By Steven R. Gecha, M.D. Princeton HealthCare System
Sports and athletic activities are great for young people, keeping them in shape and teaching valuable lessons about teamwork and leadership.
However, the old saying about having too much of a good thing is important to remember, especially when it comes to youth sports.
This month is Youth Sports Safety Month, sponsored by the National Youth Sports Safety Foundation, which is committed to promoting the healthy development of youth, and keeping them physically active and in sports for life. The national nonprofit, educational organization aims to reduce the number and severity of injuries youth sustain in sports and fitness activities.
This includes overuse injuries, which are on the rise among young athletes across the country. In fact, up to 50 percent of all injuries seen in pediatric sports medicine are related to overuse, according to the American Academy of Pediatrics.
Overuse injuries are defined as repetitive micro traumatic injuries to bone, muscle or tendon that has been subjected to repetitive stress without sufficient time to heal. Common injuries include stress fractures, plantar fasciitis (heel pain), shin splints, patellofemoral (kneecap) pain and tendonitis in the Achilles tendon, kneecap, elbow and rotator cuff.
Research shows the risks of overuse are more serious in young athletes for a variety reasons. The bones of a young athlete cannot handle as much stress as adult bones, and young athletes may not connect symptoms such as fatigue or poor performance to an overuse injury.
The biggest culprit behind overuse injuries — regardless of the sport — is an athlete being out of shape and trying to perform too much too soon, without giving his or her body time to recover. Young athletes need to realize that they need to condition their bodies before they jump into a sport. This means taking at least four to six weeks to work out and get fit.
Young athletes also should be sure to warm up and stretch prior to hitting the field, the pool or the court. Kids should spend between two and three minutes warming and loosening up their muscles by repetitive exercises like jumping jacks or jumping rope or even by a hot shower. Once the muscles are warm, they’re ready for 10 to 15 minutes of stretching exercises for the legs, arms and back.
Only after warming up and stretching are athletes ready for play. If there is more than a 15-to-20 minute break in activity, children should repeat the warmup and stretching exercises before playing again.
In addition to getting in shape before the season starts, other measures to prevent overuse injuries include:
• Resting in between seasons. Multi-sport athletes should take at least two weeks off between seasons.
• Joining only one team per season.
• Developing a relationship with a trainer or physical therapist. Most teams have a trainer or physical therapist on staff. They are great resources, and young athletes should be encouraged to talk with them and ask questions.
• Treating an injury immediately if you get hurt. Too often young athletes will play injured, which is a curse to their health and athletic career in the long term.
The main signs and symptoms of overuse injuries are soreness and achiness, along with poor performance. Often the first indication of an overuse injury is in the athlete’s play. A pitcher may not be throwing as many strikes as normal. A runner’s time may be slower. A soccer player’s shot may be off.
Diagnosis often involves a trip to a doctor who specializes in sports medicine and has expertise in the athlete’s specific sport or activity. In many cases, X-rays or MRI scans are necessary to pinpoint the problem.
Treatment depends on the injury, but most always requires rest. Reducing the intensity and frequency of the activity until the point the patient is pain-free is typically recommended for about two weeks. If you’re pain-free after two weeks, you can generally, progressively return to the sport.
Some injuries may require physical therapy and some may be treated with Cortisone shots. Cortisone, however, should not be used to treat tendonitis in the Achilles or patellar tendons due to the high risk of rupturing the tendons. Anti-inflammatory medication also may be recommended to relieve symptoms.
And let’s not forget ice. Even with all the advances in medicine, ice still plays a role in treating injuries. When icing an injury — whether a sore shoulder or an achy knee — be sure to follow the 20-minutes-on, 20-minutes-off rule. Leaving ice on longer than 20 minutes can result in ice burns. Additionally, if you’re uncertain whether to apply ice or heat, use ice.
Of course, the best treatment is preventing the injury in the first place. As Youth Sports Safety Month comes to end, remember these three points to keep you playing throughout the year:
• Spend six weeks conditioning.
• Always warm up and stretch.
• Use your trainer and physical therapist. They are worth their weight in gold.
To find an orthopedic surgeon or sports medicine specialist affiliated with Princeton HealthCare System, call 888-742-7496 or visit www.princetonhcs.org.
Steven R. Gecha, M.D., is board-certified in orthopedic surgery and specializes in orthopedic sports medicine. He is a member of the medical staff of Princeton HealthCare System.

