Overuse Injuries in Children

Overuse injuries, overtraining, and burnout among child and adolescent athletes are growing problems in the United States. As more and more kids play recreational and organized sports and as the age for team sports and team sports training continues to get younger, there has been a rise in the number of overuse injuries seen among children and adolescents.

Causes

Young athletes may be particularly at risk for sports-related overuse injuries as a result of improper technique, poorly fitting protective equipment, training errors, and muscle weakness and imbalance. Today’s youth face fewer daily physical stresses than their parents or grandparents did, yet they also experience an increase in specific stresses that are placed on them during sports and athletic training activities.

Stress Fractures and "Little League Elbow"

Some overuse injuries are more common in children because of the softness of their growing bones and the tightness of their ligaments and tendons during growth spurts. Untreated overuse injuries can lead to stress fractures—weak spots or small cracks in the bone. Certain overuse sports injuries, such as “Little League elbow” - which refers to damage to the growth cartilage in the elbow joint caused by repetitive whipping motions of the arm - are seen exclusively in child athletes because of their still growing and developing bodies.

Overuse Injuries in the Knee and Heel

Patellar pain syndrome - an alignment problem in the knee caused by overtraining - is the number-one diagnosis in my clinic today, even though it had never been seen in kids until the growth of organized sports. Other overuse sports injuries seen mostly in children include osteochondritis dissecans of the knee and ankle (repetitive grinding together of bones that causes damage to the growing surface cartilage and may result in pieces of dead bone and cartilage dropping into the joint and wreaking havoc), Osgood Schlatter's syndrome (inflammation at the point where the tendon connects the kneecap to the very top of the shinbone) and os calcis apophysitis (inflammation at the point where the Achilles tendon attaches to the heel).

Silent Danger

One of the most disturbing aspects of overuse injuries is the subtle, gradual harm they cause. Often kids won't admit to being sore - they just drop out of sports, often for life. When these injuries go undetected, the damage to a growing child's hard and soft tissues can be permanent. Evidence suggests that overuse injuries sustained in childhood may continue to cause problems later in life, such as arthritis.

Prevention and Early Detection

It is so important to catch overuse injuries early and not let them go until the end of a season. Parents should also carefully monitor their children’s practice activities. Beware if a coach seems to be requiring “too much, too soon.” Insist on rest days following heavy practice and competition, monitor your child’s growth spurts, make sure they have the proper equipment and that it is replaced as often as necessary, and keep a watchful eye on their nutrition. By taking a pro-active role, you can help your child’s athletic experience to be as injury free as possible.

William Felix-Rodriguez, M.D., is a board-certified primary care sports medicine and emergency medicine specialist with Jewett Orthopaedic Clinic’s Lake Mary office and Orthopaedic Convenient Care Center. He can be reached at 407-206-4500 or visit www.jewettortho.com.