Overuse Injuries
by Neal Blakely, APEX Physical Therapy

In our physical therapy practice, parents of athletes often ask: why did this happen? Could we have prevented it?

The answer isn’t always easy.
    
Of the more than 40 million children under the age of 18 participating in youth sports, about 3.5 million will suffer injuries.  Normally, a body recovers from tissue damage and in doing so, can often create stronger tissue.  In an overuse situation,  however, the stress / adaptation mechanism is imbalanced and tissue breakdown results.  The unique anatomy and physiology of children and adolescents contributes to these overuse injuries.
    
Primary growth plates and the bony prominences at the secondary growth centers such as knee, hip, foot and pelvis, are vulnerable to injury. In addition, young bones are porous, leaving athletes more prone to stress fractures in the lower leg and low back.
    
Ever watch a soccer player, who’s shot up in height, suddenly appear like they’ve forgotten how to run? They look like a big clumsy puppy.  That’s because sometimes, during growth spurts, rapid bone length growth doesn’t match soft tissue adaptation. The result is a loss of coordination and biomechanical fluidity, making the athlete more vulnerable to injury.
    
So how are overuse injuries prevented and managed?  Answers are as varied as the athletes themselves, but most experts recommend avoiding sports specialization prior to adolescence.  Built in rest and recovery time and structured pre - participation routines have also proven effective.  Studies also show exercises emphasizing strength, balance, and core stability help reduce injury.  Multisport athletes have additional challenges from overlapping or concurrent seasons and need to be especially careful about the cumulative effects of increased frequency of training and matches/ games.
    
Young athletes often have difficulty interpreting symptoms and may dismiss symptoms to avoid a loss of participation.  Others may interpret symptoms through fear and unfamiliarity with the body’s reaction to athletic stresses.  It’s best if parents, coaches, and athletes keep talking and evaluating, making sure athletes aren’t setting themselves up for yet another injury.