Overuse In Youth Sports & How To Avoid Preventable Injuries


Overuse injuries in youth and teen sports have grown into a nationwide epidemic, filling the waiting rooms at rehabilitation clinics and orthopedic practices with overburdened, growing young bodies struggling to heal.

As single-sport specialization extends year-round into younger age groups and as young athletes attempt to take on workloads too strenuous for their quickly growing bones, joints and muscles, and increase in overuse injuries becomes a natural consequence.

We sat down with Carson Valley Medical Center Pediatric Physical Therapist Courtney Carmichael to discuss trends the rehabilitation staff is seeing within the community and some simple tips to avoid overuse-related injuries.

Major injuries are getting younger

“As a clinician, we are seeing more injuries that are overuse-related,” Carmichael said. “We used to see ACL (anterior cruciate ligament, knee) tears in soccer at age or 15 or 16 in females. Now,  we are seeing them under the age of 13. That can be a career-ending injury.”

Carmichael added the CVMC rehabilitative services department sees many other knee injuries — torn meniscus, for example — as well as throwing arm injuries (shoudlers, elbows) in young baseball and softball players taking on a year-round or semi-year round training schedule.

“Overuse injuries are 100 preventable,” she said. “Young bodies need time to rest and recover. They also need cross training.”

Avoid one-sport specialization

“Specializing (in one sport) too early adds mental and emotional stress as well as physical stress,” Carmichael said. “Use the different sports and the different seasons as a natural form of cross training.”

She said current best-practice recommendations are for single-sport and single-discipline specialization to occur between ages 16 and 18 in males and 15 and 17 in females, and no earlier.

Ages 9-12 (males) and 9-11 (females) is a time period best used for refining basic sports skills and fundamentals across a variety of sports and disciplines.

A 2017 article in the New York Post reported that doctors nationwide are seeing drastic increases in youth sports overuse-related injuries and that a large portion of those injuries are attributable to single-sport specialization.

“It’s young people with injuries that weren’t as common when there was a diversity of sports — three different sports and three different seasons,” Brett G. Toresdahl, MD, told the Post. “The variety of stress on their body wasn’t causing it to break down to the degree we are seeing now.”

Hold off on weight training

In addition to later-stage sport specialization, Carmichael said parents should hold off on weight training until they get an OK from a physician.

“It really depends on the individual child’s development,” she said. “A physician will be able to determine the rate at which the child is growing. If you start them too early, their bones and tendons are growing at different rates and that too can lead to overuse injuries.”

As a general rule of thumb, strength and speed training should begin between 12 and 16 in males and 11 and 15 in females according to best practices, and again understanding that each individual body is different.

Wait for 100 percent

Carmichael was a specialized youth athlete herself, competing at an elite level for the United States ski team on both the national and international levels. Over time, she too experienced several severe overuse-related injuries.

Aside from the initial injury itself, she said she’s learned how important the recovery process can be.

“As a clinician now, I can think back and relate to my experience as a youth athlete,” she said. “It took me longer to heal (from reconstructive ankle surgery) than it takes an adult, at least 4 to 6 longer.”

“As an athlete in high school, you’re dealing with scouts or coaches, or parents, and it’s all about when they can get back to playing. “The question should be when they can get back to playing at 100 percent.”

“You want them to have lifetime health vs. having the same injuries and problems in the same joints the rest of their life. Having the treatment time is so important.”


For more information on Carson Valley Medical Center’s rehabilitative services department, visit this link.

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