Back when Dr. Joel Brenner, a national committee member on sports medicine and fitness for the American Academy of Pediatrics, played youth baseball, he was out on the field four times a week for three months out of the year. Now, Brenner said those same kinds of seasons routinely run six days a week for six months out of the year.
With increased pressure to combat childhood obesity and work toward athletic greatness, more children are turning up with sports-related injuries than ever before.
“There are more activities and more organized sports,” said Brenner, the Medical Director of Sports Medicine at the Children’s Hospital of the Kings Daughters in Norfolk, Va. “They’re going six to seven days a week. (Children) aren’t giving their bodies a chance to heal.”
This increase in activity has caused lasting damage in many children. An injury to an adult may end their sports season. An injury to a child could wash away their entire career and stunt their growth.
According to the Lucile Packard Children’s Hospital at Stanford University, more than 30 million children in the United States participate in sports every year. Of those, more than 3.5 million injuries are reported each year.
Many are left with overuse injuries, or injuries that happen because they are using the same repetitive motions during sports too often. An overuse injury is basically one that affects a bone, joint or tendon because of repetitive motions with little recovery time, Brenner said. They were once unknown but are now prevalent in many youngsters.
Some overuse injuries are becoming so common that they are even uniquely named, like Little League elbow, which is damage to growth cartilage in the elbow from so much throwing. Some of the most common overuse injuries are knee pain, shin splints, Little League elbow and swimmer’s shoulder.
There are, however, some protective measures that can be taken, said Jennifer Byrd, the Director of Athletic Training at the National Center for Sports Safety. Things such as proper equipment, pitch counts and weight classes can combat overuse injuries. But the sprains, strains and pains will still happen.
“Guidelines can be followed for each sport, but the incident of injury is always there because of the normal wear and tear on the body,” Byrd said.
But the average wear and tear can be detrimental. Many children are playing
sports nonstop throughout the entire calendar year.
Parents and coaches want children to succeed and earn that college scholarship. They want to see children become Olympians one day. Brenner said that’s a remote possibility as less than 1 percent of high school athletes turn professional. Even fewer will make it to the Olympics.
That’s why Brenner doesn’t see the point of juggling multiple sports for the majority of the year.
“When children play sports, they don’t need to do so for six or seven days a week, 12 months out of the year,” Brenner said.
Preventing Overuse Injuries
Any child on any court or field is susceptible to overuse injuries. A few too many pitches or one too many strokes could end their young athletic careers.
Luckily, there are some preventive steps to take to combat and help avoid these types of injuries.
The first is education, Byrd said.
“All parties involved from the athlete to coaches and parents should be able to recognize the signs and symptoms of overuse injuries and to take proper steps of rehab for the injury,” Byrd said.
When children are growing, they are more likely to sustain an injury. That’s why children going through puberty should pay particular attention to the signs of injury.
Overuse injuries are tough to detect. Nothing triggers an overuse injury, like a sudden break or tear. Rather, these develop gradually over time as kids go through the same practices and drills countless times.
Oftentimes, children won’t recognize these injuries because there is no sudden time of injury. If untreated, they can lead to permanent damage or could even lead to long-lasting complications such as arthritis.
It’s not a trip or a fall that will trigger such an injury. Rather, overtraining is the chief cause in overuse injuries.
Naturally, parents and coaches will look for a way to avoid overtraining. But the demands to succeed both as a team and individually still exist.
So how much is too much? That’s a question Brenner routinely fields. There isn’t a magical number, but a resting period is crucial, Brenner said. Children should take at least one or two days off per week to avoid overtraining. In the long run, Brenner said children should take at least two or three months away from sports every year.
“People are putting more time in,” he said. “They feel pressured to train more.”
Enrolling children in the right sports can also help ease the burden. Sports that are organized through recreations areas, schools and clubs usually field certified athletic trainers. A trainer will not only know how to treat injuries, but also how to prevent them.
Protective gear is another basic step that shouldn’t be overlooked. Many sports have common injuries that can easily be avoided. Mouth guards and eye protection should be used in any contact sports, while appropriate padding for other sports such as football and soccer are needed.
A simple acronym — R.I.C.E. — can help treat many common overuse injuries if a doctor or trainer is not immediately available. The steps are: R: Reduce or rest the injured area. I: Ice the injured area for 20 minutes at a time. C: Compress the injury with bandages, splints, boots or an appropriate wrap. E: Elevate the injury above the heart.
The body needs time to heal, but Jamie Croley of Trinity Rehabilitation said finding that time is the biggest challenge he faces.
“As an athletic trainer all I try to do is I try to find a way to break a repetitive cycle of inflammation,” he said.
In addition to ice, Croley also uses electrical stimulation, stretching techniques, ibuprofen and a type of ultrasound to get deep heat into tissue to treat an overuse injury.
To prevent the injuries, Croley suggested athletes work on their form and stretch. With baseball season underway, he suggests pitchers work on rotator cuff exercises or take a break from the mound by playing a different position.
Time off can often be the best antidote.
Playing sports year-round will likely result in injuries, regardless of steps taken before or after the activity.
But an overuse injury can’t occur if muscles, joints and bones are routinely rested.
“Even professional athletes have an off-season,” Brenner said.

Antoinette Grajeda contributed to this report.