Not so long ago (though it sometimes seems that way), a child would come home from school, do homework, then go out to play in the backyard or neighborhood. These days, kids’ play is, literally, a whole other ball game. Parents practically need a score card to keep track of their children’s complicated, intensive after-school sports schedules.

One of the first casualties of such a lifestyle, says Duke pediatrician Deborah Squire, MD, who specializes in sports medicine, is often childhood itself.

“Sports can be a great socializing tool for children,” she says, “but adults’ expectations of performance often bring too much structure and pressure into what should be a fun time for kids.”

An increased risk of injury to bones, joints, and muscles -- a special concern when young bodies are still growing -- is an all-too-common consequence. “When children begin to show promise in a sport, there’s a strong tendency on the part of coaches and parents to push them to focus on it more exclusively than they might choose to do on their own,” Squire says.

“We frequently see kids no older than eight or nine years old coming into the clinic with repetitive motion and overuse injuries, including stress fractures.”

Greg McElveen, a father of three who leads the Duke Sports Performance Program, urges parents of young athletes to consider five key points:

1. Focus first on sports skills. Research shows that child athletes who focus first on sports skills have better sports outcomes than those that focus primarily on conditioning.

Picture a child (whom we will call Nathan) -- a young soccer player whose parents have focused him on speed, strength, and endurance. Throughout his game, he tirelessly runs rings around his opponents, speeds toward the goal, and boots the ball forcefully, only to watch his shots go wide or high.

Had his parents focused him on skills, he would have dribbled deftly between defenders and tapped the ball into the goal with a smile on his face.

2. Select the most needed fitness variable and be specific. Fast-forward to Nathan with “peach fuzz” and a deepening voice. By now, he has developed good soccer skills.

His parents notice that some of his opponents are faster, some are stronger, and some have more endurance.

They should ask themselves this: which of these attributes, if improved upon, would help Nathan most? If, for example, they note that he can kick the ball a great distance but gets bumped around when racing to the ball, that means he needs stronger hips.

3. Have your child improve by baby steps, not by leaps and bounds. Young bodies can improve only a little at a time. Whether your child needs to go harder, heavier, or higher, go up 5 percent at a time, not 50 percent. Take it in stages and make sure he or she is physically ready for each step.

4. Remember the performance tripod: training, nutrition, and rest. Provide your young athlete with both a souped-up vehicle and high-octane fuel in the tank. Muscles are made mostly of protein -- most kids get plenty of that. The protein is the vehicle. The high-octane fuel is complex carbohydrates -- vegetables, whole fruits, and whole wheat grains.

To soup up your child’s car (better muscles) and fuel him or her, he or she will need enough rest. Growth hormone peaks during sleep, which helps the child build better muscles, supplied by high-octane fuel.

5. Keep it fun! An athlete performs better when happy.