There has been a big push in the sports medicine community to educate the public, coaches, and players about concussions, but another area of concern is the increasing numbers of overuse injuries in youth sports. As more children and adolescents participate in organized and recreational sports, physicians are seeing an increasing number of children and adolescents with overuse injuries caused by too much training and not enough rest. Some experts believe this may be due to some youth specializing in one sport and training year around. Gone are the days of the two or three sport athlete where changing sports was the norm, and now just playing one sport year around. With this specialization comes with a price. Playing a variety of different sports throughout the year was a form cross-training that was extremely beneficial to a young body’s physical development. Playing multiple sports, at different times of the year gives some muscles a chance to rest while others are being worked. Now those same muscles and joints are used none-stop and have no recovery time. The risks often exceed those faced by adults who get carried away with a chosen sport because young athletes are still growing mentally and physically, and so are vulnerable to certain injuries, some of which can compromise growth.
An overuse injury is defined as a micro traumatic injury to a bone, muscle or tendon that has been subjected to repetitive stress without sufficient time to heal or undergo the natural healing process. Common things I see in the office is children’s heel pain, or Severs disease, and occasionally Osgood-Schlatters disease, a form of knee pain. Some school-age competitors who are inadequately prepared, or improperly coached, continue to develop serious overuse injuries. The American Academy of Pediatrics has said the goal of youth participation in sports “should be to promote lifelong physical activity, recreation and skills of healthy competition” — not the hopes of obtaining a college scholarship, or making an Olympic or professional team.
In light of the already high, and probably increasing, rate of pediatric overuse injuries, the National Athletic Trainers’ Association in March issued a position paper replete with recommendations that can help prevent these injuries and enable children and adolescents to stay in the game without compromising their health.
Athletes, parents and coaches should all be familiar with the symptoms of an overuse injury. These include:
• A gradual onset of pain, or pain presenting as an ache.
• No history of direct injury.
• Stiffness or aching after or during training or competition.
• Increasing periods of time for pain to resolve.
• Point tenderness, visible swelling, and missed training sessions as a result of pain or injury.
Children should undergo a thorough physical examination each year prior to participating in a sport, and if injured during the season, appropriate follow-up with a specialist is highly advisable.