Overuse Injuries

An increasing number of boys and girls are playing recreational and organized sports. As a result, there is a rise in the number of overuse injuries seen among children and teens. Most sports and overuse injuries are due to injuries that affect the bone, muscles, ligaments, or tendons.

What are the most common types of overuse injuries?

Type of overuse injury	Symptoms	Possible cause
Jumper's knee (patellar tendonitis)	Tenderness right below the kneecap on the tendon	The patellar tendon in the knee joint is repeatedly pulled on, causing inflammation and pain, especially during jumping activities.
Little Leaguers' elbow or shoulder	Pain in the elbow or shoulder area, especially during activity	Repetitive overhead throwing maneuvers done inefficiently that cause damage and inflammation to the growth plates of the bones in the arm (or as a result of a fracture).
Osteochondritis dissecans	Joint pain and swelling.	A piece of the cartilage in the knee, elbow, or ankle joint that separates from the joint surface. Theories suggest that it may run in families or be caused by a metabolic problem.
Sever's disease	Heel pain with limping, especially during running and jumping activities	Repetitive running or jumping activities causes the Achilles tendon to pull on the growth plate of the heel bone.
Shin splints	Pain and tenderness over the shin area	Excessive running, running on hard surfaces (concrete), and iincorrect shoe wear can cause shin splints.
Sinding-Larsen-Johansson disease	Knee pain, especially after jumping activities	This condition is caused by excessive traction from the patella tendon on the lower pole of the kneecap.
Spondylolisthesis	Back pain	This condition is caused by overloading the low back in extension. X-rays show that a part of 1 vertebra in the low back slips forward on the vertebrae below it. It's commonly seen in football linemen, gymnasts, and ice skaters.
Spondylolysis	Back pain	This condition is caused by overloading the low back in extension. It's commonly seen in football linemen, gymnasts, and ice skaters. A stress fracture of 1 of the vertebrae is seen on X-ray.

Overuse injuries can also lead to stress fractures. Stress fractures are weak spots or small cracks in the bone caused by continuous overuse. Stress fractures often occur in the shin and foot after training for basketball, running, and other sports. There often is no swelling, but pain and tenderness often increase during movement.

Treatment of an overuse injury

The goal of treatment is to control the pain, promote healing, prevent complications, and restore normal use of the injured area.

Initial treatment for overuse injuries includes R.I.C.E. (rest, ice, compression, and elevation).

Talk with your child's healthcare provider if the injured area has a prolonged, visible deformity. Or if severe pain keeps your child from using their arm, leg, wrist, ankle, foot, or knee.

Other treatment choices may include:

• Medicine

• Activity restrictions

• Splint or cast

• Crutches or wheelchair

• Physical therapy (to manage pain, identify impairments that may have led to injury and treat to reduce complications)

• Surgery. Your child may need surgery if the injury happens again, they have pain that doesn't get better, or a muscle, tendon, or ligament is badly torn.

Long-term outlook for children with overuse injuries

Overuse injuries often heal quite quickly in children. It's important that the child stick to the activity restrictions and stretching and strengthening rehab programs to prevent reinjury.

Many sports injuries can be prevented with correct conditioning and training, wearing the right protective gear, and using the right equipment.