Overuse injuries in high school

There was a recent article in the Journal of Pediatrics that looked at the rates of overuse injuries in high school athletes. The results will not come as much of a surprise to those working with high school athletes: girls had higher rates of overuse injuries than boys and the most commonly injured sites were the lower leg, knee and shoulder. The sport played largely determined the injury site, swimming and baseball for shoulders, gymnastics for backs, track and field for lower leg. The really interesting finding was that rates of injuries changed during high school with boys having more overuse injuries as they got older and girls have fewer overuse injuries as they got older. The authors are not sure why that is occurring, but it is probably related to growth, intensity, competition and neuromuscular control. 

 

Since girls and boys have differences in neuromuscular control when they mature, it makes sense that the younger girls would be at increased risk of injury during that time until they got stronger and had improved mechanics. Why the boys got injured more as they got older is an interesting finding to keep track of in the future.

 

I think that these studies are interesting in that they confirm what we suspect, but it also gives us an opportunity to utilize the findings to create better programs aimed at decreasing injury risk. If you work with young athletes then understanding  these results can help you be a better coach. If your team is younger females then spend more time on neuromuscular training, strength training and controlling the volume in practice. If your team is older boys then continue to strength train, but control the volume and intensity in practice. 

 

Participation in athletics carries an implicit risk of injury that cannot be fully mitigated, but it can be better understood. Knowing your athletes, your sport and the common injuries can help to create better programs. If you are not sure the best way to structure a conditioning or training program talk with your school’s athletic trainer (if you have one) or a certified fitness professional.

 

You can find the study here: http://www.jpeds.com/article/S0022-3476(14)00888-9/pdf

 

 

Understanding overuse injuries in high school and college

The American Journal of Sports Medicine published a recent article examining overuse injuries in high school at collegiate sports. Overuse injuries account for the vast majority of injuries suffered in these groups (70%). Of those injuries, running was the common cause. The most commonly involved lower extremity joint was the knee and predictably, baseball, softball, swimming and diving had more shoulder involvement.

This study confirmed what practitioners have been observing when working with their athletes and the comparison between groups is helpful in identifying trends. College athletes have higher incidences that result in more time lost, women have more overuse injuries than men, and lower extremity injuries are prevalent in sports that involve running. While the conclusions are not surprising, I think the important point to remember is that repetitive loading results in tissue breakdown that causes injury without adequate time for adaptation.

Coaches and those that work in coach education can use this information to better develop pre-season and off-season training plans that take overuse injuries into consideration. Instituting programs that have athletes gradually start running or throwing in the off season to adjust to forces can decrease the injuries once the season starts. Too often, not enough is done in the off season and too much is done in the pre-season and early season. This jump in activity increases the tissue load beyond what it can absorb and leads to an injury. Utilizing a periodized program can make sure that loads are applied more thoughtfully to reduce the stress while still attaining the goal of greater skill and fitness development.

Understanding that overuse injuries are prevalent can also help strength coaches and athletic trainers come up with preventative programs. For those athletes that do a lot of running, controlling the volume is helpful, but so is making sure that there are no weaknesses in the kinetic chain. Spending time working on improving hip and core strengthening along with running drills can improve the ability to absorb force and decrease tissue overload. Similarly, making sure that the shoulders are strong and stable prior to swimming or throwing can decrease the overload that they sustain once the season begins. Continuing to monitor athletes and noticing deficits or changes can be an early warning sign that the athlete is experiencing too much strain.

Once athletes start to have pain, early intervention and volume control may be undertaken to decrease the load applied and allow the athlete to continue with participation. Knowing what the common injuries are in a sport can assist with ways of modifying the known risk factors.

http://ajs.sagepub.com/content/early/2015/04/30/0363546515580790.full.pdf+html