Youth sports undoubtedly offer a multitude of benefits, from building physical strength and stamina to instilling teamwork and discipline. However, the increasingly competitive and intensive nature of youth sports may lead to negative outcomes such as burnout and injury. According to the American Academy of Pediatrics, children are encouraged to take a couple of days off from training per week, but more importantly youth athletes are advised to take two to three months off of their primary sport per year as an off season. Unfortunately, sometimes the highly competitive and at times political nature of youth athletics makes it very challenging to actually follow this generally accepted medical advice. As a parent, how do you balance fueling your child’s passion with protecting their physical and mental wellness?
Sports participation plays a significant role in the lives of young people. It can have tremendous physical and mental health benefits, shaping their physical development and mental resilience. However, the race to excel in sports often leads to an imbalance of training load and recovery, which can have detrimental effects. Research shows that over 70% of youth athletes volitionally choose to retire from sports by the age of 13. “These kids are facing tremendous pressure at such an early age, and at the end of the day we have to remember it’s just a game” said Dr. Ketan Mody, board certified sports medicine physician and Director of the Elite Sports Medicine Institute (www.elitesmi.com). Dr. Mody contends that while athletics provides great opportunities for kids, too much of a good thing can be risky. He states “The repetitive stress and physical load that is sometimes placed on these developing bodies put children at a much greater risk for overuse and cumulative load injuries”.
A common consequence of this imbalance is overuse injuries. Overuse injuries result from repetitive stress without adequate recovery time, leading to accumulated musculoskeletal damage. These injuries are most common in the lower leg among youth athletes, especially girls, endurance athletes, and those with a prior injury.
| Injury | Common Locations |
| Apophysitis | Calcaneus (Sever’s disease), tibial tuberosity (Osgood-Schlatter disease), medial epicondyle |
| Bone stress injury (stress reaction, stress fracture) | Tibia, metatarsals, lumbar spine |
| Tendinopathy | Patellar tendon (jumper’s knee) |
| Epiphysiolysis | Proximal humerus (little league shoulder), distal radius (gymnast’s wrist) |
| Patellofemoral pain syndrome | Anterior knee |
| Osteochrondritis dessicans or Panner’s disease | Capitellum |
Overtraining, or overtraining syndrome, is another negative outcome of an imbalance in training load and recovery. Overtraining syndrome exhibits symptoms like decreased performance, fatigue, sleep disturbances, mood changes, and an increased risk of illness and injury. It is a consequence of chronic excessive exercise without sufficient recovery.
Several factors contribute to the risk of overuse injuries and overtraining. These include sport specialization, insufficient recovery, poor technique, higher Body Mass Index (BMI), inadequate sleep, and prior injury. Social and psychological stressors, such as academic difficulties, financial stress, and family dynamics, can also contribute towards overtraining syndrome.
Sport specialization, where a child focuses on a single sport, often predisposes them to the development of overuse injuries. Specialization in sports involving considerable biomechanical repetition of movement, such as pitching or running, may result in enough repetitive stress to exceed the healing capacity of the tissue, leading to injury. Dr. Mody reflects “in the past, when I was a kid, we just played whatever the season was…football, basketball, baseball, it didn’t matter. There was a natural phenomenon of cross-training based upon the time of year. You had your main sport, but you still participated in other activities. This diversification of sport led towards greater physical literacy, enhanced athleticism, and probably reduced our risk of injury.”
Properly managed training loads can cause physiologic adaptations that protect against injury. However, acute increases in training load relative to the chronic load can overwhelm these protective mechanisms and increase the risk of injury. The human body is amazingly adaptable, however if we push the training threshold and overload or advance training too quickly, the result may be tissue breakdown and injury.
Emerging research suggests that psychosocial factors can also influence the balance between stress and recovery. For instance, athletes with reduced sleep, higher levels of athletic identity, perceived life stress, and perfectionist concerns have been found to be associated with an increased risk of overuse injury. Dr. Mody advocates “it is important that these athletes remember that they are kids. In the grand scheme of things, the big game on Friday night isn’t worth returning from injury too quickly such as trying to participate following a concussion without medical clearance. I tell kids all of the time, there are so many important things in life: going to college, getting married, having a family…playing high school football should not be the pinnacle of your life.”
Preventing overuse injuries and overtraining involves identifying and addressing the factors that lead to an imbalance between stress and recovery. This includes managing training load, optimizing nutrition, hydration, and sleep, and improving psychosocial factors.
It is commonly recommended that training loads should be advanced by no more than 10% to 20% per week. Certain sports, such as baseball, have developed age-based pitching guidelines to limit repetitive stress.
Optimizing nutrition and hydration can facilitate physiologic adaptation between training sessions. Insufficient caloric intake (relative energy deficiency) and/or low vitamin D levels may predispose athletes to bone stress injuries.
Adequate sleep and rest are crucial for recovery between bouts of exercise. Insufficient sleep can undermine recovery, potentially increasing the risk of overtraining.
The consequences of long-term overtraining and overuse injuries can be severe. These include decreased performance, impaired well-being, decreased quality of life, and a reduced sense of accomplishment. Moreover, burnout from sports can represent a direct threat to the goal of lifelong physical activity and the wide-ranging health benefits it provides.
Youth sports offer an avenue for young people to develop physically, mentally, and socially. However, the increasing pressure to specialize and excel can lead to an imbalance of training load and recovery, resulting in overuse injuries and overtraining syndrome. It is crucial for parents, coaches, and healthcare providers to recognize the signs and symptoms of these conditions and implement preventive measures. This will ensure that young athletes can enjoy the benefits of sports participation without the risk of burnout or injury.
By promoting safe and healthy sport participation, we can help young athletes enjoy the benefits of sports, develop lifelong physical activity habits, and mitigate the risks of burnout and injury.
Whether you are looking for injury prevention tips or your child has unfortunately experienced an injury, our team of mobility experts at IMPACT Physical Therapy and Sports Recovery utilize a multitude of manual therapy techniques, exercises, and sports recovery tools to help keep athletes of all ages in the game. Request an appointment today.
