Participation in youth sports is a rite of passage for many and an important foundation for a healthy, active life. However, overuse injuries are a growing concern, with more children and teens sustaining painful and limiting injuries.
“There’s no question that overuse injuries are on the rise and have increased dramatically over the last decade with year-round, single sport specialization becoming more common,” said Endeavor Health orthopaedic surgeon and sports medicine expert Joseph Lamplot, MD.
Overuse injuries are often a very frustrating diagnosis for both athletes and parents, as most of the time there is no structural abnormality like a tear that shows up on MRI or other imaging, but the athlete continues to have pain, explained Dr. Lamplot.
Tailored rehabilitation for the win
“These are typically not structural issues; they are functional issues,” said Dr. Lamplot. The good news is that treatment works.
“Successful treatment includes avoiding the exacerbating activities for a brief period of time combined with rehabilitation in the form of a specific, personally tailored exercise program from an experienced physical therapist,” he said.
Shoulder impingement or scapular dysfunction is one of the most common overuse injuries that prompts a visit to specialists like Dr. Lamplot. This occurs in athletes with repetitive overhead movements like baseball and softball players, swimmers and volleyball players.
“I hear from parents, ‘will playing on this injury make it worse?’,” said Dr. Lamplot. “And while it may not make it any worse, it will definitely not get better without adequate rest and rehabilitation to rebalance and activate the muscles used in the sport.”
Taking a break is necessary
Athletes will often try a course of over-the-counter anti-inflammatories and maybe take a very short break from the sport and start to feel better, but as soon as they go back to their activities the pain comes back, and sometimes intensifies.
Depending on the injury, Dr. Lamplot suggest a break from sport for about a month, acknowledging that nobody likes to hear that’s the first step of real treatment. “It’s never convenient when there is no off season and kids are playing all year,” he added.
“Pro athletes and high-level college athletes all have more time off than most of the high school athletes we treat,” said Dr. Lamplot. The lack of recovery time, as well as insufficient strength and conditioning exercises, both contribute to overuse injuries.
Proper strength training reduces risks
Youth teams that are led by coaches who emphasize proper strength training tend to have fewer overuse injuries, said Dr. Lamplot.
Chronic pain in the frontal kneecap is another common overuse injury, and similar to shoulder problems, it is often a functional issue and stems from inadequate strength and coordination of quadricep and glute muscles. This is common in running and jumping athletes, particularly track, cross country, basketball and soccer players.
Runners and jumpers need to have both strong muscle function, or gross strength, and muscle control or balance. “You really need both to prevent injury, so again taking a break from the offending activity and an aggressive course of quad and glute strengthening is typically the most successful treatment,” said Dr. Lamplot.
A brief course of anti-inflammatory medicine can help break the pain initially, and Dr. Lamplot recommends a topical gel like Voltaren for young athletes and those who prefer not to take oral medications.
Knee tendonitis is another common overuse injury for runners and jumpers — and inflexibility, particularly in the hamstrings and quadriceps, is a major contributor.
Finding a physical therapist who is well-versed in working with athletes and these particular issues is the best way to overcome these injuries.
“It’s really therapist-dependent,” said Dr. Lamplot who emphasized the value of personally-tailored, evidence-based exercise plans.
Coming back stronger with the right treatment
“Eighty to 90% of the non-acute injuries we see in young athletes with chronic pain are overuse injuries. When they follow the treatment protocol with a good therapist, they are almost always back in four to six weeks and report being stronger than before the injury,” added Dr. Lamplot.
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