Tuesday, September 28, 2010

Injuries in youth sports – Overuse is a common cause

Sports participation for today’s skeletally immature athletes is greater than ever before. The demand of the youth athlete to participate in sports year round is commonplace. Most youth athletes are either in multiple sports with no sign of downtime in sight or they participate in one sport year-round. The injuries that I am seeing today are mostly due to the over training of these kids. The typical bump, bruise, sprain/strain have given way to a mass influx of overuse injuries like meniscal tears and cartilage injuries, osteochondritis dissecans of the knee, Little League elbow and Little League shoulder, stress fractures, patellofemoral pain, shin splints, Osgood-Schlatter disease, and Sever’s disease. The sad part of all this is that they are all preventable but I am finding that the pressure of not being there or falling behind out-weighs listening to their body. Many kids succumb to the pressure of their parents to press on and deal with the injury. Only when the athlete complains enough or they are sidelined, then parents seek treatment for their child, when they should have sought treatment the day the injury announced itself.

Often when these kids visit my clinic they deny my recommendation to cease participation and want enough treatment to keep them in the game (basically get them well enough to continue training or playing). Overuse injuries don’t quickly heal and most of these injuries can require taking an entire season off.

Many of these kids are touted as “elite athletes” or “scholarship” kids. The mindset of the parent or youth is that if they don’t get to train or play, they will fall behind. The fact is, the injury that they have can haunt them forever and may worsen to the point of surgical intervention or that they are no longer the “elite ones”. Training or playing with any injury can affect all the great mechanics that they have work so hard to develop. These injuries can also affect other areas of their body which can create further injury (the snowball effect).

The other scenario that I see is when a child has never been involved in sports and then they are thrust into a training regime that their body hasn’t had time to develop into. These kids show up to practice and are expected to catch up rather than slowly work them into to the sport. Running sports such as track and cross country coupled with soccer are a common scenario that creates lower extremity overuse injuries. When I see these kids for treatment in my clinic the parent is often only interested in getting their child well enough to get them out of pain and back into their sport. They don’t follow the recommendation of slowly working their way back into the training program.

I have pondered long and hard about why some kids get injuries and other don’t. The child’s frame and genetics play a huge part in how they their body will react to what is asked of it. Is your child overweight or do they have and eating disorder? Do they have alignment problems in their feet, knees and hips? Many injuries occur during rapid growth periods that creates muscular tightness (the bones are growing faster than the musculature). Extrinsic risk factors may include intensity and frequency of play, playing surfaces, protective equipment, and coaching.

I have read that Pediatricians emphasize, “A child is not a little adult.” In sports medicine, we must remember that, “A child athlete is not a little adult athlete.” Their bodies are constantly changing and the forces that are placed on their frame during development can create injury or affect the way their body continues to develop.

I suggest that if your child is in youth or high school sports that you be ready for an injury to occur. If you have a child that is involved in ongoing participation in sports then you need to have a plan of action for taking care of those injuries and also a plan about what you are ready to do when they need to take time off. For most injuries, the body heals well if given the opportunity. Time out from sports or at least modified activity is often needed. If I can be of any assistance or if anyone has any questions about their injury please feel free to contact me at my office.


Dr. David Sommer, DC, CSCS

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