Guest Post by:

Brittney Lang, MS ATC
Athletic Trainer
MUSC Health Sports Medicine

Over the years, we as health care professionals are seeing more young athletes move from multiple sport participation to focusing on one particular sport, with possible multiple team involvement. With this move, we are seeing more orthopaedic injuries in younger athletes than ever before. Studies are showing that half of all injuries can be attributed to overuse and lack of rest due to constant training. This push for young athletes to participate solely in one sport is often by parents and coaches wanting the athlete to succeed. We as health care professionals need to be better advocates for these young athletes and help teach parents, coaches, and athletes signs and symptoms of overuse injuries and steps to help prevent or minimize the injuries.

Young boy pitching baseball

An overuse injury is damage to a bone, muscle, tendon, or ligament that has been subjected to repetitive stress without giving it sufficient time for rest and the natural reparative process. They can be broken down into 4 stages:

  1. Pain in the affected area after physical activity.
  2. Pain during physical activity but does not restrict physical performance.
  3. Pain during physical activity that does restrict physical performance.
  4. Chronic pain and constant pain even during rest.

Overuse injuries are more serious in the young athlete because children’s bones are not yet strong enough to handle the high amounts of stress put on them by the repetitive training. They also have not built up the muscles to perform the proper mechanics that are needed to perform the athletic activity for long periods of time. For example, a young baseball pitcher not using the full body to throw the ball and instead using just the arm possibly leading to injuries in the elbow and/or shoulder. One also must take into consideration that young athletes also may not be able to connect minor symptoms like fatigue to a possible bigger injury and therefore continue to participate. This is where proper education and guidelines for parents, coaches and athletes need to be set into place for prevention, injury reduction, and signs of injury.

 Another factor that needs to be addressed is over-training for the young athlete. With the major switch of young athletes to one sport, training and playing can be seen all year round. We are also seeing athletes playing on multiple teams, many of which at the same time, putting more stress on the athlete’s body with little rest. With sports teams being available at younger ages the push from parents and coaches to hone skills and succeed can be hard on the young athlete. And if the athlete wants to play a sport at a higher level one day it is stressed from a young age that one needs to play on travel teams, and go to training camps as well as play on recreational or school teams. Many sports have tournament schedules where athletes are playing for 2 to 3 days or more and there can be a couple games a day with no real rest during the week. Due to the high increase in playing time and lack of “free time” or rest, we are seeing a higher rate of burn-out at a young age for athletes. This can in turn also lead to injuries over time.

Well-rounded young athletes who participate in multiple sports tend to see fewer injuries and continue to play longer into their life. However, although multiple sport athletes tend to have fewer injuries there is still the risk of overuse injuries. This can be due to playing and training for multiple sports year round without rest and down time, as well as playing multiple sports with emphasis on the same body part, i.e., baseball and swimming. Young athletes should still have a break between seasons as well as from daily activity for adequate recovery.

We as health care professionals need to help stress proper training for these young athletes by providing necessary education and guidelines for all involved. This should help promote a healthy physical lifestyle throughout the athlete’s life. The education and guidelines for the parents, coaches and young athletes should promote fun, skill development and success in the activity. Young athletes should be monitored to reduce the rate of over participation and training in sports. Goals should be made for all involved on what the athlete wants to achieve in the sport. It is up to us, the health care professional, to be advocates for these young athletes when possible to help achieve healthy injury free lifestyles in sports.

Cited: Brenner, J. S. (2007, June). Overuse Injuries, Overtraining, and Burnout in Child and Adolescent Athletes. Pediatrics, 119(6).