The health benefits of being physically active are generally well known and widely accepted. For many of us, activities such as running, biking, swimming and playing sports are part of our regular routines. However, when we train particularly hard in one sport or activity (for example, doing a single motion or a series of motions repeatedly), an overuse injury is more likely to occur. 

According to a scholarly article published by the National Institute of Health (NIH), approximately 50 percent of all sports participants will be injured, and at least half of these injuries will be attributed to overuse. It cites the most common overuse injuries occurring in the adult population as epicondylitis (tennis elbow, golfer’s elbow), shoulder impingement/rotator cuff tears, patello-femoral dysfunction (pain under the kneecap at contact with the thigh bone), Achilles tendonitis and what it calls the "ultimate" overuse injuries: stress fractures.

Advice to Children: Don’t Focus So Hard
Likewise, while playing organized sports is one of the best and most popular ways children and teenagers stay active, today’s young athletes tend to concentrate on a single sport, instead of playing multiple sports, and they are training and competing year-round. It’s not surprising then that orthopaedic practices are finding a much higher incidence of overuse injuries in young people than they did a generation ago. About a quarter of these injuries are found to be serious.

And they are not necessarily something children will grow out of. Preteen and teenage athletes are often still growing, and sports injuries that happen in high school, or even younger, can continue into adulthood or resurface later in life to cause issues, including surgery and arthritis. 

A Growing Concern
All parts of the human body do not grow at the same rate, and faster-growing bones tend to pull muscles and tendons taut. Bones regenerate in a process called remodeling, and stress fractures result when the amount of bone breakdown for remodeling exceeds the ability of new bone to form. Athletes who over-train cause older bone to break down more rapidly than the body can make new bone, leaving the bone weak and vulnerable.

Children have growth plates, which are areas of cartilage tissue near the ends of long bones that expand and ossify (turn to bone), creating longitudinal bone growth. Growth plates harden into solid bone once a person is full grown. Because growth plates help determine the length and shape of the adult bone, injuries to them can result in disruptions in bone growth and even bone deformities. These injuries occur most often in contact sports like football or basketball, and in high-impact sports like gymnastics and skateboarding.

So Here’s The Game Plan
Rather than “playing through the pain,” the best course of action often is to seek proper and expert treatment as soon as possible. A game plan, so to speak, needs to be established for treatment and returning the athlete to play, and all parties – the athlete, coaches and parents – must understand and adhere to the guidelines. It is helpful for adults to monitor the child for signs of continued pain or dysfunction.

And of course, the best course of action is really to prevent injuries in the first place. Recommendations include limiting the number of teams a child can play with in one season, and taking breaks from one sport to play another. A good rule of thumb can be gleaned from research that showed young athletes who play a single sport for more hours a week than their years of age – such as a 10-year-old who played 11 or more hours of soccer, for example – were 70 percent more likely to experience serious overuse injuries. 

The good news is that through proper conditioning, training and equipment, many youth sports injuries can be prevented. With the start of the new school year, young players who have not kept up their physical regimen during the off seasons should start slowly, gradually increasing activity level and intensity. 
However, whether through an overuse injury or an acute, traumatic event, athletes experiencing symptoms should be examined by a medical professional, most often an orthopaedic specialist. Leaving injuries untreated could result in permanent damage or disability, including a chronic, lifelong condition.

* Among the sources referenced for this article is the website www.orthoinfo.org, as well as a USA Today news article. 

Stephen DeBiasi is chief executive officer at OrthoWilmington, PA, which offers the widest range of orthopaedic services, specialties and technologies in Wilmington and the surrounding region. The mission of OrthoWilmington, PA, is to focus on one patient at a time, demonstrate consideration and respect, serve as leaders in quality and education, and support the community's overall health and wellness. 

For more information, visit www.Orthowilmington.com or call 910.332.3800. Like OrthoWilmington, PA, on Facebook at https://www.facebook.com/OrthoWilmington or follow on Twitter at https://twitter.com/orthowilmington.