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.
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