Common Overuse Injuries in Young Athletes

Children are susceptible to certain injuries because their growth plates are still open. Sever’s Disease, Osgood-Schlatter or Sinding-Larson-Johannsen (SLJ), and Little League Elbow are just a few diagnoses that children can acquire at the growth plates. Typically children diagnosed with these injuries are very active in sports, which may cause the overuse injury in the growth plate.

If these injuries are not treated appropriately, damage to the growth plate may occur and impact the child’s potential bone growth. This is why it is important for parents and coaches to be aware of symptoms of growth plate injuries, as well as treatment options. Read below to learn more.

Sever’s Disease is an inflammation of the growth plate at the calcaneus or heel bone.¹

• Does your child complain of pain in their heel or achilles?
• Do you notice a bump on the back of their heel?
• Is your child involved in a lot high impact activities such as basketball, running, gymnastics and/or volleyball?

Young athletes suffering from Sever’s disease will typically feel pain when their heels are squeezed. Sports that require repetitive jumping or landing from a height put the child at risk. Children with tight calf muscles are more susceptible to this injury.

Rest is the best treatment option for this diagnosis.² That said, there are a few other things that can be done to help relieve symptoms. Gel heel cups, for example, can be placed in gym shoes to reduce excessive strain on the heel.¹ Appropriate shoe wear may also assist with decreasing pain; this includes gym shoes that have arch support and good heel support or cushion. Children with Sever’s Disease should avoid wearing flip flops or flat shoes to limit the continued strain at the heel bone. Gentle calf muscle stretching with more aggressive hamstring stretching can also reduce pain attributed to Sever’s Disease.

If pain or discomfort persists, further care from the child’s physician should be sought. Parents and coaches should also keep in mind that modification of activity level will need to occur for proper healing. This means decreasing the child’s participation in sporting activities.

Osgood-Schlatter/SLJ are both diagnoses involved at the level of the knee.

• Does your child complain of pain in their knees?
• Do you notice a bump under your child’s knee?
• Is your child involved in a lot of activities that are high impact – such as basketball, running, gymnastics and/or volleyball?
  

More commonly known as “jumper’s knee,” children diagnosed with Osgood-Schlatter or SLJ typically have knee pain either just below their patella (knee cap) or on the very top of their tibia (shin) bone. There can also be a bony prominence on the tibia that results if this becomes more of a chronic issue.

Children that play sports like soccer and basketball may experience pain with jumping, sprinting, shooting, kicking or shuffling. They may also complain of pain with stairs or getting up from their desk chairs at school. When this is the case, it is a good idea to seek a formal evaluation from a pediatric orthopedic.

Rest is typically the first step in recovery for these growth plate injuries. Additional treatment options include ice, physical therapy, stretching of the hamstrings and quadriceps muscles, as well as strengthening of the core and hip muscles without bearing weight in the legs.

If the injury persists, the child should seek further care from their physician. Similar to Sever’s Disease, modification of activity level needs to occur in order for proper healing to take place.

Little Leaguer Elbow is a general term used to describe when a child experiences elbow pain due to excessive throwing or overhead activities.

• Does your child complain of elbow pain?
• Is this worse when throwing a ball overhead or swinging their arms overhead?
• Is your child involved in softball or baseball?
  

Children with Little Leaguer Elbow most commonly experience pain just above the inner part of the elbow. ¹ This area will be tender to the touch. Excessive throwing can cause strain at the ligaments, chronic inflammation at the growth plate and more serious issues in this area, such as fractures.¹

Baseball pitchers are especially at risk due to the repetitive motions involved in the many phases of throwing, which includes:

• Wind Up – the throwing arm is still in the glove hand; typically not harmful to the elbow
• Early Cocking – starts when the throwing arm leaves the glove hand; some (low) force is placed on the elbow
• Late Cocking – the throwing arm moving behind the pitcher is at the end of shoulder external range of motion; stress on the elbow increases
• Acceleration – the throwing arm starts moving forward toward the plate; stress on the elbow is still increased
• Follow-Through – the throwing arm is slowing down as the arm moves across the pitchers body

The Late Cocking and Acceleration phases of throwing place the most stress on the elbow.¹

Similar to the previous two diagnoses discussed, rest is the best treatment option. Gentle stretching of the elbow and shoulder are important to maintain range of motion while activity level is decreased. As pain lessens, resistance exercises may be added. Typically, a return to throwing program, or formal physical therapy, is warranted. This often requires referral to a medical professional.

It is important for families and coaches to know about this disorder and how to prevent it. Young athletes should adhere to the rules of Little League. There is often a pitch limit per game, per week and per season. Coaches should also give their pitchers rest days as recommended by the Little League.¹

If you think your child has an overuse injury, Athletico provides complimentary injury screens at a clinic near you. Schedule yours today!

Schedule a Complimentary Injury Screen

References:

1. Dutton’s Orthopedic Examination, Evaluation, and Intervention, Third Edition. Mark Duton. The McGraw-Hill Companies, Inc. (pg 1414-1415) 2012.
   

2. Tomlinson, Pamela. Athletico’s Pediatric Program President. Pediatric Pearls Pamphlet.