I hate to bring up ‘back in the day when I played,’ but the biggest thing missing today, is kids getting together and playing in a little open gym and just learning how to play. A lot of times in AAU, it’s star-driven and it’s just up and down the court. When you’re watching AAU basketball and you see a real skilled player that knows how to play the game, he sticks out like a sore thumb. —Runnin' Utes head coach Larry Krystkowiak

SALT LAKE CITY — For Kurt Christensen it was a reality check when he took his 11-year-old son to see orthopedic surgeon Vern Cooley because of some fluid on a knee.

The former BYU basketball player had supported his son Adam’s decision to play basketball from a young age, and he had been playing dozens of games a year since he was in third grade and was now in fifth grade. His son hadn’t even hit puberty yet but was seeing a surgeon because of an overworked knee.

Christensen distinctly remembers Dr. Cooley’s words.

“Vern looked at me and said, ‘Kurt what are you doing? Shut it down.’’’

Christensen had just been doing what parents all over Utah have been letting their kids do since the 1990s — play in AAU basketball leagues on nearly a year-round basis.

While the doctor’s words didn’t keep Christensen from barring his son from playing basketball, it made him take a step back and realize that his kids didn’t need to be playing basketball nearly 365 days a year.

Back when he was a teenager in the 1980s and an all-state basketball player for Highland High, Christensen didn’t have anything such as AAU basketball. He recalls going to college camps at the University of Utah and Utah State and spending a couple of weeks at camps over at Highland. Otherwise, it was hoops in the backyard or at the local ward house.

When Christensen’s first two children were born in the late 1990s, AAU basketball was just becoming the thing to do for serious basketball players and when his kids turned 8 or 9, he got them involved in AAU basketball, often coaching the teams himself.

From his experience, Christensen calls AAU basketball and playing against competition in out-of-state tournaments “a two-edged sword.’’ He can see the benefits while also recognizing some of the downfalls.

“It presents a unique opportunity for Utah kids to play against bigger, stronger and faster kids,’’ he said. “The kids become battle-tested and certainly tougher and no one in Utah will intimidate them. The negative is the abundance of games and in some cases the violent nature of the games that are played out of state, where the officiating can be horrible.’’

Last month Christensen’s son was among thousands of kids from all over the country representing thousands of teams that descended on Las Vegas for five days, using up every available gym in the city to play tournament games.

Some were elite teams such as the Utah Prospects featuring Lone Peak star Frank Jackson or Salt Lake Metro, the premier Utah team for the past two decades, while others were teams put together by fathers who want to give their kids a chance to get experience playing tournament basketball.

Over the past two decades AAU basketball has become a huge business and a necessary stepping stone for athletes who have aspirations of playing basketball in college, or in rare cases, professionally. It can cost families thousands of dollars a year and take up all of a family’s vacation time.

With the exorbitant multi-million dollar salaries that NBA players currently bring down, it’s little wonder why so many people want to get in on the action, whether it’s parents that hope for that one-in-a-million shot for their son to play in the NBA or promoters hoping to cash in on the next LeBron James. In the recent NBA draft, 26 of the 30 first-round draft choices were “graduates” of AAU programs.

Although it's a prerequisite for American basketball players, several prominent NBA and ex-NBA players have been critical of AAU basketball.

In an interview with ESPN earlier this year, Kobe Bryant called AAU basketball “horrible,” “terrible” and “stupid.’’ Charles Barkley said it was “the worst thing that ever happened to basketball.’’ Another former NBA player, Robert Horry, was quoted as saying of AAU basketball, “I hate it, I hate it, I hate it.’’

The reasons for their disdain centers on the lack of skill development, the money-grabbing nature by some coaches and sponsors and the risk for long-term injuries because of the excessive amount of games young players engage in.

“AAU basketball doesn’t teach our kids how to play the game at all,’’ said Bryant, who grew up playing basketball in Italy where his father played pro basketball. “You wind up having players that are big and they bring it up and they do all this fancy crap and they don’t know how to post. They don’t know the fundamentals of the game. It’s stupid.”

Horry took his kids out of AAU basketball and told a panel in New York last year, “A lot of these AAU coaches are in it for themselves. I think it exploits these kids. That’s why you see some of these kids get hurt so easily now because they are overworked. I wish they’d play another sport like baseball because their bodies get so worn down.’’

College coaches have to be careful what they say about AAU basketball, because nearly all of their players participate in the year-round program for many years before they come to college and the college coaches have to maintain good relationships with AAU programs.

However, a couple of local coaches, Utah’s Larry Krystkowiak and Weber State’s Randy Rahe, as well as Jazz general manager Dennis Lindsey, who has teenagers participating in AAU basketball, expressed mixed feelings about young players playing nearly year-round on AAU teams.

“It’s really important, but like anything there’s good and bad just like there’s a lot of well-run college programs and some that are not so well-run,’’ said Krystkowiak. “I think you can say the same thing about AAU basketball. There're good coaches and well-run programs and they can be very beneficial and some that aren’t.’’

“There are some terrific AAU coaches out there who run a program with discipline and try to run it the right way,’’ added Rahe. “Those that do run it the right way have coaches that are in it for the kids only. Then you have the other side with coaches where it’s about them and they want to see what they can get out of it.’’

Kystokowiak’s biggest issue with AAU basketball is one that is echoed by many — the overabundance of games.

“They play so much basketball, so much more basketball than I ever played,’’ said Krystkowiak, who played nine years in the NBA. “Some important factors are being lost while they’re playing. When you’re playing your third game in one day and trying to get through it, not everybody’s giving their best efforts. It’s a crazy pace, it’s all up and down and it’s about showcasing your talents and it’s not always about winning games.’’

That’s a big negative for Rahe. He feels like kids become sort of numb to the idea of winning because they’re constantly playing.

“These kids play so much that sometimes the effect of losing games is not that important to them,’’ he said. “So if they lose a game, they’re going to play another game, and sometimes kids get in the habit of, Hey, how important is winning and losing in these games?’’’

Lindsey couldn’t agree more.

“This is a big one for me,’’ he says. “Summer basketball can promote an attitude of ‘There’s always another game, there’s always another tournament, there’s always another trophy.’ So it can marginalize winning a possession, winning a quarter, winning a half, winning a game because it’s 3 o’clock in the afternoon and they’ve got a 7:30 game later.’’

Dave Hammer is one of the original AAU coaches, having started his Salt Lake Metro program back in 1994. Over the years, more than 100 of his boys from Jeff Johnsen to Tyler Haws, as well as 60 girls, have gone on to earn Division I college scholarships. He bemoans the fact that AAU basketball has become so “tournament-driven” and he has changed his philosophy over the years to focus on skill development with more practices and fewer games.

Hammer doesn’t disagree with Lindsey and the college coaches about players becoming sort of insensitive to winning and he tries to balance it with an importance on skill development.

“It’s kind of a weird thing to coach because you’re trying to develop the kids and give them the opportunity to be seen, but still win,’’ he says. “I’d rather have Metro win than lose, but it isn’t the only thing that matters. We’re more development-oriented, we work on skills and are not as tournament-driven as some other programs are. That’s been our mode of operation.’’

All agree that there are too many games and just too much basketball overall. Krystkowiak yearns for the old days when kids played other sports (he played football in the fall, tennis and baseball in the spring and summer) and when basketball was more for fun and working on individual skills.

“I hate to bring up ‘back in the day when I played,’ but the biggest thing missing today, is kids getting together and playing in a little open gym and just learning how to play,’’ he said. “A lot of times in AAU, it’s star-driven and it’s just up and down the court. When you’re watching AAU basketball and you see a real skilled player that knows how to play the game, he sticks out like a sore thumb.’’

Krystkowiak also likes the idea of taking time away from basketball and sports in general.

“As much as I love basketball, I used to take long periods off,’’ he said. “I think sometimes the best thing to do is to take parts of the summer off. Maybe you don’t play every session in July, you just play two out of three. I wouldn’t have a problem if my kids told me they want to sit out some. I think it’s really good for kids.’’

Lindsey agrees, saying, “When you have a child playing AAU, select baseball or volleyball, you have to have a balance where there’s time to rest, to be excited about their sport.’’

Then there’s the effect too much basketball is having on young bodies.

“Like any good thing, you can do it too much,’’ said Lindsey. “Multiple games in one day, four games in two days, results in concerns about injuries. There is some anecdotal evidence with players of a particular age that the wear and tear on their bodies is advanced.’’

Lindsey does see the positive side to it all.

“There are some things about AAU basketball that the negative rap is deserved,’’ he said. “The thing I would say is that all things are not all great or all bad. There are some legitimate AAU programs, some here locally and some great ones in Texas. Sometimes these coaches are surrogate fathers and disciplinarians, they provide rides . . . There are quality coaches, quality programs but they are sometimes obscured by some AAU mentality that hands are out and they’re trying to make money.’’

Christensen acknowledges he still lets his four children play AAU basketball, but tries to not let them overdo it. He has a family rule that they don’t touch a basketball the whole month of August, just after the big summer tournaments get over.

And he makes sure his kids aren’t playing so much they suffer from overuse injuries that are affecting more and more kids every year. He recently pulled his son out of a tournament — much to the chagrin of the coaches, who wanted his son to play — because he was concerned about a minor injury.

Christensen’s older kids have done well and thrived in high school in part because of AAU basketball. His oldest daughter, McCall, starred for the 5A championship team last spring at Brighton High, while his son, Adam, made varsity at Brighton as a freshman.

However he’s learned a lot over the past decade, while coaching hundreds of games with his older kids. He has two younger children who also love basketball and Christensen plans to continue coaching them.

But his philosophy has changed over the years.

“I did it wrong on the first go-around,’’ he said. “My emphasis will be on development and learning to love the game. I don’t think we’ll look at the scoreboard too much.’’