Child health
Overuse injuries:
The new scourge of kids' sports
By Lyle
Micheli, MD, Director, Division
of Sports Medicine
Dr. Lyle Micheli talks
to KCBS in Los Angeles on how children can avoid injuries while
participating in organized sports
I am a passionate advocate of children's sports, but I'm not
so gung-ho that I can't recognize the profound changes taking
place in children's sports and the problems these changes have
created. In particular, I'm concerned about the rise of "overuse"
injuries.
These injuries were once virtually unknown in young athletes,
but that has changed with the emergence of organized sports and
their emphasis on repetitive coaching drills, as well as the recent
trend toward sports specialization in young athletes. Patellar
pain syndrome—an alignment problem in the knee caused by
overtraining—is the number one diagnosis in my clinic today,
even though it had never been seen in kids until the growth of
organized sports. Talk of stress fractures, tendinitis and bursitis
is no longer confined to pro athletes; it now can be heard in
high school locker rooms.
Certain overuse sports injuries, such as Little League elbow—which
is damage to the growth cartilage in the elbow joint caused by
repetitive whipping motions of the arm—are seen exclusively
in child athletes because of the softness of their growing bones
and relative tightness of their ligaments and tendons during growth
spurts.
Other overuse sports injuries seen mostly in children include
osteochondritis dissecans of the knee and ankle (repetitive grinding
together of bones that causes damage to the growing surface cartilage,
and may result in pieces of dead bone and cartilage dropping into
the joint and wreaking havoc), Osgood Schlatter's syndrome (inflammation
at the point where the tendon connects the kneecap to the very
top of the shinbone) and os calcis apophysitis (inflammation at
the point where the Achilles tendon attaches to the heel).
Unlike acute sports injuries like sprains, strains, bruises and
breaks (which the Consumer Products Safety Commission tells us
result in four million emergency room visits every year), the
exact prevalence of overuse injuries is difficult to ascertain
because the symptoms develop over time and do not require immediate
emergency care. Suffice it to say that overuse injuries in kids'
sports are so common that pediatric sports medicine clinics, such
as the one at Children's Hospital Boston, have opened to respond
to the problem.
One of the most disturbing aspects of overuse injuries is their
insidiousness. Often kids won't admit to being sore—they
just drop out of sports, often for life. When these injuries go
undetected, the damage to a growing child's hard and soft tissues
can be permanent. Evidence suggests that overuse injuries sustained
in childhood may continue to cause problems like arthritis later
in life.
As overtraining is the most common cause of overuse injury, the
most effective way to prevent them is to make sure qualified personnel
are coaching kids. The American Red Cross teaches a sports safety
course that I and other members of the U.S. Olympic Committee's
panel of experts on youth sports helped design. I urge you to
have the coaches in your local youth sports program contact their
local Red Cross chapter for this and other safety information.
Another important measure is to make sure kids have a proper pre-season
physical every year to rule out underlying conditions that might
predispose them to overuse injury—anatomical abnormalities,
such as knock knees, flat feet and swayback, for instance. Finally,
if kids want to participate in strenuous sports, they should be
fit enough to do so; a properly performed pre-season physical
should rule out fitness deficiencies and help your child's doctor
recommend an exercise program.
Every day I see happy, healthy, confident youngsters with a glint
in their eye that tells me they're hooked on sports for life.
By reducing overuse injuries, we can make sports safer and even
more rewarding for their young participants.
This article was adapted from content provided by Children's
Hospital Boston to the Health and Parenting sections of Yahoo!
October
2004
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