Lasting effects of overuse injuries, burnout in youth sports underestimated

Emphasis on competitive success in youth sports has led to intense training, frequent competition and early single sport specialization, as well as a rise in overuse injuries and burnout. The American Medical Society for Sports Medicine recently released a new clinical report providing guidance to physicians and health care professionals who provide care to young athletes and recommendations for evaluation and treatment.

Through a systematic literature search, researchers found current studies reported overuse injuries comprise 50% of sports injuries, but underestimate the burden of these injuries because many do not result in time loss from sport. The clinical report also highlights several specific higher-risk overuse injuries that may result in prolonged recovery and have the potential to endanger future participation, since some may lead to long-term complications. There is also emphasis on several unique risk factors for overuse injuries and burnout in children and adolescents, such as social, emotional, cognitive and physical factors.

“Not only are overuse injuries in young athletes likely much more common than is realized, these injuries can require lengthy recovery periods, and in some cases, they can result in long-term health consequences,” John P. DiFiori, MD, chief of sports medicine and non-operative orthopaedics at UCLA and president of the American Medical Society for Sports Medicine, stated in a news release. “Children grow and mature at different rates, making chronologic age a poor barometer for parents and coaches to set expectations and gauge progress. Understanding this can be critical to a child’s self-esteem and motivation to continue participating.”

Researchers recommended a history of prior injury —an established risk factor for overuse injuries— should be noted as part of each injury assessment and pre-participation examination. Adolescent female athletes should be assessed for menstrual irregularity as a predisposing factor to bone stress injuries. And because early sport specialization may increase risk for overuse injury and burnout, parents and physicians should encourage sport diversification among younger athletes, with the possible exception of early entry sports such as gymnastics, figure skating and swimming and diving.

Researchers also recommended limited weekly and yearly participation time and limited sport-specific repetitive movements; scheduled rest periods; and careful monitoring of training workload during the adolescent growth spurt, as injury risk seems to be greater during this phase. Finally, injury rates can be reduced with pre-season conditioning programs and pre-practice neuromuscular training.

For more information:

DiFiori JP. Clin J Sport Med. 2014;24:3-20.

Disclosure: The researchers have no relevant financial disclosures.

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