By Amy Nickerson, M.A.

With so many young people specializing in one sport nowadays, parents need to be aware of the likelihood of acquiring overuse injuries and how such injuries can affect their student-athletes.  The physical demands of playing a sport year-round can take its toll.

According to the American Academy of Orthopedic Surgeons, when young athletes participate in just one sport throughout the year, they continually use the same muscle groups, which can stress the same areas of the body over and over.  This can lead to muscle imbalances that, along with overtraining and lack of rest, put them at serious risk for overuse injuries.

What is an overuse injury?

Overuse injuries develop gradually over time due to repetitive stress on tendons, muscles, bones or joints.  In the case of sports specialization, when an athletic activity is repeated so often that certain areas of the body do not have enough time to heal between playing, you tend to see more injuries.  While mostly affecting muscles, ligaments and bones, these injuries can also cause serious damage to growth plates. Growth plates are the areas of developing cartilage where bone growth occurs in children. Repetitive stress can lead to injury of the growth plate and can possibly disrupt the normal growth of the bone. 

Common overuse injuries/Signs and Symptoms

Parents should be aware of the most common signs of overuse injury, such as pain and swelling.  Usually with overuse injuries the pain cannot be tied to an acute injury, such as from a fall or a hit, and it often increases with activity and intensifies in stages.

Overuse injuries can occur in any sport where the athlete experiences excessive amounts of stress and strain on the body.  However, in youth sports they are most commonly seen in football, basketball, baseball, soccer, gymnastics, volleyball and wrestling. Some common overuse injuries include:

• Little Leaguers’ Elbow or shoulder – pain in the elbow or shoulder area which can result from repetitive overhead throwing moves. Most often seen in baseball players, hence the name.

• Jumper’s knee (patellar tendonitis) – pain or tenderness right below the knee or upper shin area.  Often occurs as a result of too many jumping activities. This most commonly affects basketball players, football players and runners.

• Osgood-Schlatter disease - painful inflammation on the bump just below the knee.  This can occur when the quadriceps is overused in sports during a child’s growth spurt. Commonly seen in basketball players.

• Shin Splints – pain and tenderness over the shin area caused by excessive running, running on hard surfaces and improperly fitted shoes. Many runners experience this, but also athletes who play football, soccer, and basketball.

• Sprains and strains of various ligaments, muscles and tendons. Ankles are usually most vulnerable. 

Overuse injuries can usually be diagnosed after going through a thorough history and physical exam.  Your family doctor or pediatrician can do this, but you might want to see a sports medicine specialist with specific interest and knowledge of the sport or activity involved.  In some cases, X-rays are taken and occasionally other tests such as MRIs or bone scans might be necessary. 

Treatment depends on the specific diagnosis.  Generally, for minor symptoms, cutting back on the intensity or frequency of the sport can bring relief.  The challenge with this, however, is it can be very hard these days to negotiate fewer practices or less time spent participating in the sport.   There is often pressure to NOT slow down whether it comes from coaches or from the student-athletes themselves, who might fear losing out by slowing down.  Still, some sort of balance must be made to help the injury heal. Following the doctor’s orders is key, but also looking at ways to minimize more overuse is also important.  If symptoms persist, a sports medicine specialist can help to create a detailed treatment plan addressing the specific condition. In some cases, physical therapy is also helpful.

Prevention is always the best medicine 

Clearly, prevention is the best way to avoid these injuries.  Athletes should always get a pre-participation physical exam before playing their sport. This helps identify any underlying conditions or other areas of concern.  Also, following a structured warm-up program is a must.  Stretching before a workout and afterwards helps minimize muscle strains and other soft-tissue injuries. Athletes should also begin a general fitness routine (including strength, endurance and flexibility training) well before the season starts, usually at least two months prior.  Proper training, both before and during the season, can help prevent overuse injuries.  Last but not least - The American Academy of Pediatrics recommends that student-athletes playing one sport receive a minimum of one day off per week. 

Until next time,

Your All-Pro Team Mom

Resources

http://orthoinfo.aaos.org/main.cfm

www.aap.org