(Continued from Avoiding Overuse Injuries…)
Overuse injuries are a result of repetitive strain on tissues such as bone, tendons, ligaments, or specific muscles. Injury occurs when these tissues undergo sustained stress without enough time for recovery. This can lead to pain, inflammation, and a cycle of tissue damage. If unchecked, these acute injuries lead to chronic injuries. Injuries may occur because of intrinsic factors in the athlete such as anatomical misalignments, flexibility issues, or strength imbalances. However, extrinsic factors, such as training volume and progression, are often the trigger.
Young athletes are particularly vulnerable because of skeletal immaturity and incomplete or imbalanced muscle development. Susceptible areas of injury include growth plates (physis), tendon attachments at these growth plates (apophysis), and tight ligaments and tendons that result from growth spurts.
Sports medicine specialists categorize these injuries in three ways:
• Repetitive micro trauma is caused by normal stress to the bone without adequate recovery (i.e. stress fractures)
• Growth plate injuries or fractures, which can cause permanent damage and interfere with proper growth if untreated
• Muscle, ligament, and tendon injury; these are often related to different mechanical properties in growing children.
Parents are the first and most important factor in overuse injury prevention. Many children will not willingly pull themselves out of a sport. They do not want to miss the experience, may be concerned about losing a spot on the team, or may worry about letting down parents, coaches, and/ or teammates.
A classic example of a parent’s importance in prevention is the Little League pitch count. This rule is in place to avoid excessive stress to the shoulder and elbow by limiting the number of pitches a youth can throw in a game and per week. However, many kids play on multiple teams and spend hours in their backyards “practicing” their throwing. Coaches may have no idea how many pitches that athlete may actually have thrown in a given week. Without parent supervision and diligence, the pitch count is meaningless.
While prevention is optimal, early recognition of overuse injuries is paramount to a quick recovery and avoiding long-term consequences. If a complaint of pain and disability is not forthcoming from a young athlete, several signs may be present. These may include: excessive use of over-the-counter pain medications, changes in performance or techniques (i.e. funny gait), and psychosocial signs such as social withdrawal, anxiety, or depression. The bottom line is that our children participate in sports for fun, to boost self-esteem, to maintain physical fitness and to foster selfdiscipline. Accidental injury may be a part of sports, overuse injuries should not be.
Overuse Prevention Tips
• All children involved in organized athletics should undergo a pre-participation exam with a qualified sports medicine specialist. If done properly, this exam can detect conditions that may limit participation or predispose an athlete to an injury.
• Prevent overuse with conditioning and training to address muscle imbalances.
• Avoid sudden activity increase and always allow for a progressive increase in activity level.
• Cross-train throughout the year to prevent any one area of the body from becoming overworked and stressed.
• Do not push children to participate in sports at a level inconsistent with their interests and abilities.
• Avoid sport specialization in a single sport before adolescence.
• Never encourage a child to “play through” the pain.
• Follow the 10 percent rule: training (intensity, frequency, duration) should increase no more than 10 percent per week.
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