Thirty-two percent. This number could have a plethora of meanings in relation to recreation and parks. Is it a .320 batting average in baseball? If so, you could be headed to great things. Is it a 32 percent shooting percentage from the foul line? That would suggest spending more time in the gym, although you make more than I do. Unfortunately the 32 percent represents something quickly becoming more prevalent than hitting a baseball or making a foul shot. This is the number of children at risk for diabetes, high blood pressure, and other obesity related problems, according to a recent study done by pediatric cardiologist Dr. Reginald Washington. One obvious solution is to put our youth in as many activities as possible so they stay active, right? I say not necessarily.
A lesser known problem which raises as many red flags is the growing rate of overuse injuries in young athletes ages 5-14. One study found there are roughly 3.5 million youth sports related injuries reported yearly. Nearly 70 percent of those are reported as overuse injuries, or approximately 2.45 million cases. The silver lining is that the Centers of Disease Control and Prevention estimates 50 percent of all, not just overuse, sport-related injuries are avoidable. Luckily there are several steps to help avoid overuse injuries. The first step is to define what an overuse injury is. In general terms, it’s an injury that occurs due to excessive use of a body part. More specifically, it’s damage to a muscle, bone, ligament, or tendon due to repetitive stress without enough rest for the body to heal itself. Most of these injuries are caused by overtraining, at least by youth standards. Children’s bones are not strong enough to withstand the stress that those of adults can, yet some children try to mimic the training of older athletes. Their muscles, tendons, and ligaments cannot take the repeated use that those of older athletes can. Another key factor is children can’t always pick up on the signs and symptoms of an overuse injury.
Obviously each injury is going to have different accompanying signs and symptoms, but there are some general issues that will be present with most overuse injuries. If the pain lingers for a week or more, or the pain doesn’t go away with regular rest, then you might need to get the area checked out. (I promise not to slip into Jeff Foxworthy “You might be a redneck” mode. It almost happened though). Pain throughout the night is another common sign, as in numbness or tingling in the extremities. Finally, the child may be favoring an injured area or saying it feels like it’s giving way under pressure.
Overuse injuries are usually sport specific since each sport targets different muscle groups. I’ll go over a few, then provide some websites at the end so you can find more injuries and more information on them. Of course the best source is to go to a health care provider and have them diagnose any problem. Jumper’s knee is tenderness just below the kneecap. As the name implies, the inflammation is usually caused by jumping repeatedly. Shin splints and compartment syndrome are both characterized by pain and tenderness in the shin area. A change in sensation is also sometimes felt in compartment syndrome. This is usually caused by excessive running on a hard surface and/or improper footwear. Heel pain could signify the onset of Sever’s Disease. This is when continuous running and jumping activities cause the soft tissue around the growth plate in the heel to become irritated. Lower back pain is common in activities such as dance, ice skating, and gymnastics due to repeated flexion and extension of the lower back muscles. Swimmers sometimes develop shoulder and chest problems due to overhead movements with the arms. Overhead throwing movements also cause issues like Little League shoulder and elbow, especially in the summer. Damage and inflammation to the soft tissue and growth plates can cause pain in both the shoulder and elbow, especially if improper throwing techniques are practiced.
OK, so you’ve identified with one of the conditions above. Now how do you make it better? It’s important to remember everyone’s body is different so there’s not a master plan everyone can follow to cure these issues. There are some basic guidelines though. RICE is a common practice when it comes to all injuries. The ‘R’ stands for rest. An injury cannot heal if the area is subject to continuous stress. The ‘I’ stands for ice. Icing the injury can help reduce swelling in the area. The ‘C’ is compression. A compression wrap also helps alleviate swelling while also limiting the range of motion of the injured area. The ‘E’ is for elevation, which also helps reduce swelling in the area. This can help treat the symptoms, but it will not address the underlying problems. To properly treat an injury it’s imperative a family physician or physical therapist becomes involved. Two young athletes with the same issues playing the same sport may have very different reasons for their injuries. One child may be hurt due to a mechanical problem with performing the skill while the other may have a physical disposition leading to the injury. Regardless of the reason, it’s important the athlete, parents, coach(es), and health care provider set goals to recovery so everyone is clear to what needs to be done.
The best course of action is to avoid the injury before it happens. There are several steps parents and coaches can take to sidestep these problems. A preseason session of four to six weeks working on sport specific drills can help transition an athlete from one sport to the next. During the season, it’s important the athlete takes at least one day a week of no activity to allow the body to recover. Another way to lessen the load is to mix in different activities during the training time. For example, a basketball player may have practice Monday and Tuesday, spend Wednesday on a stationary bike, in a swimming pool, or in the weight room, practice Thursday, a light practice Friday, game Saturday, then Sunday off for recovery. The key is to limit the activity of the child and to stop at the onset of overuse injury symptoms. ‘Playing through it’ will compound the problems so it’s important the coach takes a proactive stance in this. Most young kids may try to play through their nagging injuries because they’re afraid of disappointing their coach and/or losing playing time. There are other factors which may seem obvious, yet they are often overlooked with the hectic schedule of a busy child. With all the running around, it’s a lot easier to eat convenient foods versus healthy foods. It’s important the children eat properly to get the vitamins and minerals they need for their growing bodies. Sleep is also imperative, as the body heals itself while asleep. If having two practices and homework are causing the child to get less than eight hours of sleep then something’s got to go. Which one should go you ask? Well, Bill Gates is worth about $100 zillion dollars and probably can’t hit a baseball so I know which one I’d choose. Warming up and cooling down, including stretching, are also important with each activity. Footwear is often overlooked but plays a big role in injury prevention, both during the activity and in everyday life. Proper footwear can help cushion and align the joints in the body, lessening the wear and tear on the body.
Young athletes are going to want to be involved in as many activities as possible, and that’s great they’re willing to try new things. Just keep in mind they can’t always notice the onset of injuries nor do they usually control the factors discussed in the paragraph above. It’s important the coaches and parents closely monitor children in multiple events with an objective mind. Just because little Sally’s the best soccer player in her age group doesn’t mean she should be playing on three different teams. What’s more important, winning a tournament when Sally is 11 or having Sally healthy enough to be a lifelong athlete? The trophy is nice, but it won’t mean as much if Sally struggles to get out of bed with bad knees and a bad back at age 40. Heck, sometimes it’s tough to get out of bed at age 26. I’m asking you to please seek medical advice if your child has any of the signs and symptoms listed above. They’ll thank you later.
I’d like to thank Mr. Paul Marquis from County Physical Therapy as an invaluable source of information on this topic as he’s worked with most of these issues. For more information regarding what you can do to prevent overuse injuries from occurring, talk to someone experienced working with such injuries. As promised, these are some Web sites that can also provide more information: http://www.medicalnewstoday.com/articles/108262.php; http://www.sgptr.com/overuse_injuries.pdf; http://pediatrics.aappublications.org/cgi/content/full/119/6/1242; http://www.educatedsportsparent.com/injuries.html; http://www.health.uab.edu/14222/; http://kidshealth.org/parent/nutrition_fit/fitness/sports_safety.html; http://sportsmedicine.about.com/od/children/a/overusekids.htm
Adam Murchison is a Recreational Programmer with the Presque Isle Recreation and Parks Department.