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Overuse Injuries and Young Athletes

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Gabe Lewullis, MD, is a Lehigh Valley Health Network sports medicine orthopedic surgeon with LVPG Orthopedics. He was a star basketball player at Allentown Central Catholic High School. Lewullis is also well-known for scoring the winning basket with 3.9 seconds to play in Princeton’s 1996 NCAA Tournament upset of defending national champion UCLA.

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One of the most common conditions I see is sports overuse injuries, particularly among younger athletes – teenage years and in some cases younger. I can tell you it’s reaching epidemic proportions nationally. But not everyone understands what this condition entails.

When people hear about overuse injuries, they automatically think of baseball pitchers. Several decades ago, “Tommy John surgery” became a popular term when that major league pitcher had a revolutionary surgical procedure in the mid-1970s to save his career. A healthy tendon was extracted from his right forearm to replace the ulnar collateral ligament in his pitching arm, which was severely damaged by overuse. He missed an entire season while recovering, then changed the way he pitched to reduce the stress on his arm. He wound up pitching for 13 more seasons.

This remains a famous overuse injury. But overuse injuries can affect many areas of the body. A runner can develop stress fractures in his or her feet. Repeated stress can cause a gymnast problems in the arms and legs. Think of the professional tennis player who develops one much larger forearm from continuous use. That’s a muscle reacting to repeated stress.

I believe the increase in overuse injuries is attributable to a trend that started in the last 20 years or more. During this period, young athletes have tended to specialize in one sport and play it year-round. In the case of team sports, they often play in more than one league. And if the child happens to be gifted in that sport, you’ll find many parents encouraging that specialization with thoughts of a college scholarship and perhaps a professional career.

But rigorous play – using the same continuous motions – coupled with little recovery time is the root cause of overuse problems. Parents of developing adolescents are astounded when X-rays show clear evidence of how overuse can affect growth plates. Beyond the physical, there are emotional factors as well. For a young person, repeated participation in one activity with no break can lead to burnout. The fun we’ve all experienced merely participating in a sport can easily disappear. These days, many kids only play team sports in organized leagues. Pickup games with your friends just for the love of the sport seem to be a thing of the past.

Sports medicine has made remarkable strides in returning athletes to their previous forms. But everyone reacts to injury differently, and you shouldn’t automatically assume your child will bounce back completely. Many people are never the same after an injury.

If your child is experiencing pain or discomfort while competing, be sure to have it checked by a primary care or sports medicine physician. If you see a change in your child’s form or technique while competing, be sure he or she isn’t compensating for a physical problem. If your daughter is an athlete and is experiencing changes in her menstruation cycle, have it checked as it could be connected to an overuse issue.

The best prevention of sports overuse injury is rest. Remember, a couple days of rest from a sport isn’t going to alter a career, but an overuse injury could.