Overuse injuries - what they are, why they occur and how to stop them

This artile is sourced from http://www.footy4kids.co.uk/

Overuse injuries - what they are, why they occur and how to stop them
Dr. Michael Busch, Orthopedic Surgeon, Children's Healthcare of Atlanta
The [child's] body [is] a lot like a paperclip. If you just keep bending it over and over and over again, eventually that paperclip is going to break".

What are overuse injuries?

Overuse injuries in youth soccer usually result from repetitive forces that cause 'micro trauma'. Damaged tissues become inflamed, causing swelling and a loss of function. Continuing to exercise leads to a vicious cycle and the injury becomes chronic.

Occasionally, children can suffer even more serious injuries (such as fractures) as a direct result of too much coaching. Especially if it is combined with a punishing programme of match play.

Too much soccer coaching and match play (and, more importantly, the wrong type of coaching) can cause serious, long-lasting injuries to children. This is simply because a child's body is not fully developed and is unable to withstand repeated impact, even if that impact is simply from running for a long time on hard or uneven ground.

How common are overuse injuries?

Overuse injuries are responsible for almost 30% of the injuries in soccer and range from mild tendinitis (swelling of a tendon) to a stress fracture.

What damage can be caused by too much coaching and/or match play?

1. The inflammation, or even fracture, of a child's delicate 'growth plates' (tissue at the ends of growing bones). Fractured growth plates are not only painful, they can result in a bone that stops growing.

2. Knee pain caused by soreness and swelling from inflammation of the tendon or cartilage under the kneecap.

3. Spondylolysis - persistent lower back pain caused by trauma, or from repetitive flexing, twisting, or over extension of the back muscles.

4. Osgood-Schlatter's disease (apophysitis) - a painful bump where the kneecap tendon attaches to the shin bone.

Risk factors

A child is especially vulnerable to overuse injuries while going through growth spurts (bones growing quicker than the connecting tendons). This usually occurs between the ages of 10-14 for girls and 12-16 for boys.

Having pushy parents doesn't help! Andre Agassi used to have a tennis racket taped to his hand when he was just two years old, and a tennis ball suspended above his cot for something to 'fix his eyes on'.

That may be an extreme example. But parents of young soccer players can also become over concerned with their child's success, and encourage them to train too hard before their bodies (and minds) are strong enough to withstand the pressure.

In addition, poor quality coaching can lead to overuse injuries. Children shouldn't be treated as though they are mini adults (no laps please!). While failure to warm up and cool down young players properly can greatly increase the risk of an overuse injury.

Coaches have to put their players' health before trophies. Don't get your players in for lots of extra training sessions just because you have got a cup final coming up! If you do, that cup final could be their last.

The danger signs

• Reluctance to attend practice sessions
• Sudden deterioration in performance
• Getting tired easily
• Becoming impatient or arguing with team mates
• Repeated minor injuries and pain that doesn't go away

 How much is too much

Not a great deal of hard data is available on this subject. That is because large groups of children would have to be put through an increasingly punishing schedule of coaching to see how long it takes them to collapse. I don't think many parents would be willing to allow their kids to perform such tests!

 
You just need to be sensible, watchful and treat children as individuals.

 
How to minimise the risk

• Modify or stop training during growth spurts.
• Don't force children to take part in sports they are patently unsuited to for reasons of physique or temperament.
• Make sure all young players are adequately warmed up before exercise and cooled down afterwards.
• Children should never be told to 'run it off' - even minor injuries need to be properly treated.

How to treat overuse injuries

Rest and, if appropriate, use ice to reduce inflammation or compression wraps to reduce swelling. Always get medical advice at the earliest opportunity.

 
References

1. Federation of Holistic Therapists
2. Briggs, James: Children in Sport / Child Abuse in Sport. Sports Therapy: Theoretical and Practical Thoughts and Considerations, 2001