Northside Hospital - Avoiding overuse injuries in youth sport

Avoiding overuse injuries in youth sport

By Dr. Mark Sakr

Are high school and middle school athletes susceptible to different injuries than adults?
Absolutely. Growing athletes are still undergoing structural changes in their muscles and bones. As children and teenagers grow, their bones lengthen quicker than the muscles can adapt, often leading to tense and tight muscles or tendons when exercising a lot. Injuries to the growth plate can occur from the repetitive use, causing lingering pain and inflammation. (While adults don’t get these growth plate issues, they can develop similar overuse injuries called stress injuries.)

What causes growth-plate injuries?
Growth-plate injuries can occur from a few different issues. Direct trauma or injuries like falls or significant impacts on the ends of bones can cause fractures or avulsion injuries (essentially, a tear or detachment) at growth plates. Also, overuse and repetitive pulling on a bone by the tendon attachments of muscles can cause inflammation and pain at those sites.

How can growth-plate injuries be avoided?
Overuse growth-plate injuries can be avoided by performing appropriate and directed stretching of muscles that are frequently used in a particular sport. Leg and ankle stretches in runners and, similarly, elbow and shoulder stretches by overhead athletes can be very helpful.

How can parents or coaches tell when a young athlete is injured vs. simply not yet used to working certain muscles?
It can be very difficult to tell the difference between injuries and de-conditioning. Most injuries and pain from working out that don’t have a specific cause, such as a fall, will improve with rest. If a few days of rest and a lighter exercise load don’t help, or if the pain lingers into day-to-day activities, it’s worth getting the issue looked at by a health care provider. De-conditioning usually improves with each consistent workout, so if there’s a big break over the summer, or even for just a few weeks, ease back into workouts gradually.

Are there guidelines on how many miles a week are safe at certain ages?
There aren’t any well-established research studies regarding an exact mileage limit on young athletes. The answer to “how much is too much?” truly depends on each individual athlete’s training and experience, as well as on many other factors. However, injuries tend to be more common during peak growth spurts, and some are more likely to occur if underlying biomechanical problems are present. Make sure that endurance athletes are stretching regularly, and having their gait and technique evaluated for proper mechanics is a valuable tool, when available.

Dr. Mark J. Sakr is a fellowship-trained sports medicine physician with board certifications in sports medicine and family medicine, and serves as the Director of Non-Operative Sports Medicine for the Northside Hospital Sports Medicine Network. Visit for more information.


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