Sports Injuries

Over the past decade athletics have changed dramatically. Athletes are practicing year round which leads to an increase in sport specific training, strength/conditioning, psychological demands, and competition. Escalating participation in sports has lead to increase demands on the body and more overuse injuries in young athletes are becoming apparent. I have dedicated this site to young athletes and parents that wish to better understand sport performance and necessary factors to advance to the next level.

The past decade has brought an increase in sport participation and has lead to overuse injuries in young athletes. One of the biggest contributing factors is improper training. These injuries result from repeated intrinsic (growth) and extrinsic (repetitive motions) stresses followed by inadequate recovery. The American Academy of Pediatrics has reported an increase in the number of children specializing in a sport year round which appears to be contributing to the rise of injury. A resent report in San Diego states that there is roughly 125 baseball teams for children under the age of 10 that partake in as many as 80 games a year, far more than most college teams. Parents are hiring private batting coaches for their Little League players under the presumption that batting makes their children better applicants for college. The general thought is that if children do not specialize before high school, then they are not prepared to compete at higher levels. The increase in athletics for youth does not come without an increase risk of injury. Proper education to the parent and the young athlete will come enhanced skill and peak performance.

The most common cause of overuse injuries comes from repetitive motions that stress bones, joints, tendons, ligaments and muscles followed by inadequate rest. As we know stresses to these structures can make them stronger but without proper recovery time they result in the opposite and become injured. Because these injuries do not result from trauma and are not acute they are often difficult to diagnosis and require medical attention. Improper alignment and function may also predispose one to injury. For instance, a coach might not know proper spinal/scapular/shoulder movement and might find it hard to deny a volleyball player from playing time.

The fact that children are growing separates young athletes from mature athletes. A common location for growth in youth is in the epiphysis of bones and associated growth cartilage located at the growth plate. This is where bones grow and lengthen by adding more bone and is located at the proximal (beginning) and distal (end) of bones. Young athletes commonly get this confused with growing pains but can raise a concern when the individual is partaking in continuous physical activity. For instance, a young athlete complains of deep dull pain and is a pitcher for a Little League team. With continuous use and misalignment, muscles are known to compensate and can become shortened and/or lengthened depending on the location. Because the bone is still growing at the epiphysis, tightened muscles are able to torque the bone. Again, an injury that is associated with overuse. Studies are now showing that overuse of young pitchers can result in tightened rotator cuff muscles causing a torque in the humerus. High school and college pitchers are now noticing a new bread of injury due to torsion in the humerus bone. This phenomenon is also seen in sprinters and jumpers located at the proximal anterior tibia, a syndrome called Osgood-Schlatter and Sever’s disease located at the Achilles tendon into the heel. These conditions come with great concern because intrinsic stresses can live with the athlete for a lifetime once the bone sets.

Prevention of Overuse Injuries

The American College of Sports Medicine has stated that roughly 50% of overuse injuries in children and adolescents can be prevented. An experienced coach must be educated in proper training skills involving technique and length of practice. A suitable warm-up and an organized practice schedule will help reduce injury and enhance sport performance.

Regardless of the sport, warm-ups with repeated contractions are necessary in reducing muscle tears and preventing serious muscle tears. A warm up will increase the temperature of the body and encompassing muscles which help muscle contraction and relaxation. General warm ups such as jogging, and related warm up such as kicking a soccer ball help warm up the entire body and specific muscles related to the sport. It is important to use the same muscles pertaining to the sport. An adequate amount of time for a warm-up is 10-12 minutes and should not result in muscle fatigue. The physiological benefits to warm-ups are: muscles contract faster, muscles relax faster, range of motion is increased, increase temperature will enhance metabolism, increase blood flow, and psychological preparation. Varying practice is a great way to reduce overuse injury. Repetitive activities can result in fatigue, boredom, and lack of fun. Distributing a diverse practice is better for performance, learning and injury prevention. Random practice is far more superior in retaining motor task compared to repetitive practice. Studies have shown an athlete will retain better performance when mixing up forehands and backhands in tennis opposed to numerous repetitions of just forehands and backhands. Random practice will bring about desired results more quickly and will enhance game play decision making. In other words, practice in game like situations. Varying practice sessions will decrease fatigue, produce desirable learning effects, and allow more time for recovery.