Too Much of a Good Thing? Overuse Injuries in Young Athletes

During a time when child obesity is high and programs are telling our kids “Let’s Move,” an increasing number of children and teens are bucking the trend of inactivity by competing in organized sports.

Youth participation in sports, in fact, is on the rise, according to the Centers for Disease Control and Prevention (CDC) – so much so that the CDC estimates nearly 30 million children and adolescents participate in youth sports in the U.S.

While the pendulum swings from the obesity epidemic toward better movement and athletic participation, however, another epidemic has sprung up recently that threatens the long-term musculoskeletal health of our more active youths: overuse injuries. Of the more than 3.5 million sports-related injuries that occur in youth sports each year, about half of them are due to overuse.

During a time of the year when the weather’s warming and youth sports leagues are kicking into gear, now is an ideal time to educate parents, coaches and athletes about the dangers of overworking young bodies. According to Dr. James Andrews, a world-renowned orthopedic surgeon and specialist in repairing damaged ligaments who is well-known for performing surgeries on high-profile athletes, the incidence of overuse injuries in kids and teens has grown considerably over the last 15 years.

“I hate to see kids we’re not used to seeing get hurt … Now they’re coming in with adult, mature-type sports injuries,” he said during a 2013 interview. “It’s a real mess.”

Dr. Andrews said he began seeing a sharp increase in youth sports injuries – baseball in particular, but in other sports as well – around 2000. Why the spike? Dr. Andrews blames specialization (playing one sport year-round) and what he calls professionalism, or training kids as if they’re professional athletes.

The fact that young athletes are still growing puts them at greater risk for injury than adults, says the American Academy of Orthopaedic Surgeons (AAOS).

Overuse injuries, the AAOS said, occur gradually over time, when an athletic movement or activity is repeated so often that the body doesn’t have enough time to heal properly between practices or competition. Common consequences include growth impairment and long-term health problems.

“The deal is, as sports physicians, we’ve all been amiss for years worrying about putting people back together and fixing things and new techniques,” Dr. Andrews said. “But we’ve largely ignored the real problem: prevention of injuries. Everybody now agrees that the time is right to keep these kids from getting hurt so often.”

In this spirit of prevention, the following are steps parents, coaches and young athletes (from any sport) should take to help prevent overuse injuries, courtesy of Dr. Andrews, STOP Sports Injuries and the AAOS:

Don’t Play Year-Round: According to Dr. Andrews, young athletes should take a two-month break (at minimum; three to four months are most ideal) from a sport each year in order to allow their bodies to recover.

Make Sure Athletes Warm Up Properly: This includes stretching, gradually raising the heart rate and releasing musculoskeletal tension in order to help prevent injury. A physical therapist can help a player, team or league develop proper, sport- and age-specific warmup regimens.

Use Proper Mechanics: Improper mechanics can lead to all types of sports injuries while putting players at greater risk of overuse injuries. Whether running, throwing, swinging, kicking or tackling, a physical therapist can evaluate your mechanics and provide advice that both elevates performance while reducing the risk of injury.

Increase Training Level Gradually: Follow the 10 percent rule, which dictates that training activity, weight, mileage or pace should never be increased by more than 10 percent per week. This allows for ample recovery.

Stop for Pain: According to the AAOS, frequent complaints of pain from young athletes (e.g., “My shoulder hurts,” “My elbow’s sore,” etc.) is an indicator that the athlete requires a period of rest from the sport. If pain persists, visit a physical therapist for a pain assessment or make an appointment with your family physician.

Keep Lines of Communication Open: Kids will push themselves too hard at times, and they don’t always want to admit it. Regularly ask your child or teen open-ended questions about levels of activity and comfort to glean signs of pain or over-activity. Sometimes a sudden lack of motivation for a sport is a sign of discomfort and even burnout.

A physical therapist is an invaluable resource for creating sports-specific warm-up and training regimens for athletes of all ages, in the spirit of performance enhancement as well as injury prevention. They are also trained to assess occurrences of sports-related pain and recommend possible treatment options. Contact your PT for more information.

RESOURCES:
American Academy of Orthopaedic Surgeons: Overuse Injuries in Children
The Plain Dealer (Cleveland.com): Noted surgeon… wants your young athlete to stay healthy…
STOP Sports Injuries: Youth Sports Injuries Statistics
STOP Sports Injuries: When Play is Too Much
STOP Sports Injuries: How to Prevent and Stop Overuse Injuries in Kids
Stanford Children’s Health: Sports Injury Statistics