As coaches who work with young athletes-we are carrying great responsibility!

Not knowing how we are influencing the health of our young athletes is just not good enough excuse!

So what are the overuse injuries?

The overuse injuries occur gradually over time, when certain athletic activity is repeated so often that the areas of the body don’t have enough time to heal between the practices. 😮

Nowadays it is common for a child to play just one sport year-round. And many children play in more than one team at the same time, as well. (Sounds familiar?) 🙂

So, when a young athlete participates in just one sport throughout the year, he or she continually uses the same muscle groups and applies the same stress to specific areas of the body. This can lead to muscle imbalances that, when combined with over training and inadequate periods of rest and recovery, put young athletes at serious risk for overuse injuries.

And because young athletes are still growing, they are at a greater risk for injury than adults. The consequences of overdoing a sport can include injuries that impair growth, and may lead to long-term health problems.

Overuse injuries can affect muscles, ligaments, tendons, bones, and growth plates. In children, these structures are still growing, and the growth is generally uneven. Bones grow first, which pulls at tight muscles and tendons. This uneven growth pattern makes younger athletes more sensitive to muscle, tendon, and growth plate injuries.

Growth plates are the areas of developing cartilage where bone growth occurs in children. The growth plates are weaker than the nearby ligaments and tendons. Repetitive stress can lead to injury of the growth plate and disrupt the normal growth of the bone.

So let’s dive in short explanations for some of the most common overuse injuries!  🙂

Heel

Sever’s disease is a common cause of heel pain in growing kids, especially those who are physically active. It’s a painful bone disorder that results from inflammation (swelling) of the growth plate in the heel.

A “growth plate”, also called an epiphyseal plate, is an area at the end of a developing bone where cartilage cells change over time into bone cells. As this occurs, the growth plates expand and unite, which is how bones “bloom”, I mean grow.  🙂

It usually occurs during the growth spurt . It’s approximately 2-year period in early puberty when kids grow the fastest. This growth spurt can begin any time between the ages of 8 and 13 for girls and 10 and 15 for boys.

Sever’s disease rarely occurs in older teens because the back of the heel usually finishes growing by the age of 15, when the growth plate hardens and the growing bones fuse together into mature bone.

Shoulder

Proximal humeral epiphysitis is an injury to the upper arm bone at the shoulder. It happens to young athletes who are still growing. This problem is caused by a lot of throwing. Repetitive throwing puts stress on the growth plate, and the growth plate becomes irritated. In severe cases, the stress may lead to a small break in the growth plate.

Elbow

Medial apophysitis  is an injury to the upper arm bone at the elbow. It happens to young athletes who are still growing. This elbow injury is caused by overuse of the arm, usually from too much throwing. The bones of young children are still growing. Repeated throwing causes wear and tear on the new, weaker bone in the elbow. In severe cases, the growing bone may actually break away from the rest of the upper arm.

The main symptom is pain at the inner side of the elbow. It can swell and the elbow may be tender to touch.

Knee – Sinding-Larsen-Johansson

Sinding-Larsen-Johansson (SLJ) syndrome is a painful knee condition that mostly affects teens during periods of rapid growth. SLJ syndrome is a juvenile osteochondrosis that disturbs the patella tendon attachment to the inferior pole of the patella.

It is an inflammation of the bone at the bottom of the patella (kneecap), where the tendon from the shin bone (tibia) attaches.

Repetitive stress on the patellar tendon can cause this growth plate to become irritated and inflamed. SLJ mostly happens between the ages of 10 and 15 because that’s when most of us have growth spurts. SLJ is more common in teens who play sports that require a lot of running or jumping, because these activities put excess or repetitive strain on the knee.

Some authors classify SLJ as a pediatric version of “jumper’s knee”. But unlike “jumper’s knee” which is seen at any age, SLJ syndrome is seen in active adolescents, as already mentioned – between 10-15 years of age.

Symptoms: localized pain, swelling or tenderness is felt at the front of your knee – at the base of your patella (kneecap), where the patella tendon inserts into the patella.

Knee – Osgood-Schlatter disease

Osgood-Schlatter disease is an inflammation of the bone, cartilage, and/or tendon at the top of the shinbone (tibia), where the tendon from the kneecap (patella) attaches. Most often only one knee is affected.  OSD usually strikes active adolescents around the beginning of their growth spurts, the approximately 2-year period during which they grow most rapidly.

Long-term consequences of athletic injuries

On a long-term basis, the consequences of a sports injury may include decreased sports participation in later life, as well as loss of function and chronic pain.

The literature on long-term consequences of injuries in youth sports is poor, most investigations were focused on the adult population.

*This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopedic advice or assistance should consult his or her orthopedic surgeon or doctor.

References:
Adirim TA, Cheng TL. Overview of injuries in the young athlete. Sports Med2003
Gillquist J, Messner K. Anterior cruciate ligament reconstruction and the long-term incidence of gonarthrosis. Sports Med 1999
Krivickas LS. Anatomical factors associated with overuse sports injuries. Sports Med 1997
Maffulli N, Magra M. The younger athlete. In: Brukner P, Khan K, editors. Clinical Sports Medicine. North Ryde: McGraw-Hill Australia; 2006
Myklebust G, Engebretsen L, Braekken IH, Skjolberg A, Olsen OE, Bahr R. Prevention of anterior cruciate ligament injuries in female team handball players: a prospective intervention study over three seasons. Clin J Sport Med 2003
McGuine T. Sports injuries in high school athletes: a review of injury-risk and injury-prevention research. Clin J Sport Med 2006