. increased hip internal rotation and tibial (lower leg) external rotation with or without foot pronation

Is Specializing in One Sport a Bad Idea?

“You must play only one sport.”
“You cannot play only one sport.”
 What a difference one word makes! The first statement implies that the athlete must specialize and do nothing else. The secsingle sportond statement indicates that playing only one sport is not allowed. Both statement are heading the wrong direction.
It is easy to look down upon the parent or coach who highly encourages demands that an athlete devote their life to one sport. And rightly so. We know that specializing in one sport too early can be problematic in terms of health, and potentially adverse to their ultimate peak performance (see footnote below).  This is especially the case when the child or young adult has a desire to participate in something else. Childhood is short. Life is short. Kids can and should be encouraged to do what is healthy and fun for them. Anyone who demands that someone play exclusively one sport is off the mark and in serious want of perspective.
It has become common to criticize all single sport athletes in a similar vein. But what about the serious athlete who does not want to play another sport? Now more than ever, parents and athletes are asking for one year-round sport. If an organization does not offer it, they travel elsewhere, presumably to a place that takes the sport “more seriously.”
But what if truly respecting the total athlete, including their health and recovery, will ultimately help them reach the highest level in their *focus* sport?
“Club X doesn’t play year-round, they must not be too serious.”
Needs to be changed to…
“Club X doesn’t play year-round, they must be seriously smart.”
It is ideal for a young single sport athlete to play something else as well. Taking life in seasons, with a mental and physical shift, is a good thing for anyone. A break will do wonders for perspective and physical ability. Or, to put it in more marketable terms;
 What if gaining The Edge has to do with staying active but shifting gears, experiencing a different role (possibly not the star), and generally having a rhythm to the year? I keep saying that the next “Big Thing” in sports performance is to truly, like REALLY, optimize and respect recovery rather than just giving it lip service.
But let’s say the child, carrow not linearoach, or parent is still not convinced of the value of another activity. Do we strong-arm them into it? No way! Being a single sport athlete can be done poorly and can be done well. Single-sport athlete done poorly looks like playing with intensity 4 seasons per year. Leagues, tournaments, showcases, you-name-it, YES to all’ve it. Let’s fire it up and be perpetually ahead! And if there is a week off, let’s train twice per day, three, no, four times as hard!
Again, going hard in one sport year-round is not ideal. It increases the likelihood of injury and by no means guarantees a better athlete. A component of dominating may indeed be taking a (relative) break from that sport. Ironically, Single-sport athlete done poorly may also look like sitting around for three months playing X-box. Both of these extremes result in sub-optimal performance at best.
So to answer the question, specializing in one sport is not a bad idea, so long as it’s done well. Single Sport Athlete Done Well involves:
 -Identifying a peak season or event(s) and planning a build-up to it
 -Paying great respect to the stress-recovery process
-Acknowledging that being a single-sport athlete can be an advantage (more skill work and experience) so long as there are seasons of low physical and psychological stress.
 -Focusing on moderate-intensity deliberate skill practice in the off season.
 -Filling the off seasons with ancillary activities that specifically match the needs of the athlete to the demands of the sport. May I suggest a focus on targeted resistance training and conditioning as your “off season sport?”
An example:
My sons have caught soccer fever. The free time once reserved for fishing, basketball, flag football, biking, swimming, or practicing flips in the back yard is now ALL filled with juggling, playing small-sided games, arguing about small-sided games, soccer practices, and actual league games.
 If they wish to play only soccer, I will attempt to sporadically distract them with many serious and structured training techniques such as mountain biking, hiking, swimming, and obstacle courses. Later I will encourage them to hit the weights with methods that specifically support soccer.
In summary, single sport athletes need to understand the process of consistent effort and recovery.
They need to understand specific ways that they can improve at their sport for each day and season without playing the sport each day and season.
They need to learn the value of training to build resiliency, improve movement efficiency, and work on weak areas, but without involving the exact same physical stresses of the sport.
They need reminders and perspective to keep having fun, enjoying the process of working toward a greater end, and building life skills that transfer beyond the field.

Risks of being a single-sport athlete (presumably) DONE POORLY

Adult Inactivity: A study by Ohio State University found that children who specialized early in a single sport led to higher rates of adult physical inactivity. Those who commit to one sport at a young age are often the first to quit, and suffer a lifetime of consequences.

Overuse Injury: In a study of 1200 youth athletes, Dr Neeru Jayanthi of Loyola University found that early specialization in a single sport is one of the strongest predictors of injury. Athletes in the study who specialized were 70% to 93% more likely to be injured than children who played multiple sports!

Burnout: Children who specialize early are at a far greater risk for burnout due to stress, decreased motivation and lack of enjoyment.