When athletes don't take time off, the parts of the body required for repeated movements in throwing, jumping or pivoting don't have enough time to recover. That can be particularly hard on growing bodies.
"Children ages 12 to 16 are at highest risk for these problems," says Jeffrey Nepple, MD, a Washington University orthopedic surgeon and pediatric sports medicine specialist at St. Louis Children's Hospital. "They're undergoing growth spurts and are changing at rates that are faster than any other time during their lives. That's when they're at the greatest risk for injuring themselves."
A Balancing Act
Unlike acute injuries, overuse injuries aren't caused by a single event, such as getting hit in the knee. Instead, subtle pain becomes more noticeable over time and often disappears or reappears based on use. Variety is the key to keeping these problems away.
"If you concentrate in a specific sport, you tend to overuse certain muscles and joints in certain areas, and muscle development isn't well balanced," says Gregory Finn, MD, a Washington University clinical associate pediatrician at Blue Fish Pediatrics. "Children who play multiple sports tend to have a lower incidence of overuse injuries. Plus, participating in a variety of sports will condition children to be better athletes in any single sport."
Setting Safe Limits
In addition to varying their activities and alternating those from season to season, Dr. Nepple recommends having at least one to two rest days each week. Most importantly, Dr. Finn emphasizes, young athletes should take a break from all sports for one month each year.
Parents and coaches can reduce a child's risk for overuse injuries even more by keeping track of specific motions. For instance, the American Sports Medicine Institute advises adolescent baseball pitchers to pitch no more than 100 innings in games in any calendar year, and to stop overhead throwing of any kind for four months annually. Little league baseball regulations set daily limits on the number of pitches athletes should throw:
AGE DAILY PITCH LIMIT
In addition to limiting the number of pitches thrown per day, pitchers should limit the number of days they throw per week. "The daily pitch limit represents the maximum number of pitches for one day, but pitchers should not throw at these levels for multiple days in a row," says Dr. Nepple. "Pitchers need to rest their arms between games."
The American Sports Medicine Institute provides guidelines for days of rest based on number of pitches thrown at
Roughly 3.5 million young athletes are treated for sports injuries each year. Nearly half of those injuries are caused by overuse.
The International Association of Athletics Federations also offers guidelines for child athletes:
• Runners ages 12 to 14 should run no more than 12.4 miles per week. Those ages 15 to 16 should run no more than 26.2 miles per week. The maximum weekly distance for 17-year-olds is 37.3 miles.
• Track & field throwers (shot put, discus, javelin, etc.) should throw no more than 20 times in a given training session—and have no more than three sessions per week—up to age 14. The maximum for throwers ages 15 to 18 is 40 throws.
• Track & field jumpers (long jump, pole vault, etc.) should perform no more than 10 jumps per training session—and have no more than three sessions per week—up to age 14. The maximum for jumpers ages 15 to 18 is 20 jumps.
"Sports should be a source of both happiness and health for kids," Dr. Finn says. "Taking a smart, balanced approach to sports is the best way to produce excellent athletes for a lifetime."
To make an appointment with a pediatric sports medicine specialist, call 314-454-KIDS (4357).
For over 130 years, Children's Hospital and its Washington University School of Medicine physician partners have remained a resource for pediatric health and wellness for the St. Louis region and beyond.
They provide care in every pediatric specialty — from fetal care through adolescence. In 2016, U.S. News & World Report ranked St. Louis Children's Hospital in all 10 specialties, the only children's hospital in Missouri to earn this distinction. Their Level One Pediatric Trauma Center is nationally verified by the American College of Surgeons (ACS), the highest national recognition possible.
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