We were talking about AAU earlier, I randomly ran into a 2019 article that talks about just how much AAU is contributing to youth bball injuries and thus players coming into the NBA with already-broken bodies.
This is just a small excerpt of a longer article.
In Part 2 of a two-part series, ESPN reveals how doctors, trainers and surgeons are forced to rebuild the world's best young basketball players.
www.espn.in
Typically, a procedure to reconstruct a torn ACL might take 60 minutes for an adult, but this one is taking longer because the X-ray technician is wheeling over the machine after almost every maneuver and because each X-ray is scrutinized to make sure that nearby growth plates, which have not yet closed, are not endangered. Extra time is also taken to ensure that the meniscus, the cushion of the knee, is repaired to prevent the early onset of arthritis. These steps would not be taken on an adult who has stopped growing, but this is not an adult.
It is a 9-year-old boy.
Years ago, as a 10-year-old growing up in Chicago, Dr. Pandya had planned to follow his father, a family doctor, into medicine -- in his case, specifically to become the
Chicago Bulls' team doctor. During his residency training in Philadelphia, Pandya decided that he wanted to work with kids. And seven years ago, he moved to the Walnut Creek branch of the UCSF Benioff Children's Hospital, which examines patients up to age 25. But one day, about five years ago, in came a new patient: an 8-year-old boy, a local basketball player who had ruptured his ACL.
"He was this kid who was basically playing four or five days a week," Pandya recalls. "He was doing drills all the time, and he was playing and landed wrong." His ACL popped. Pandya couldn't believe that such an injury could happen to someone so young.
In the years that followed, Pandya says, more kids that age began to come in, and the operating rooms filled with surgical trainees who came to watch because they had never seen such injuries to kids. But, in time, it became so commonplace that soon the shock wore off -- no longer did an ACL surgery to an 8-year-old raise eyebrows, nor did the constant stream of patients so young seem unusual. Five years ago, Pandya estimates that he alone would see about 1,500 pediatric sports injuries and perform maybe 150 surgeries -- ACL, cartilage, shoulder injuries -- in a single year; those numbers have "skyrocketed," he says, and last year stood at 6,000 and 400, respectively. More than half of his operations are now on those under the age of 14.
Often, Pandya says, he knows exactly what he'll find before ever making an incision, before the arthroscope reveals what's beneath the surface. He can roll the knee in his hands, and it might feel loose, like a bunch of untethered parts. He knows he'll see cartilage that should look paper white but is grayish -- not smooth, but rough -- not hard and solid, but soft and spongy. He knows he'll see an ACL and it will it not look intact, like a new shoelace, but frayed, like it's been through a meat grinder.
During the procedures, Pandya is focused on each step, knowing the pitfalls -- avoid hitting a nerve or blood vessel, be precise when drilling through bone to create a small hole through which to thread the new tendon. On the 15-minute drive from his home in Oakland to the clinic, he mentally prepares himself.
How will the kid respond? How will the parents respond? Will each side listen? Will they take the rehabilitation seriously? Will they take the proper steps and be diligent?
Sometimes, he'll see kids who aren't injured but are in pain, month after month. "Look, you just need to stop," Pandya will tell the parents, "if you play 40 hours a week of basketball, you're going to get injured."
Time and again, though, the first question parents ask is not about the well-being of their kids, but simply, "When can my kid get back out there?" Pandya will explain the potential hazards of the surgery, including risk of infection or re-injury. He'll show them a picture of what a healthy knee looks like for someone of their child's age -- and then show them what their kid's knee looks like now: routinely worn to the point that it appears three decades older than it should.
But often, he says, the only time parents appear truly shocked is when they're told how long their child will be sidelined.
Pandya sees the kids throughout their rehabilitation process. Some he's seen for years; he reconstructed their ACL only for it to be torn again. In some cases, he has repaired their ACLs three times by their early teenage years. The parents drop the kid off for physical therapy almost every day, but the kid lives with the injury, the rehab, every single day. Sometimes, they'll confide in Pandya.
Look, I don't want to go back, the kids will tell him.
I'm afraid of going back. I don't enjoy it anymore. I've spent my past three years just rehabbing. That's all I do. I go from one surgery to the next. I just want to be a kid.
Today, when he leaves the operating room, Dr. Pandya removes his surgical mask. He's 5-foot-6 and lean, a former collegiate track athlete at the University of Chicago. He's just finished his second ACL reconstruction surgery of the day; he does up to four a day now, two days a week. Earlier this morning, he reconstructed the ACL of a 12-year-old boy, a skier. The day before, another ACL, that of another 12-year-old boy, a soccer player. He heads to his office, takes a seat and resets for a minute.
The article goes into depth regarding how much more stress young developing athletes go through today compared to previous generations. Sadly, they focus on teenage Zion as someone who was already seeing the impact of overplaying on the youth circuits.