The number of children and teenagers visiting doctor’s offices with overuse injuries is climbing dramatically. An overuse injury is any type of muscle or joint injury – such as tendinitis, shin splints, or a stress fracture – that’s caused by frequent repetitions of the same movements. These types of injuries occur in a wide range of sports, including baseball, basketball, track, soccer, dance, gymnastics, and more. Some of these injuries are unique to a certain sport, such as elbow and shoulder injuries prevalent in baseball players. The most common overuse injuries involve the knee and foot.

Overuse injuries – doing too much, too often – occur when muscles, tendons or ligaments experience higher stress than they are used to. An overuse injury typically stems from:

• taking on too much physical activity too quickly
• exercising for too long
• doing too much of one type of activity
• improper technique and/or poor form

Nationally renowned orthopedic surgeon Dr. James Andrews said that he is seeing four times as many overuse injuries in youth sports than five years ago and more kids are having surgery for chronic sports injuries.

Why are Overuse Injuries on the Rise in Youth?

Experts attribute this increase to the fact that more youth today are specializing in one sport year-round.

In previous generations, youth switched to a new sport each season. For example, it was common for a young boy to play football in the fall, soccer in the winter, and baseball in the spring with small rest periods between each sport. Playing multiple sports, at different times of the year, is a form of cross-training that gives some muscles a chance to rest while others are being worked.

This type of athlete seems to be a thing of the past.  As organized youth athletics has grown in popularity, the pressure to compete has led to children specializing in one sport all year long. Many parents and coaches believe that athletes who are not playing for the entire year are losing a competitive advantage over someone else who is playing year-round.

The problem is that when a child participates in just one sport throughout the year, he or she continually uses the same muscle groups and applies unchanging stress to specific areas of the body. Complicating the situation is that youth are still growing, which also puts stress on their bodies.

Orthopedists say that omitting a rest period between seasons and not switching to activities with alternate motions and stress loads are major factors in the risk of overuse injury and burnout.

“As an orthopedic surgeon, I can tell you that most of the injury cases I treat could have been prevented if the young athlete was given ample time to rest and heal,” said Dr. Douglas Mangan, an orthopedic surgeon in Arizona.

“Parents think the more you pitch [for example], the better you are going to be in terms of playing further into college or into the professional level, but we believe, as physicians, the more you throw at that level, the less chance you have of a long career playing baseball or moving on to the next level because of the overuse injuries we see limiting these players long term,” said Dr. Grant Jones, an orthopedic surgeon and professor at Ohio State University.

What Does the Research Say?

The idea that sports specialization is a problem has been supported by research. For example, in the September 2018 issue of the Pediatrics Journal, researchers organized athletes into three categories: low specialized athletes who played a wide variety of sports; moderately specialized athletes who spent at least some time on two or more sports, and highly specialized athletes that focused on one sport year-round. Highly specialized athletes were 18% more likely to have an overuse injury than moderately specialized athletes, and moderately specialized athletes were 39% more likely to have an overuse injury than athletes who played a wide variety of sports.

How Can Parents Prevent Overuse Injuries in Children?

Most overuse injuries are avoidable. Here are some prevention tips:

Build in rest. Young athletes need to vary their training just like professional athletes do. All pros have an off-season where they change their training routine and rest more. They still specialize in one sport, but they adjust their seasonal training to allow complete recovery. No one can go 100% in a sport year-round without risking injury or reduced performance.

Vary training. Instead of focusing on one type of exercise, build variety into your fitness program. Incorporating a variety of low-impact activities — such as walking, biking, and swimming — can help prevent overuse injuries by allowing your body to use different muscle groups. For competitive athletes, include strength training for the major muscle groups in your arms, legs and core at least twice a week, as well as daily stretching for increased flexibility.

Pace yourself. If your child is starting a new fitness program, be careful. Make sure that the changes in the intensity and duration of a physical activity are gradual. For example, if you want to increase the amount of weight you’re using while strength training, increase it by no more than 10 percent each week until you reach your new goal.

Learn proper form. Take lessons or find a reputable coach who knows the proper form for different physical activities. That might even mean more than one coach – a trainer who knows proper exercise form and a sports coach who knows proper form for different moves particular to the sport. Using the correct technique is crucial to preventing overuse injuries.

Do not play through pain. Many young athletes believe pain is a sign of weakness, but it’s your body’s way of warning of a potential injury. Let your teen know that playing through pain isn’t a badge of honor, but rather a sign that they need to do something different, such as rest or improve form, or they will end up sidelined for a longer period of time.

Final Thoughts…

Typically, young athletes are advised to rest an overuse injury about 3 months before they return to the particular sport. Overuse injuries that go untreated, are not properly rested, rehabilitated or subsequently avoided through proper techniques, can progress to additional injuries and permanent limitations. Our youth are best served by preventing injuries in the first place. Make sure your young athlete cross-trains, takes a season of rest, begins new activities gradually, and engages in different types of physical activities throughout the year.