Preventing Overuse Injuries in Youth Athletes

OVERUSE INJURIES IN YOUTH SPORTS

Sports participants of any age can suffer acute or overuse (chronic) injuries.  Acute injuries are those that happen unexpectedly to an otherwise healthy participant; examples include muscle strains, joint sprains, and fractures.  Overuse injuries are those that develop over time because of repetitive stress; examples include tendinitis, stress fractures, and “shin splints.”  Pediatric/adolescent overuse injuries are those repetitive stress injuries that are happening in participants under the age of 18.  There are approximately 30 - 35 million sports participants between the age of 5 - 18 (Soprano & Fuchs, 2007), causing a significant increase in the number of pediatric overuse injuries.  Studies have reported that overuse injures account for an estimated 50% of all athletic injuries, requiring twice as many visits to sports medicine physicians as acute trauma (Cuff, et al., 2010; McLeod, et al., 2011). There are also approximately 2.6 million emergency department visits in the United States for sports-related injuries for those between age 5 -24 years old, with the highest percentage being in males 5 - 14 years old (Soprano & Fuchs, 2007).

There has been significant focus on the prevention of pediatric overuse injuries because of their increasing occurrence and the potential for long-term rehabilitation programs and significant missed participation time (McLeod, 2011).  Youth athletes are participating in sports with developing skeletons leading to the possibility of growth plate injuries such as Osgood-Schlatter’s, Sever’s disease and others (McLeod, 2011; Soprano & Fuchs, 2007).  These conditions can cause significant pain and disability and are best treated by preventing them in the first place.  The exact causes for such repetitive stress injuries are unknown due to lack of research, but suggestions are that injuries can be the result of improper technique, training errors, excessive sport training, and muscle imbalances or weakness (McLeod, 2011).

Focusing on the prevention of these overuse injuries the National Athletic Trainers’ Association issued a position statement (April 2011) in an effort document the best practice to date on the prevention of pediatric overuse injuries.  The position statement addresses the following areas as key steps in preventing overuse injuries:

• Injury surveillance research
• Pre-participation physical examination
• Identify risk factors
• Coach education and medical supervision
• Sport alteration
• Training and conditioning programs
• Sport specialization

Overuse injuries are not life-threatening events, but they can be very painful and debilitating.  It is just as important for parents to understand how to prevent overuse injuries as it is to be prepared for an emergency.  Parents are critical in making sure that their children are getting an appropriate amount of rest and limiting the number of months during a given calendar year that they participate.  The amount of time spent participating in sports in a given calendar year is the biggest controllable risk factor for injury based on available research (Cuff, Loud & O'Riodan, 2010).  Given the growing number of private leagues and the continued availability of school sport programs athletes may also be participating in two sports concurrently.  Appropriate rest is necessary for proper recovery.  Parents should be sure their youth athletes are getting the necessary rest in a given athletics season and calendar year.

While the information provided by the NATA is a good jumping off point for parents, its intended audience is athletic trainers and other health care providers.  This begs the question, what resources are out there for parents who want to learn more about overuse injuries?  STOP Sports Injuries is a campaign and website developed by a coalition of organizations and corporations invested in preventing overuse and traumatic injuries in kids.  I have focused on this particular campaign because of the resources it makes available to parents.  There are educational resources available about a variety of injuries, tip sheets for preventing overuse injuries, and sport specific tip sheets just for starters.  There is also a blog, media resources and a repository of key position statements regarding the care of young athletes.  Simply click on “STOP Sports Injuries” link and look around.

REFERENCES:

Cuff, S., Loud, K., and O'Riodan, M.A. (2010).  Overuse injuries in high school athletes.  Clinical Pediatrics, 49(8):  731 - 736.  Available at http://cpj.sagepub.com/content/49/8/731.

McLeod, T.C., Decoster, L.C., Loud, K.J., Micheli, L.J., Parker, J.T., Sandrey, M.A., and White, C.(2011).  National Athletic Trainers' Association position statement:  Preventing pediatric overuse injuries. Journal of Athletic Training, 46(2):  206-220. Available at http://www.nata.org/sites/default/files/Pediatric-Overuse-Injuries.pdf.

Soprano, J.V. and Fuchs, S.M. (2007).  Common overuse injuries in the pediatric and adolescent athlete.  Clinical Pediatric Emergency Medicine, 8(1):  7 - 14.  Available at http://www.clinpedemergencymed.com/article/S1522-8401(07)00010-9/fulltext.

Submitted by Heather L. Clemons, MS, MBA, ATC