Sports-Injuries and your Child

Kids need an off season too

The real reason for children’s overuse sports-injuries

By David Dansereau, MS,PT

As a private practice physical therapist and sports nutritionist I am writing this article to hopefully educate parents, coaches and children about the long-term implications sports-injuries may have on a developing body if not treated properly and how ignoring overuse sports-injuries will most likely have lasting negative consequences which could plague the child later in life.  I've had this article on "the back burner" for some time and recently a young athlete asked me what he was doing wrong with his throwing because playing baseball was causing him severe elbow pain.  His history revealed he was playing 3 "overhead" sports concurrently that involved a throwing motion: baseball, tennis and  lacrosse.  I looked at him and explained it was not his fault, and that his body was still growing.  But, is it the parent's fault for not providing an off season for their child?  This article looks at the fast pace schedule of children's sports programs and overuse injuries that are growing at an alarming rate.

[Att: Parents- Are you to Blame??]

Consider this the next time you stop by the fast food joint between practices to fuel your kids with low quality nutrition:

 Inadequate nutrition can hinder recovery in kids that are prone to injuries sustained in sports and regular physical activity—and overweight and obesity can only complicate matters. The rising prevalence of overweight and obesity in children and adolescents further increases the risk of injury, not only during sports and exercise but also during routine daily physical activity. In fact, injuries that are usually triggered by middle-age weight gain in adults are now commonly seen in overweight children and adolescents.

Kids at Risk

Active kids these days are playing multiple sports at the same time, participating in up to 2-3 leagues per sport and often jumping right into the next sport season without adequate time to rest and repair injured joints and muscles.    It is also now common practice in our society to enroll very young children into organized sports at a level of competition previously made available only to their older siblings. (see my personal sidebar at the end of this article)  Both of these trends are most likely to blame for a resulting increase in adult type injuries among children and adolescents that I as well as other physical therapists are treating more frequently.

The Alarming Trends

Participation in children’s sports has skyrocketed over the past few years and with it so has the emphasis on preparing the young athlete for higher levels of play. In many sports, children and adolescents are being handled like miniature semi-professional athletes and trained accordingly.

Increasing numbers of young children are training year-round for one sport to compete at a high level of play.   This sport-specific approach to athletics puts them at risk for overuse injuries. In some cases, damage is permanent, increasing the risk that the athletes— will suffer crippling arthritis or require extensive surgery from sports-injuries acquired in their youth.

As the level of intensity and time devoted to training, practices, drills and competition all have increased, so have the number of injuries sustained each year by young athletes. While some of these injuries also occur in adults, others are unique because young bodies are still developing.   Especially in the growing child, the growth plates and joints are already under a lot of stress, so not allowing time for rest can result in fatigue, pain, discomfort, and often injuries.

Common Sports-Injuries in the Young Athlete

Overuse syndrome—playing the same sport constantly instead of participating in a variety of activities—can result in injuries such as swimmer's shoulder, Little League elbow, runner's knee, jumper's knee, tennis elbow, Achilles tendonitis and shin splints. These conditions can develop into chronic problems later in life.

Children and adolescents are predisposed to overuse injuries because of the relative weakness of their growing bones and the tightness of their ligaments, tendons and muscles during growth spurts.

The growth spurt experienced in adolescence heightens the risk of injury in young athletes. Intense participation in sports during a growth phase can result in growth plate injuries. When a child is in a growth phase, structural changes and rapid growth rates make growth plate areas more susceptible to injury.

The growth plate is like a cap on the end of a long bone. Eventually, it will cement as the skeleton matures, but in children it is the weakest part of the skeleton.  Growth plate injuries are most common in boys aged 14 to 16 and girls aged 11 to 13 and are often associated with gymnastics, long-distance running, baseball/softball pitching, and contact sports.

Particularly susceptible areas in young athletes are the knee and hip joints, lower spine, ankles, and feet.  These joints take a pounding especially in children participating in soccer, football, wrestling, and gymnastics. Joint sprains, stress fractures, soft-tissue strains, contusions, and overuse injuries commonly occur and are often sport-specific. For example, soccer, basketball, and other sports that involve running and directional changes can cause ankle and knee injuries. Young gymnasts may injure their wrists, ankles, and knees. Stress fractures, knee and hip injuries, and sport-specific sprains are common in athletic children.

Overuse injuries are associated with sports that involve highly repetitive movements, such as baseball pitching and swimming. Young athletes are especially prone to overuse injuries because they may not have the strength or endurance to sustain long workouts.  Muscle strength imbalances, poor flexibility, inadequate strength training, overtraining, and lack of appropriate rest/recovery can contribute to the risk of overuse injuries.

Where is the fun?

[Personal sidebar] To emphasize this point, I remember last winter I tried to find a basic learn to skate program for my child in my local area, and I was shocked to discover that no public skating program exists as I had remembered participating in as a child.  Conversely, the walls of the ice rink were filled with brochures that offered power skating clinics, drills and peak performance schools for kids starting at age three !  Whatever happened to having your child learn to skate by pushing a simple folding chair and having some fun ?  By the way, we took a glossy brochure home that day only because my child liked the photos and wanted keep one “to play with it”.  I think I’ll plan to flood my backyard again this winter and hope for cold weather to coach my kids on my own -thank you.

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