As more children and teens participate in organized sports, doctors are seeing an alarming increase in the number of young athletes suffering from overuse injuries. Nearly half of all sports injuries in middle and high school students are caused by overuse.

“Children and teens are at increased risk of these types of injuries because their bones are still growing and are more vulnerable to stress,” said Dr. Ashley Brouillette, a pediatric sports medicine primary care physician at Children’s. “They don’t want to be sidelined and so may play through the pain, not realizing the damage they are doing. While some soreness with sports is expected, any significant or prolonged pain should be evaluated by a specialist.”

What is an overuse injury?
An overuse injury is damage to a bone, muscle, ligament, or tendon due to repetitive stress. These injuries occur over time, usually from improper training or improper technique when performing repetitive motions (for example, running, overhead throwing, or serving a ball in tennis). Overuse injuries occur in athletes playing all kinds of sports, from football and swimming to baseball, tennis, and golf.

Unlike traumatic injuries like fractures or cuts, overuse injuries can be difficult to diagnose because the symptoms are often subtle and can include:
• Pain that gets worse when your teen is active
• Swelling
• Limping
• Limited range of motion
• Pain that continues for a while, worsens or lasts for a week or more following injury

How to prevent overuse injuries
According to Dr. Brouillette, one reason for the increase in these types of injuries is that more young children, sometimes as young as seven, are focusing on one sport year-round, which leaves these athletes vulnerable to overtraining, stress, and burnout.

She recommends the following strategies to prevent these injuries:
• Schedule your teen for an annual physical evaluation before participating in sports.
• Schedule a sports motion analysis session to have your teen’s mechanics analyzed. Proper technique decreases the risk of injury and helps improve performance.
• Encourage your athlete to warm up properly before an activity by engaging in dynamic warm-up exercises, like jogging in place, high knees, butt kicks, walking lunges, and “world’s greatest stretch”. Static stretching should be done post-activity once the muscles are already warm
• Use the 10% rule when increasing training: Don’t increase training activity, weight, mileage or pace by more than 10% a week.
• Athletes should take at least one day off from organized activity each week and at least three months off during the year (in one-month increments) between sports.
• Hours of sport-specific training per week should not exceed age in years
• Encourage your child to try a variety of sports involving different movement patterns and muscle groups. Young athletes who play the same sport year-round or sports with similar body demands (such as the overhead shoulder motions of swimming and pitching) are more likely than others to experience overuse injuries.
• Ensure sports equipment and protective gear, such as running shoes and helmets, fit and are worn properly
• Be aware that overuse injuries can occur during practice as well as during games.

“It’s important your athlete is able to participate normally without a limp or altered mechanics,” said Dr. Brouillette. “This can help avoid repeat injuries and more time on the bench.”

Children’s Healthcare of Atlanta