News this month
Increase in adult-type injuries among children and adolescents

Approximately 35 million children and young adults between the ages of 6 and 21 years participate in sports. Team sports are a great way for children to improve physical coordination, boost self esteem, maintain physical fitness and foster self-discipline.

Unfortunately, increasing numbers of young children are becoming sports-specific and training year-round to compete at a competitive level of play, which puts them at risk for overuse injuries. In some cases, the damage is permanent, increasing the risk that the athletes—some of them as young as 9—will suffer crippling arthritis or require extensive surgery as they get older.

Overuse injuries from repetitive strain
Overuse injuries occur as a result of repetitive strain on tissues such as bone, tendon and ligaments, as well as specific muscle groups. Injury occurs when these tissues undergo sustained stress without enough time for recovery. Overuse injuries tend to occur in competitive sports: most commonly baseball, basketball, running, gymnastics and swimming.

“But just about any recreational activity that involves repetitive motion has the potential to cause an overuse injury, especially if kids are pushed too hard,” says Paul Stricker, MD, FAAP, a pediatric sports medicine specialist and a member of the executive committee of the American Academy of Pediatrics (AAP) Section on Sports Medicine and Fitness.

Overuse syndrome, playing the same sport constantly instead of participating in a variety of activities, can result in injuries such as swimmer's shoulder, Little League elbow, runner's knee, jumper's knee, tennis elbow, Achilles tendonitis and shin splints—conditions that can develop into chronic problems later in life.

Young athletes
Media coverage of competition in sports such as gymnastics, figure skating, tennis, swimming and diving has attracted attention to a number of very talented but very young competitors. The demand to succeed creates a constant pressure for these athletes to train longer, harder, more intensely and, in some cases, at an earlier age. As the age of competitive athletes in sports such as gymnastics and tennis decreases, the pressure to succeed early in athletes' careers has intensified.

The New York Times reports that doctors in pediatric sports medicine are treating injuries in children that they once saw only in adults, blaming an over-aggressive culture of organized youth sports. According to the U.S. Consumer Product Safety Commission, more than 3.5 million related injuries in children under age 15 were treated in the U.S. in 2003.

Prevent overuse with conditioning and training
Most overuse injuries can be prevented with proper conditioning and training. The American Academy of Pediatrics recommends cross-training in moderation throughout the year to prevent any one area of the body from becoming overworked and stressed and to help maintain overall fitness levels.

Children should be encouraged to participate in sports at a level consistent with their abilities and interests. Pushing children beyond these limits is discouraged as is specialization in a single sport before adolescence.

Parents and coaches should be cautious when a young athlete has significant pain and should not encourage a child to “play through” the pain.

“Children and adolescents are predisposed to overuse injuries because of the relative weakness of their growing bones and the tightness of their ligaments, tendons and muscles during growth spurts,” said Dieter Lindskog, MD, pediatric orthopedist at Yale-New Haven Children's Hospital.

The American College of Sports Medicine estimates that 50 percent of overuse injuries in children and adolescents are preventable. Pre-participation screening, required by most schools, should be encouraged for all children involved in organized athletics. The pre-participation exam can detect condition that may limit participation or predispose an athlete to an injury and assess general health.

Educational campaign underway
The American Academy of Orthopedic Surgeons (AAOS) and the National Athletic Trainers' Association (NATA) launched a public service campaign in March to educate young athletes, parents, coaches and the media on how to prevent, treat and rehabilitate overuse injuries.

The Youth Sports Injuries public service campaign is a year-long campaign with advertisements featuring kids playing baseball that will appear in major magazines, newspapers and at airports with the provocative headline: “What will they have longer, their trophies or their injuries?”