How To Prevent Overuse Injuries in Young Athletes

Young athletes who specialize in one sport often view their dogged training as a route to athletic success. But the intense workload often leads to another destination: A doctor’s office.

Overuse injuries account for more than 50% of medical visits by young athletes. Study after study shows that repetitive stress from focused year-round training puts children at greater risk of getting hurt.

So, how can you keep your child injury-free and in the game as they chase after goals? Let’s put a playbook together with sports medicine specialists Molly McDermott, DO, and Paul Saluan, MD.

Factors leading to overuse injuries

Do something once, like throw a baseball, and your body barely notices. But do it 10,000 times over months or years of relentless training, and you begin to learn the true meaning of wear and tear.

Repeating the same movement again and again stresses affected muscles, tendons and even bones, says Dr. Saluan. That’s a reality that makes one-sport athletes particularly vulnerable to injury.

“You have kids who live, sleep and breathe a sport — and they’re paying a price,” he states.

But while training volume is a driving force behind overuse injuries, it’s not the only factor putting young athletes on the injured list. Other contributing causes include:

• Training intensity: The high intensity level of many year-round training programs drives up injury risk. Many young athletes push harder for longer without giving their bodies time to recover. Physical breakdowns become almost inevitable in that scenario.
• Improper mechanics: Less-than-perfect form during an activity can add strain to already taxed joints and muscles. “It’s essential for young athletes to learn proper form before increasing workload to stay healthy as they train,” says Dr. McDermott.
• Conditioning level: Athletes are more prone to injury when they push to reach a high level of performance too quickly or following a layoff or interruption. “There’s a process that needs to be followed to build up,” says Dr. Saluan.

Common types of overuse injuries

Overuse injuries in young athletes can affect nearly any part of their body from head to toe. These injuries — which cut across many sports — are among the most common.

• Achilles tendinitis (back of the ankle/lower leg)
• Back injuries (like spondylolysis)
• Hip flexor strain
• Iliotibial (IT) band syndrome (upper leg and knee)
• Little League elbow and shoulder
• Osgood-Schlatter disease and patellar tendinitis (knee)
• Plantar fasciitis (foot)
• Rotator cuff tendinitis (shoulder)
• Sever’s disease (heel)
• Stress fractures (most common on weight-bearing bones in the lower body)
• Tennis elbow and golfer’s elbow
• Wrist strain

Signs of overuse injuries in young athletes

How can you tell if your young athlete is pushing their training a little too far? Signs of potential overuse injuries include:

• Joint or muscle pain during an activity
• Stiffness, swelling or loss of motion after activities
• Unusual fatigue despite getting normal rest
• Changes in sleep routines, especially if it’s linked to pain
• Unexplained moodiness
• Decline in physical or academic performance

“Sometimes, young athletes won’t be open about how they’re feeling because they’re worried about being shut down — and that can be challenging,” recognizes Dr. McDermott. “Trust your gut if you sense that something is off.”

Preventing overuse injuries in young athletes

The best defense against overuse injuries can be summed up in three words: Take time off.

A three-month break is recommended for young athletes focused on a single sport, says Dr. Saluan. Stepping away from the activity allows the body — specifically, overtaxed joints and muscles — time to recover.

But to be clear, the recommendation for a “break” isn’t a challenge to log 90 consecutive days on a couch. “Keep moving your body,” he advises. “Just move it differently.”

That means switching things up. If you’re a runner, maybe try swimming for a bit to lessen the pounding on your knees and ankles. (Vice versa, too.) Or just dedicate a few months to full-body weight training.

In the old days, that happened naturally as young athletes moved from sport to sport with the seasons. The pattern minimized overuse injuries because different activities work different areas of the body.

“But by focusing on just one sport, the concern is that these young athletes are accelerating joint degradation,” says Dr. Saluan. “There’s a fine line between being active and healthy and overdoing it.”

In-season tips to prevent overuse injuries

The in-season grind of training and competition can make young athletes more susceptible to overuse injuries. Encouraging kids to follow these tips may offer some defense, says Dr. McDermott.

• Take rest days. Young athletes should set aside at least one day a week for rest. And rest means REST. “It should be a full day off to let the body recover,” emphasizes Dr. McDermott.
• Get enough ZZZs. Sleep allows young bodies and minds to recharge to meet tomorrow’s challenges. Be wary of school and training schedules that steal hours of shut-eye.
• Eat healthy. Late practices can lead to less-than-nutritious food grabbed on the go. Young athletes need the right fuel in their tanks to operate at peak efficiency.
• Stay hydrated. Drinking enough fluids can boost performance and help prevent injury.

“The idea is to build a mentality that recovery and taking care of your body are key parts of being an athlete,” she adds. “It’s not just about pushing through training. It’s about being ‘the best’ outside of that, too.”

Impact of overuse injuries on young athletes

Trying to push a young athlete through an overuse injury can lead to long-term damage. Joint degradation at an early age can set the stage for arthritis and chronic tendonitis years in the future.

Young athletes need to listen when their bodies communicate through pain, stiffness or soreness. What seems like a small problem can quickly blossom into a more serious injury if ignored.

“Pain is not something that should be tolerated in young athletes,” states Dr. Saluan. “It’s a call for attention.”

Are children more prone to overuse injuries?

Absolutely.

“Repetitive stress takes a toll on the body, especially at the growth centers of young athletes who are vulnerable to injury before skeletal maturity,” explains Dr. McDermott. “That’s a big reason we see so many overuse injuries in kids.”

Final thoughts

Self-awareness is critical for athletes to avoid overuse injuries. Knowing when something feels off and — more importantly — taking steps to address it is key to staying healthy and in the lineup.

Taking time off isn’t always easy, given the pressure to succeed that often comes with sports.

“That’s where mindset comes in,” notes Dr. McDermott. “If we can start thinking of recovery and rest as part of being an athlete, we may be able to reduce overuse injuries and help kids stay healthy and fit.”

Or to put it another way: “The best way to deal with an overuse injury,” says Dr. Saluan, “is to stop it before it happens.”