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Parents should worry: Sport specialization and overuse injuries

Monday, April 17, 2017

By Nathaniel Franley, MD

Medical Director of ACMC Sports Medicine

While sports are a tremendous part of many kid's growth and development mentally, physically, and socially, today's culture can sometimes place a high emphasis on athletic development. I want parents and coaches to be aware of the risks of pushing our youth too hard. Sometimes excessive training can lead to injuries called overuse injuries, defined as injuries due to overloading the musculoskeletal system without proper rest to allow for adequate healing. An important factor in strength and speed gains is recovery-without it, a young athlete's body is more prone to injury and less likely to make progress in training. Another factor leading to overuse injury is sports specialization, in which an athlete trains year-round in a single sport. In some technical sports, such as gymnastics, figure skating, and diving it's necessary to specialize at a young age (before 12) to reach peak success, but this has been shown not to be true, and may actually be harmful, in most other sports.

Here are some facts compiled in a 2014 Position Statement by the American Medical Society of Sports Medicine:

  • Estimates of overuse injuries compared to acute injury range from 45.9-54%.
  • Overuse injury rated vary by sport, ranging from 37% (skiing) to 68% (running).
  • Early sport specialization may not lead to optimal long-term success in most sports.
  • Playing multiple sports develops different skill sets, which may improve overall athletic success in the future.

In addition to possibly limiting an athlete's overall athletic development, sport specialization may lead to overtraining and burnout. Red flags to look out for include decreasing levels of enjoyment in a sport, decreasing performance, and even loss of menstruation in female athletes. These are important clues to recognize, as overtraining can lead to not only overuse injury such as tendinitis, stress fractures/reactions, but also depression and metabolic issues or even lack of sleep and energy. For example, decreased menstruation frequency can be a signal for low bone density and low energy availability. This negative cycle can actually affect an athlete's progress.

So how can we prevent overuse injuries?

  • Limit total training time throughout a week and a year.
  • Avoid sport specialization until at least age 12 (or preferably later), based on child's growth rate and readiness.
  • Emphasize skill development more than competition and winning.
  • Encourage experimenting with multiple sports.
  • Properly directed preseason conditioning programs can reduce injury rates.
  • Neuromuscular or balance and stabilization training can reduce lower extremity injury.
  • For pitchers, limit pitches to less than 100 innings total/year (more than that increase injury risk 3.5 times)
  • Limit pitchers to throwing less than 8 months a year (more than that increases risk for elbow and shoulder surgery)

ACMC Family Medicine and Sports Medicine Specialist Nathaniel Franley, MD sees patients at Ashtabula County Medical Center. He attends many local high school athletic events in addition to seeing patients in both regularly scheduled clinics and special fall sports Injury clinics. He oversees local sports concussion testing, athletic training programs, and manages full spectrum non-surgical orthopedic injuries such as fractures, tendinitis, arthritis, etc. To schedule an appointment with Dr. Franley, call 440-997-6969.