• Adolescent
• sports
• public health
• obesity

Professionals involved in efforts to promote health in child populations are faced with a growing challenge. Children in many societies are burdened with the disease consequences of overweight and obesity, in part related to physical inactivity.1–3 Prevalence rates of childhood obesity have been increasing since the 1980s,4 5 and their known consequences include reduced quality of life, increased rates of chronic disease and associated healthcare costs, and early mortality.6–10 Obvious solutions to this problem include the promotion of physical activity via sports and active recreational opportunities. Such strategies can lead to reductions in risk for chronic disease which in turn lead to gains in health status that carry forward from childhood into the adult years.11–15

The same health professions that are charged with the responsibility of promoting physical activity in child populations are also faced with the reality of its negative health consequences. Injury related to childhood physical activity can occasionally lead to death or ongoing disability.16 Physical activity injuries are also a leading reason why children present to the emergency department and other acute care settings for urgent medical care.16–21

The obvious benefits (reduced obesity) and risks (increased injury) of childhood physical activity set the stage for a debate within …