The most common injuries we see in youth sports are overuse injuries. By their very nature, overuse injuries are insidious. They develop gradually over time with repetitive motions and inadequate time for recovery. As such, they can be harder to detect early on before significant time away from sport is required. However, you can prevent many of these injuries by carefully monitoring training load, encouraging rest and recovery, teaching proper technique, and reacting quickly when pain does occur.
HOW OVERUSE INJURIES OCCUR
Overuse injuries occur in developing athletes when bones, tendons, and muscles are stressed faster than they can recover or grow stronger. Growth plates (physes) are weaker than adult bone and can be irritated with repetitive loading from running, jumping, throwing, and more. Since there may not be significant inflammation during the early stages of injury, athletes can do training sessions, practices, and games until pain is present most of the time or performance begins to decrease.
COMMON YOUTH OVERUSE INJURIES
Like acute injuries, overuse injuries are common at sites of frequent impact or stress. Stress fractures can occur throughout the lower half after repeated impacts, particularly in the tibia or foot. Similar overuse injuries occur where muscles attach to bones that are growing quickly, like Osgood-Schlatter disease or Sever’s disease.
Repetitive throwing, running, or jumping can lead to tendinopathy when given inadequate rest. Overuse injuries can happen to young athletes of any sport.
KNOW SOME KEY RISK FACTORS
There are several important risk factors for overuse injuries. Training a large amount in one sport year-round is one of the most significant contributors. Doing the same activity week after week places large amounts of stress on certain tissues without allowing time to recover.
Many athletes who struggle with overuse injuries spend the majority of their time training in one sport. These athletes often have little to no rest days or significant time off throughout the year. High rates of participation and competitive play during athletic season also increase the training load.
Another big risk factor is growth. Many muscles and tendons become tighter during growth spurts as bones get longer. These stresses can lead to pain at the joints and attachments. Other factors such as poor technique, inadequate fitness levels, and pressure from coaches and parents can also increase risk.
LOOK FOR THESE EARLY SIGNS
Many overuse injuries start as pain that occurs during or after sport that resolves with rest. As more time is spent training and playing on the injured tissue, this pain typically returns and worsens. There can be swelling, stiffness, and local tenderness.
Often young athletes will limp or change their throwing/golf swing/running form to compensate for pain. Decreased endurance and “tightness” are also very common. Some athletes may avoid practice, become irritable when discussing the sport, or not want to push themselves.
Any pain that lasts more than 1-2 days and does not improve with rest should be evaluated. Pain that worsens over time or occurs when not participating in sports is another red flag.
PREVENT OVERUSE INJURIES WITH INCREASES IN TRAINING
The best way to avoid overuse injuries is to progress training slowly. A common rule of thumb is known as the 10% rule. This rule states that you should not increase either the duration or intensity of training by more than 10% each week. This allows your body to adapt to new loads.
Tracking your sports time, intensity, and days off from training can help identify when you may be at risk of an injury. Taking at least one or two complete rest days per week is ideal for recovery and allows continued growth and development.
REDUCE STRESS BY CROSS-TRAINING
A great way to prevent overuse injuries is to play multiple sports. When athletes play one sport all the time, they are using the same motor patterns and placing repetitive stress on the same tissues. By encouraging athletes to try many sports, you can reduce this repetitive stress.
Cross-training by playing sports like baseball, swimming, hockey, or cycling can help athletes improve cardiovascular fitness without adding stress to overused tissues.
ENCOURAGE REST AND RECOVERY
Just as important as training is recovery. Getting enough sleep, eating a balanced diet, and hydrating are all important to allow the body to repair itself and improve athletic performance. Fueling with enough protein and nutrients like calcium and vitamin D are especially important during growth periods.
This is another reason why taking an off-season or extended break from your primary sport is beneficial. More breaks allow more time for recovery and less overall stress on developing bones, muscles, and tendons.
RETURN TO PLAY GRADUALLY AFTER AN INJURY
If an athlete does get an overuse injury, it is critical that they take enough time off to allow for full recovery. Not only should they be pain-free at rest, but they should not experience any pain with activity. They should also demonstrate normal strength and range of motion.
Before returning to sport, they can perform functional tests to assess readiness. Balance, strength, and hop tests are common ways to test injured athletes. Sport-specific progression drills should also be completed before returning to game situation. Rushing return to play can cause re-injury and prolonged recovery time.
CONCLUSION
As you can see, most overuse injuries can be prevented with some simple precautions. Monitoring your athletes training load, encouraging rest, cross-training, and reacting quickly to pain can prevent most injuries from occurring. It is important to remember we are striving for health long into the future, not just performance today.
Communication between athletes, parents, coaches, and clinicians is the best way to keep sport safe and appropriate for your athlete’s stage of development.
Frequently Asked Questions
Q: How much rest should I be giving my young athlete?
A: Ideally athletes should take one to two complete rest days per week. It is also beneficial to take scheduled breaks from your sport throughout the year. This gives your body a chance to recover from the stresses of training and competition.
Q: Is it okay for kids to specialize in one sport early?
A: Early sport specialization can significantly increase your risk for overuse injuries. You put large amounts of repetitive stress on tissues when participating in one sport. While most adult athletes are able to withstand this stress, children are still developing both physically and mentally.
Multi-sport participation is encouraged throughout childhood and early adolescence.
Q: When should I bring my child to see you for sports-related pain?
A: If pain is present for more than one to two weeks, becomes worse with activity, is present at rest or night, or is affecting sports performance it is time to seek medical attention. The earlier that most injuries are caught, the easier they are to treat.
Stopping minor problems from becoming larger problems is one of the best ways to prevent missed time from sports.