How Much is Too Much? Overuse Injuries in Youth Sports

Picture yourself in the shoes of a young baseball player.

You adore the sport – you do exercises to improve your strength and repetitive exercises to work on mechanics.

You play on several teams just to stay game-ready, and you play year round: spring leagues, summer leagues, fall leagues, indoor training during the winter.

Simply put, baseball consumes you!

In this scenario, the young baseball player’s living engine is running hard, and running constantly – if it were a car on a race track, it’d need a pit stop to refresh and renew.

For young athletes, especially those playing at a high level, their living engine is constantly running in the form of young muscles being put through their paces every day.

Over time, the muscles are strained, creating friction along the tissues and joints.

If this frenetic pace continues, the body’s natural lubricants start to break down – and that’s when overuse injuries happen.

Rest and the principles of training

Too many people (and particularly young people) think that the ideal way to train is defined by being able to put your body through the paces of rigorous activity on a daily basis, whether that activity is on the field or in the gym.

After all, if you can throw 100 pitches day after day and feel OK, you must be doing it right – your body can handle the load, right? Who needs rest?

However, rest is a key aspect of training for anything, whether it’s getting ready for the season as a professional athlete or preparing for your first 5K.

 There are eight established principles for training:

1. Specificity: When your training program mirrors the demand and output of your fitness goal.
2. Overload: When the demand on your body is greater than what you’re accustomed to (in a safe, controlled way).
3. Adaptation: The body’s response to the training (i.e. muscles getting stronger).
4. Progression: Changing the overload incrementally in response to the adaption.
5. Maintenance: Keeping those adaptions in place through consistency.
6. Individualization: Programs specifically designed to an individual’s well-being.
7. Warm up/cool down: The body’s need to slowly get acclimated to and cool down from exertion.
8. Retrogression/plateau: The body reaches a point of stalemate – it must regroup and go about training a different way.

When it comes to overuse injuries, that last principle is key.

In the case of a young baseball player, he or she may begin a “long toss” program to get the arm acclimated to the rigors of repetitious throwing.

Over the course of that program, the muscles will adapt to the added stress, and the body will respond over time by strengthening the muscle fibers.

However, after seeing speedy results at the beginning of the program, the player will eventually see that pace slow down as he or she hits a plateau.

When young athletes reach a plateau or stalemate, they too often try to push through (in this case, by simply throwing more or throwing harder) – and this is when we see overuse injuries.

Athletes achieve true, long-lasting progress by allowing the body to complete the cycle of adaptation and response – rest is a key component of that cycle!

The rest period gives your body time to recover from the exertion, to adapt to the new demands, and to strengthen the muscles.

Training is only effective when it allows the body time to adapt and be more efficient.

To be blunt, training without incorporating rest simply won’t work and is a recipe for injury!

The dangers of overuse among children and teens

Overuse injuries are problematic regardless of one’s age, but they can be particularly harmful for children and teens.

While it’s true that every individual is different, the bones and muscles of children and teens are still growing.

Still-growing bones are susceptible to repetitive loading, and the still-adapting muscles can be easily strained from the repetitive push-pull motions that come with training, lifting weights, and playing sports.

As a result, it’s important to be vigilant for the signs of overuse.

How can you spot potential signs of overuse?

While overuse will look different for everyone, there are some warning signs:

1. Performance-related warning signs: Consistent decrease in performance or persistent fatigue/sluggishness. In the case of sports training, the reappearance of already corrected errors is a warning sign as well.
2. Physiological-related warning signs: Decreased maximal workload capacities or persistent, low-grade stiffness and soreness of muscles and joints.
3. Psychological/behavioral-related warning signs: Apathy or disinterest toward a previously enjoyable activity. Loss of competitive drive or desire.

How are overuse injuries treated?

If you or your child has pushed beyond the body’s limits and are struggling with overuse injuries, it can be frustrating – you want to keep training, but everything you do seems to aggravate the injury.

Physical therapy can help the body recover from overuse injuries by using targeted, corrective exercise and supportive therapies that allow the injury the necessary time and setting to heal.

Whether you’re dealing with muscle strains, simple contusions, tendonitis, or even subluxation, the Physical Therapy Team at South Shore Health is here to help get you back in the game.

Brien Wolter, PTA has two decades of experience working in the orthopedics and sports medicine fields.

Learn more about Physical Therapy at South Shore Health.