HYPERSPECIALIZATION BEGETS HYPEREXTENSION.

Title Nine of the 1972 Civil Rights Act made women's sports part of the business of intercollegiate athletics, and where there is business, there is an old boy's network.  Where play turns to business, there are also rewards to proper preparation, never mind the hazards.

Like their male counterparts, girls have started to specialize early in their careers, working on just one sport year-round, often as a way to capture the attention of college coaches. With more scholarship money available than ever, girls feel pressured to specialize at a young age in the hopes of winning a spot on an elite team or gaining an edge in the increasingly competitive college admissions game. Despite persistent warnings from orthopedic surgeons and trainers, young athletes bent on specialization continue to suffer from preventable overuse injuries, like stress fractures and stress reactions, according to the American College of Sports Medicine. "More than 50 percent of what we see in sports medicine are overuse injuries, which are entirely preventable," said Dr. Joel Brenner, chairman of the American Academy of Pediatrics and the Council on Sports Medicine and Fitness.

Preventable, perhaps, but it is the American way to push the envelope and come up with better repairs when it's unavoidable.

Stability Enhancement Systems, an innovative company dedicated to reducing injury risk in athletes through targeted personalized interventions, was called on by the Northern Illinois women's basketball team last month to come to its rescue, and to help figure out why four players in the last year have suffered serious knee injuries, including leading scorer Courtney Woods last month.

Build a better mousetrap and all that.

SES was established in 2011 and has developed quite a reputation for its good work. Over the last four seasons, SES has put more than 650 athletes through its individualized matrix testing and programming and none of them, that's right, zero, has had season-ending knee injuries.

Central Michigan coach Sue Guevara sympathizes with [Northern Illinois coach Lisa] Carlsen and would much rather be facing an NIU team at full strength today. She knows how disruptive injuries can be. She hired SES a few years ago when knee injuries decimated her team.

"My heart sank when I heard about Courtney's injury," Guevara said of Woods. "I know what that's like. We went out and hired SES when we had a bunch of knee injuries and I can't say enough about them. They do a great job of evaluating each player and creating specific exercises for each player. It's not just a (blanket) approach for the whole team.

"For us, it's been money well spent. We have a kid this year who already had some knee problems (coming into the program) and she has an injury right now, but other than that, we haven't had a knee injury since we started working with SES."

Carlsen said she did her research about SES to make sure it would be a good fit for her program. She noted that Notre Dame hired SES a few years ago when a rash of knee injuries hit its women's basketball program, and that SES also works with USA Basketball.

"I feel like I'll be a doctor when all this is done," Carlsen said with a chuckle. "I've learned so much about joint stability in addition to muscle strength and how that all factors in.

"I am hoping this will help us and help our kids stay healthy. The way I see it, we owe it to our kids to do this, and to the program."

The institutional incentives are against it, though, according to Atlantic authors Linda Flanagan and Susan Greenberg.

For starters, we can strive to identify the particular conditions that make women more susceptible to catastrophic knee injuries and develop training regimens that reduce that risk. According to Dr. Levine, preventative measures to protect against A.C.L.s remain "an elusive 'holy grail'."

Eliminating the eating disorders that are so common among female athletes might be unrealistic. Female athletes have figured out that sports can provide a fast track to getting thin. Girls' and women's social value remains tied to appearance, particularly body size, and Kate Upton on the cover of the Sports Illustrated swimsuit issue speaks a lot louder than the athletic trainer admonishing them to eat enough protein and carbs. Short of a massive cultural realignment (and we're not holding our breath), perhaps the best we can do is take aim at the most serious eating disorders--anorexia and bulimia—and continue to educate coaches and parents to encourage healthful eating and exercising.

A big part of reducing overuse injuries for girls and boys both will involve getting the word out about the perils of early sports specialization. For years, the American Academy of Pediatrics and top professional orthopedic organizations have cautioned against kids' specializing and overtraining, to little effect. Still, imposing enforceable restrictions on playing time won't work because of the vast and complicated array of sports and teams. If a child plays basketball for his school, church, and travel teams, who imposes the rules? "Parents have to be the advocates of their children, even if that means going against what the coach recommends," Dr. Brenner says. "It's about putting the child first."

Good luck with that. Middle school competitors are committing to collegiate programs.

Sydney Supple wasn’t your average middle schooler, though.

Now a senior at Oshkosh North, Supple committed to play softball at Northwestern University when she was in eighth grade following what she called a whirlwind of emotions during her recruiting process.

It sounds like she's still a future Wildcat, although she has reservations.

Following her recruitment to Northwestern, Supple helped push for a new NCAA rule when she was 16, three years after committing, in softball where coaches are barred from contacting recruits until Sept. 1 of their junior year.

The rule took affect [c.q.] in 2018.

It wasn’t easy, either, she says.

“Don’t want to sound like a hypocrite because there’s nothing I regret about my decision,” Supple said. “I’m lucky, not everyone has a positive experience.”

Fifty years ago, John Hersey's The Child Buyer was supposed to be dystopian fiction, and it was a brainy but socially inept overweight kid getting recruited for some secret government project.  These days it's the precocious athletic kids.

Supple said athletes are also taking leaps of faith.

“Easy to say you love the game in sixth or seventh grade, but that can change as a junior when you’re juggling school and everything else,” Supple said. “You need to find out what’s important to you and sometimes that’s not until you’re older.”

That's what Boston College lacrosse recruit Sophia Gouraige found out.

Gouraige, once at college, quickly found herself dreading practices. "You always had to be on your game, study what was in your binder, know the plays, get out there and be your best, be the fastest, score the goals," she says. "It felt like a tryout at every practice."

Though she loved lacrosse, she didn't want to spend all her time playing it. She was eager to explore other things, and with a push from the coach, she left the team during her sophomore year. "When you go to college, it's all about how to win the national championship," says Gouraige, now 21. "Why can't sports just be fun?"

It can be, but as soon as you're playing for stakes, it's work. A train dispatcher is only as good as his last move. A researcher is only as good as his last paper.  A candidate is only as good as her last campaign.  And there is always somebody willing to outwork you.