By Dr. Kristen Geiger
Pediatric Sports Medicine Specialist
Boulder Medical Center

Here is a situation that you may have experienced if you have young athletes in your home:

Your child, who is active in sports during the school year, complains about aches and pains in the foot, knee, shoulder or elbow. With the arrival of summer, athletic activities change and your child’s pains lessen or resolve. When school and demanding athletic schedules start again, the aches and pains return and your child is forced to play through the pain or miss practices and competitions.

Does this cycle sound familiar? If so, your child may be experiencing overuse injuries. An overuse injury is damage to a bone, muscle, or tendon that has been subjected to repetitive stress without sufficient time to heal. Overuse injuries can be aggravated by a lack of rest and inadequate pre-season conditioning.

Overuse injuries in kids and teens are different than those in adults, due to differences in growth and development. Young athletes are more prone to overuse injuries because of their rapidly growing arms and legs that lead to less flexibility, strength, and muscle coordination.

Repetitive Movements and Injuries

Kids and teens often play the same sport for multiple teams. This can lead to repetitive movements that cause overuse injuries.

In baseball and softball, for instance, pitchers’ throws may be counted by one team but who tracks throws when a pitcher is playing for other teams or throwing on their own? Catchers and other positions don’t track their throws but are often as active as pitchers. When these young athletes experience pain when throwing, many parents and players are unaware that this is not a “normal thing”. Thankfully, most children and teens will do well with rest and physical therapy but some throwing pains may require therapeutic treatment that includes surgery.

Overuse injuries happen in almost all youth sports including soccer, lacrosse, volleyball gymnastics, basketball, track and field, cheerleading, swimming, golf, and more. According to the American Academy of Pediatrics, half of all sports medicine injuries in children and teens are from overuse. They describe overuse injuries in these stages:

• Pain In the Affected Area After Physical Activity
• Pain During Physical Activity, Not Restricting Performance
• Pain During Physical Activity, Restricting Performance
• Chronic, Persistent Pain, Even at Rest
• Prevention and Treatment

Early diagnosis and treatment for injuries can be addressed during the summer when your child is not as active with sports and other obligations. A little preventive training can help your young athlete avoid missing out on team participation, games, and tournaments this fall. Addressing aches and pains early can also prevent recurrence of pain, exacerbation of injuries, and development of new injuries.

I encourage healthy, active lifestyles in all of my patients. Here are a few tips to prevent and treat overuse injuries:

• More and more these day, kids are “specializing” in a sport — playing one sport year around with rare breaks — at much younger ages. I recommend that my patients participate in a variety of sports that work different muscles groups and skills.
• Parents can support breaks from organized sports and encourage free-play and recreational participation to prevent overuse, reduce burn-out, and encourage long-term participation.
• Explore low-impact cross-training options. Yoga is excellent, as it’s available to all ages and is a great activity for a lifetime of participation. Swimming and biking are also fun and effective for cross-training.

I recommend that athletes have a pre-participation physical evaluation (PPE). The best time for a PPE is 6 weeks or more before the first practice of the season to allow for extra evaluation or rehabilitation.

Address complaints about aches and pains through early prevention treatment. This is an important way to prevent chronic injuries and keep your child stay healthy and enjoy the sports they love.

Dr. Kristen Geiger

Dr. Kristen Geiger specializes in Pediatric Sports Medicine at Boulder Medical Center. She is active with her husband and two young boys, trying to keep up with them cycling, hiking, climbing peaks, camping, cooking and traveling.