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Sports and Overuse Injuries

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Sports: How much is too much?

As more children and teenagers participate in organized sports, pediatricians are seeing an increasing number of sports-related injuries. Approximately half of these are caused by overuse – too much training and not enough rest.

Dr. Joel Brenner, co-director of CHKD’s Sports Medicine Program, is the lead author of the American Academy of Pediatrics’ new policy on “Overuse Injuries, Over-training and Burnout in Child and Adolescent Athletes.” He answers some questions below to help parents and coaches find the right balance between encouraging children to succeed in sports and pushing them too hard.

WTG: What constitutes too much training?

Brenner: Young athletes should limit training in one sport to no more than five days a week, with at least one day off a week from any organized physical activity. They should also take two to three months a year off from their primary sport. This does not have to be continuous time off. It can be divided into several shorter breaks. They can use this time to work on strength training and conditioning, which will help reduce the risk of injuries during the season.

WTG: But don’t kids need to practice hard year-round to be competitive?

Brenner: The focus should be on fun, fitness, skill acquisition, safety and sportsmanship. Less than one percent of high school athletes make it to the professional level. A more important goal is to develop a life-long love of exercise, which won’t happen if kids associate sports with too much pressure or physical pain.

WTG: What are some common overuse injuries in children?

Brenner: They usually occur in and around joints that have lots of repetitive movement, such as the shoulders of swimmers and baseball players and the knees of runners and soccer players. The injuries can range from chronic inflammation to tears, pulls and ruptures of tendons and other tissues. Stress fractures are also common overuse injuries.

WTG: Are they more common at certain ages?

Brenner: Athletes are most at risk right around puberty, when their bones are growing quickly.

WTG: What are the signs that a child is training too hard?

Brenner: Chronic muscle or joint pain, personality changes, elevated resting heart rate, decreased sports performance, fatigue, lack of enthusiasm about practice or competition or difficulty completing ordinary activities. A physician should always evaluate pain that lasts more than 48 hours, especially if your child has trouble using the area in pain.

Dr. Brenner is a sports medicine and adolescent medicine specialist with Children’s Specialty Group PLLC at CHKD.

(757) 668-7000

About Dr. Brenner

Dr. Brenner is the medical director of CHKD's sports medicine and adolescent medicine programs and the director of CHKD's sports concussion program.

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