5 Strategies for Preventing Overuse Injuries in Youth Sports Medicine

Orthopedic Sports Medicine

As the importance of sports in society increases, young athletes can easily fall into competitive and year-round sporting activities, leading to overuse injuries. In many cases, these injuries can be prevented if the athletes, parents and coaches are educated about how to identify potential injuries, says David Marshall, MD, medical director of the sports medicine program at Children's Healthcare of Atlanta.

"In sports medicine, we tend to be more reactive meaning I don't get involved until someone gets hurt," says Dr. Marshall. "I'd like to see a more active approach."

He discusses five strategies for keeping young athletes healthy and for communicating preventative measures to them as well as their parents and coaches.

First and foremost, Dr. Marshall recommends spending the adequate amount of time explaining these measures to children and their parents.

"Human nature is resistant to change unless you understand the reason for change," says Dr. Marshall. "Spending time with the athletes, parents and their coaches goes a long way."

1. Emphasize the off-season.
Instead of cross training or taking the off-season break, many young athletes are pushed to compete in year-round sporting activities. Dr. Marshall recommends young athletes take one to two months rest from their primary sport. "The athletes think if they take time off they'll lose their skills or get rusty. They are afraid another kid below their level will surpass them if they don't continue playing. They feel they need to maintain year round participation and training in order to maintain that edge," says Dr. Marshall.

However, the same could happen if the athlete overuses their muscles in a single sport. Reusing the same muscles increases the chance of injury because the young athlete's growth plates are not strong enough to withstand the constant activity. If the athlete incurs a trauma injury, such as a broken bone or an ACL tear, they will be sidelined for a longer period of time during the season.

2. Communicate in metaphor.
Many of the injuries in young athletes occur as a result of overextending the growth plates. Since the growth plates in young athletes are still cartilage instead of bone, they cannot withstand as much activity as older athletes can. Physicians are able use a multitude of diagrams and models to show athletes what happens when they overextend themselves. However, for some children, using a metaphor could help visualize the process of overuse.

Dr. Marshall tells young patients that the muscle, joint and growth plate are like a big cable attached to a screw attached to a plastered wall. The cable and screw can be strongly bound, but if the plaster is still wet and someone pulls on the cable, the anchor will give away regardless.

3. Send athletic trainers to high schools.
Sports medicine practices should provide athletic trainers for high school teams. These trainers should be readily available at the school three to five days per week in order to assess the athletes' physical condition as well as assist the athletes with minor injuries. Having the athletic trainer available for assessment means the coaches and athletes are alleviated from the responsibility of deciding which athletes need rest from their activity or treatment beyond what the athletic trainers provide.

4. Reinforce the consequences of multiple concussions. Young athletes, especially those involved in contact sports, are susceptible to concussions. Without adequate education, athletes may be unaware they suffered a concussion because they did not lose consciousness. However, symptoms such as dizziness are indicative of a concussion and incurring a second concussion could lead to cognitive delays, brain damage or death. Even young athletes who are conditioned to recognize concussions may not admit to this injury.

"The kids might know they've suffered a sign of concussion but they don't want to tell anybody because they don't want to come out of a game," says Dr. Marshall. He says physicians can convince young athletes to rest after receiving a possible concussion by emphasizing the damage a second head injury could create.

5. Encourage pre-season sports physicals.
If a young athlete has a sports physical before beginning the season, physicians can identify disorders such as flat feet, poor arches and tight hamstrings and treat the patient accordingly. The physicians can recommend rehabilitation techniques to strengthen or correct a flaw before the child aggravates or injures the weak areas.

Additionally, Dr. Marshall says coaches should be educated on how to identify the common injuries and disorders an athlete within their sport and age group could receive for further injury prevention. Sometimes this can be a problem, Dr. Marshall says, when youth sports teams rely on parent volunteers as coaches without requiring any further training in sports injury.

Learn more about Children's Healthcare of Atlanta sports medicine.

Read more coverage on youth sports medicine:

- Treating Young Athletes: Q&A With Sports Medicine Specialist Dr. Patrick Wupperman


- Orthopedic and Spine Leader to Know: Dr. Andrew Gregory of Vanderbilt Orthopaedics

- 3 Tips for Communicating With Parents of Young Athletes


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