When it comes to sports, kids are “not miniature adults,” says Scott Ramsey, co-owner of Hershey Orthopedic & Spine Rehabilitation (hersheyrehab.com).
Young athletes are often pressured to train like adults, say sports medicine experts. The result? Out of 5 million sports injuries in children under 18, nearly half come from overuse of growing young bodies, reports the Centers for Disease Control.
“They model themselves after the adult and pro athletes,” says Ramsey. “They try to emulate that. The intensity, the duration, the frequency of the workouts is too high, too soon.”
How can overuse injuries be prevented? Check out these five tips that parents and coaches should know.
1. Vary routines
The problem: Young people aren’t ready to “use the same muscle groups over and over repetitively,” says Ramsey. “That’s not how kids were meant to move.”
Throwing that stresses shoulders and elbows is a big contributor to overuse injuries, says Dr. Michael W. Gish, sports medicine orthopedic surgeon with Orthopedic Associates of Lancaster (fixbones.com). And yet, more children specialize in one sport year-round, constantly repeating damaging motions. “We’re even seeing ligament injuries in children that in the past we were only seeing in adults,” he says.
The solution: Make the single-sport athlete take a three-month break every year, or “mix things up a little bit,” says Gish. “Have a day for conditioning, a day for throwing, a day for hitting. Don’t do the same thing every day, day in and day out.”
2. Get rest
The problem: Lack of rest breaks down the joints and body parts that are repeatedly stressed, says Gish.
Plus, children are sure to tire during tournaments and long games, says Ryan Grube, physical therapist in the Drayer Physical Therapy Institute’s (drayerpt.com) Lancaster and East Petersburg offices. When muscles are fatigued, joints take the strain, “and that’s when we see catastrophic injuries.”
The solution: Rest is “absolutely critical,” says Ramsey. That doesn’t mean quitting sports altogether but resting from the primary activity—taking the runner off the track, benching the basketball player. “It’s changing the type of repetitive stress on the body—taking a break from competitive sports and just having time to play,” says Ramsey.
Children also need 10 to 12 hours of sleep, notes Grube. “They’re getting that amount of sleep to allow their bodies to grow and repair and recover.”
3. Change out the warm-ups
The problem: Studies now show that old-style static stretching is probably not helpful and can actually reduce performance and cause more injuries, says Ramsey. Static stretches put the body into cool-down mode, signaling it to relax, he says.
The solution: Dynamic warm-ups that move joints, boost heart rates and increase blood flow to muscles and joints are more effective. Basic jogging, walking lunges, walking with high knees or exercises known as “butt kickers” are good warm-ups, says Grube. “We always think of warming up the muscles, but what we’re essentially warming up is the nervous system. We want to warm up the nervous system and joint system and muscular and myofascial system all together.”
4. Don’t “just shake it off”
The problem: Injured adult athletes are often told to shake it off and return to the field, but “it’s not normal for a kid to play through pain,” says Gish. “If you see a child limping or in pain, take it seriously.”
Sometimes, children don’t verbalize their pain, or a parent doesn’t notice the signs. Pain that’s been lingering is “more problematic” to treat, says Ramsey.
The solution: Watch for signs and listen for hints. Muscle soreness is normal after a new activity starts, but complaints for a week or two are “a big red flag” that it’s time to dial back on the intensity of workouts, says Ramsey. Continued pain means the child should see a doctor or physical therapist.
5. Think prevention
The problem: Prevention of overuse injuries isn’t top-of-mind for many families. Safe Kids USA reports that nearly two-thirds of sports-related injuries occur during practice, but one-third of parents don’t make sure their children take game-time safety precautions at practice.
Preseason physicals don’t catch tendencies that lead to overuse injuries, says Grube. Asymmetries such as a weak hamstring in one leg or one markedly stronger shoulder can force other body parts to overcompensate, boosting the risk of injury.
The solution: A functional movement screen, or FMS, from a physical therapist can catch “movement impairments and asymmetries,” says Grube. A balance test for the legs can also predict potential injury risks.
Prevention programs from sports medicine professionals can prescribe safe training regimens that build muscle and bone in equal proportion. “If we’re exposing them right away to lifting, speed, and strength training—that’s treating them like adults,” says Grube.
At the heart of the matter, parents should be “proactive or authoritative” in guarding against overuse, says Ramsey. “It ultimately falls on the parents to set limitations.”
Learn more at www.stopsportsinjuries.org