Overuse injuries occur when an athlete does too much, too soon, causing pain in the effected body area, says Eric Laudano, head athletic trainer at the University of Pennsylvania.
Overuse injuries account for fifty percent of all youth sports injuries,
but half may be preventable, says the National Athletic Trainers'
Association.
Prevention advice
The NATA says there are five ways parents, coaches and athletes can help to reduce the number of repetitive stress injuries in children and adolescents.
1. Proper education and supervision.
- Athletes, parents and coaches should know the warning signs or symptoms of overuse injuries;
- Athletes need to nofify an adult if they experience signs of an overuse injury;
- Coaches should be trained in sports safety ,
training techniques and skills, psychosocial aspects of childhood and
adolescence, child development and common health and medical concerns.
- Organized youth and interscholastic sports should be supervised by adults with knowledge of and training in monitoring for overuse injuries.
2. Pre-participation physical exams (PPEs). Student athletes should undergo a PPE before beginning a new sport (or prior to the start of a new sports season) to screen for potential risk factors, including:
- Previous injury
- Psychololgical issues
- Muscle imbalances
- Inflexibility
- Muscle weakness
- Instability
- Conditioning
3. Rule changes and participation limits. Studies suggest that
the most consistent predictor of overuse injury is the sheer volume of
sports activity, whether measured as number of throws/pitches or quantity of time participating. The NATA recommendations:
- As general rule, athletes should limit sports to no more than 16 to 20 hours a week.
- Athletes should take at least 1 to 2 days off per week from
competitive practices, competitions, and sport-specific training.
Coaches and administrators should consider these required days off when
organizing schedules for the season.
- Athletes should participate on only 1 team of the same sport per season
when participating on 2 or more teams in the same sport (e.g. high
school and club) would involve practices or games (or both) more than 5
days per week.
- Adult rules for sports should be modified for children and adolescents, such as:
- shorter quarters or halves
- bases closer together
- less frequent games or practices
- age-related limits on number and type of pitches for baseball
pitchers (for specific recommendations on preventing overuse injuries in
baseball pitchers, click here )
- gear-ratio limits for cyclists
- age-related distance limits for runners (e.g. 5 km at age 12, 10 km at age 14 etc.),
- limits on number of practices and length for swimmers at various levels of competitive age-groups swimming)
4. Training and conditioning programs. Proper training and conditioning, both before and during the season, may prevent overuse injuries:
- The general decline in physical activity (e.g. free play , walking to school, and regular physical-education classes), coupled with a general increase in sedentary activities (e.g. watching television, spending time on a computer , texting, playing video games, physical activity limited to sports participation )
means that there are more athletes with poorer levels of general
fitness or conditioning who may not be able to tolerate the demands of
training required for sport participation.
- Athletes should begin a general-fitness routine encompassing strengthening, endurance, and flexibility training as well as lifestyle physical fitness (e.g. taking the stairs instead of the elevator) at least 2 months before the sport season starts.
- Once a general foundation of fitness has been established, athlete
should begin to gradually increase training loads following the 10% rule, which allows for no more than 10% increase in the amount of training time, distance, repetitions, or load per week.
- Coaches should be encouraged to use a structured warm-up program which includes technique training, neuromuscular control, and balance and strengthening exercises. Programs such as the PEP Program have shown in studies to reduce the risk of noncontact anterior cruciate ligament (ACL) injuries .
- Coaches should develop an overall-prevention mentality, including improved warm-up , cool-down, taping unstable ankles , rehabilitation ,
promoting fair play, and exercises to improve joint stability,
flexibility, strength, coordination, reaction time and endurance.
5. Delayed sports specialization.
- Although there is little evidence-based research to demonstrate
that early specialization of athletes participating in the same sport
year-round from a young age has negative consequences on physical growth
or psychological outcomes, many clinicians, health care organizations,
and youth sports experts , have advocated for diversity in sport participation or delayed specialization.
- The theory is that participation in only 1 sport can result in
increased risk for repetitive microtrauma and overuse, and that
multisport athletes who do not obtain adequate rest between daily
activities or between seasons, and those who participate in 2 or more
sports that emphasize the same body part are at higher risk for overuse
injuries than those in multiple sports with different emphases.
- Specialization in 1 sport may also be associated with nutritional and sleep inadequacies, psychological or socialization issues, and ultimately burnout which might be avoided with a balanced lifestyle and a strong support system made up of parents, friends, coaches, and health care providers.
- Young athletes who participate in a variety of sports tend to have
fewer injuries and play longer, thereby maintaining a higher level of
physical activity than those who specialize before puberty.
- Youth athletes should be encouraged to participate in multiple
sports and recreational activities throughout the year to enhance
general fitness and aid in motor development.
- Athletes should take time off between sports seasons and take two to three non-consecutive months away from a specific sport , if they participate in a single sport year-round.
- Athletes who participate in simultaneous (e.g. involvement in high
school and club sports at the same time) or consecutive seasons of the
same sport should follow the recommended guidelines with respect to the
cumulative amount of time or pitches over the year .
Posted December 6, 2011