These days, it is not uncommon for a 12-year-old to participate on 3 soccer, baseball, hockey or volleyball teams all at the same time. What’s more, this number of over-committed young athletes continues to grow.
However, proper education and communication between physician, coach, athlete and parents can prevent this epidemic of injuries so that sports can continue to provide health benefits for our young people, states Westchester Health Orthopedics and Sports Medicine specialist Eric Small, MD in a recent blog.
What causes overuse sports injuries
The cause of overuse sports injuries in adolescents can be characterized by intrinsic and extrinsic factors.
Intrinsic factors include: alignment, muscle imbalance and prior disease states.
1. Alignment. Several basic alignment issues predispose a young athlete to overuse injuries, knee pain (patellafemoral pain syndrome) and shin pain (medial tibia stress syndrome):
- varus deformity (bow leggedness)
- valgus deformity (knock knees)
- pes cavus (high arches)
2. Patellafemoral pain syndrome. Patellafemoral pain syndrome is characterized by nonspecific pain around the knee. This condition is more common in females because of several reasons, including an enhanced Q angle (the measurement of the angle between the quadriceps muscles) and an abnormal quad/hamstring ratio.
3. Muscle imbalance. Muscle imbalance is another common contributor to overuse sports injuries in adolescents. Athletes who primarily do an overhand sport (tennis, baseball or swimming) suffer from shoulder imbalances.
4. Prior Disease States. Athletes who have experienced a prior un-rehabilitated injury are prone to suffering the same injury again. For example, athletes who have suffered from shoulder/elbow, patella or Achilles tendonitis are likely to suffer the same injury again.
1. Training Error. A training error can be defined as too much, too soon and too fast. An athlete must take into account the volume and intensity of training when setting up an exercise regimen.
2. Shin Pain. Shin pain is a common complaint in active young athletes. Treatment includes icing, decreasing impact activities by 30-50%, plantar flexion/dorsiflexion stretching and strengthening.
3. Hydration. Inadequate hydration plays a key role in contributing to overuse injuries, particularly in young athletes. Children and adolescents need to hydrate (an extra 8 ounces of fluid) prior to exercise to ensure adequate muscle hydration.
4. Nutrition. A pre-competition snack containing 300-800 calories should be consumed 1.5-3 hours prior to training and should contain protein, carbohydrates and low fat.
5. Equipment. The equipment that an athlete uses is an extremely important factor in contributing to overuse injuries. Shoes that are too old, worn and improperly fitted can lead to lower extremity tendonitis and stress fractures. Running shoes should be changed every 250-300 miles or every 6 months. Soccer cleats provide little arch support and therefore shoe inserts are recommended. Similarly, a tennis racquet, baseball bat or lacrosse stick that is too heavy or too light may alter biomechanics of sports movement and lead to overuse injuries of upper/lower extremities or the lower back.
6. Apophysitis. Apophysitis conditions (muscle-tendon-bone friction/inflammation) are seen on a daily basis in the primary care physician’s office. These clinical issues are a result of muscle imbalances and training errors.
To read Dr. Small’s blog in full, click here.