Keep sports abuse on your radar, help parents be proactive

Michele LaBotz, MD

From tough coaches, to hazing, to sexual abuse scandals, abuse in sports happens and it isn’t always apparent that there’s a problem until it’s too late. However, pediatricians can help prevent abuse and provide support to parents and athletes.

Michele LaBotz, MD, a private sports medicine physician from Yarmouth, Maine, led a session titled “Athletes abused in sport: How does this happen and how can we help?” on November 5 at the American Academy of Pediatrics (AAP) 2018 National Conference and Exhibition in Orlando, Florida.

Highly publicized cases, such as that of the ex-Michigan State University and US Olympic team gymnastics physician Larry Nassar, have brought attention to the potential for abuse in sports. Athletes are vulnerable to physical, emotional, and sexual abuse, and the culture in athletics might make it difficult to recognize or report this abuse out of fear for retribution or appearing weak.

LaBotz’s session focused on reviewing cases of abuse and incidence, including both traditional abuse, harassment such as “sexting,” and more. It also brought attention to the different kinds of perpetrators of this abuse, including teammates and coaches.

Look for warning signs

Studies from across the world estimate that 38% to 75% of young athletes experience psychological abuse in sports, and a European study estimated that 14.3% are sexually abused, according to LaBotz’ presentation. Although abuse can happen across the board, LaBotz notes that female athletes are at up to 4 times more likely than male athletes to face sexual abuse.

It’s nearly impossible to prevent all abuse in sports, but LaBotz says pediatricians should be prepared to recognize the patterns and risk factors associated with different forms of abuse in sports and be able to counsel parents and participants on how to minimize their risk.

“Many warning signs are the same as that for any other form of abuse, but there are several sport-specific patterns: emotional and/or behavioral changes, especially new onset of disinterest in the sport or sport dropout; avoidance of individuals or sport-related situations; recurrent and/or persistent illness or injury; and decreased athletic performance,” LaBotz told Contemporary Pediatrics prior to the conference.

She says strong family support systems, ego control, and healthy self-esteem are all important elements of abuse prevention. Teams and organizations should institute policies focused on abuse prevention including background testing, and parents should not be afraid to ask open questions about those policies, according to her presentation. Appropriate strategies to prevent abuse should also be considered, including limiting one-on-one exposure, overnight trips, bathing practices, and being wary of activities outside the organized programs.

“Pediatricians need to recognize young athletes are at risk for maltreatment and encourage and empower young athletes and their caregivers to create a culture of safety in youth sports programming, and to be aware of resources that will enable them to do so,” LaBotz says. “The desired patient outcomes are decreased rates of young athletes who experience or witness maltreatment of any type, but particularly in the sport-related setting.”