Too much of a good thing
Cross-training and common sense should be enough to avoid overuse sports injuries, or at least help to cure them once they've begun.
Overuse injuries in athletes, especially youth athletes who concentrate on one sport year-round or who refuse to quit when the pain begins, are common to trainers, coaches and doctors.
Scott Zema, an assistant professor of athletic training at Slippery Rock University, who also is the head trainer for the SRU football team, said trainers and coaches see a lot of overuse injuries at the beginning of a sports season.
"People think they can go out and start where they left off, even if the last time they exercised was six months, a year or 10 years ago," Zema said.
Overuse injuries can range from soreness due to inflamed joints or muscles to broken bones.
As an example, Zema cited a recent case in which a high school track runner who had stress fractures in her shins refused to stop running.
"At a track meet, her tibia snapped as she was running," he said.
Zema said just taking some time off from a sport and allowing injuries to heal and muscles to rest, or switching exercises, known as cross-training, would help all athletes, including those who just exercise on the weekends.
Jordan Frank, 19, of Avon Lake, Ohio, is a freshman football player at SRU who suffers from a history of knee overuse. He said he has learned how to deal with the problem on a daily basis."I ice it every day before and after practice and if need be, I go to a rehab program that the athletic trainers come up with," Frank said. "I also take two Aleve every 12 hours."Frank said he has had chronic pain in his knees for more than a year. After the effects of overusing the knee set in, Frank learned he had developed a condition in which his kneecap was scraping against the tendon in his leg."It takes a toll on you physically and mentally, but you do whatever you can with the help of your trainers, dig down and fight through it," Frank said. "It's just an annoying and constant pain."Frank said he works through the pain by relying on his support system of teammates and staff, and doesn't plan on having surgery soon.Kate Van Campen, 19, of Philadelphia is a freshman water polo player. She started swimming when she was 7 and aggravated a shoulder problem after a scrimmage last year."During training in February, we were scrimmaging against the guys team and I was defending against a guy," Van Campen said. "They swam by me and our arms got interlocked and my whole arm got pulled back — my shoulder joint popped out and then back in."She said she experienced shoulder pain on a regular basis before the injury, but developed a chronic problem after the collision."Since then I have done that five or six times, and went through two MRI scans and have been to see orthopedic doctors," she said.The condition she has is called chronic subluxation, and involves the joint popping out of place, then back in.Van Campen will have surgery after her season is over, but said that won't guarantee anything. Until then, she does strength exercises and a physical rehabilitation program at the university to alleviate the pain.
Jennifer Swanson, a physical therapist who writes for Rehab Management Web site, "The interdisciplinary journal of rehabilitation," says 30 percent to 50 percent of all pediatric sports injuries are attributed to overuse.These injuries include tendinitis, bursitis and stress fractures.Swanson further attributes overuse injuries in children to sports specialization, or concentrating on one sport throughout the year.With the advent of indoor playing fields and swimming pools, as well as private gyms with private instruction, some children may only play or prepare for one sport all the time. An example is swimmers who move from the outdoor club team in the summer to indoor teams in the fall and winter.Dr. Jan Grudziak, a pediatric orthopedist with UPMC Children's Hospital in Pittsburgh, said the top three youth sports for overuse injuries are baseball, gymnastics and swimming."With baseball players, pitching causes problems; with gymnastics, its microfractures in the lower limbs; and in swimming, we find shoulder, back and knee problems," he said.When faced with a parent who promotes athletics for their children, Grudziak said he takes a thorough history of the patient's activities, and what condition is causing pain or a problem participating in sports."I need to know if they warm up before exercising or playing games, and if so, for how long and what are they doing," he said, adding that he also needs to know if they are cross-training. That includes exercise, plus weight training, balance training and exercises that use other parts of the body besides those for their specific sport."After that, I find out if they rest while maintaining other activities," Grudziak said.He may prescribe physical therapy and a review of the patient's technical skills, such as how are they delivering pitches or performing a swimming stroke."Gradually, we will increase their exercise, usually six to eight weeks, but sometimes it takes up to six months to fully recover," Grudziak said.
Athletes must use common sense: When something hurts, rest and find out why it hurts. But coaches, trainers and parents must use the same common sense when dealing with pediatric and adolescent athletes, Grudziak said."Coaches need to resist pressure from parents who want the children to play, regardless of their condition or what doctors may say," he said.Grudziak also said coaches and trainers need to help their players study their sports, so they know how to play them right."And don't focus on the one single sport," he said. "If the sport is football, you don't just hit each other all of the time. One day there's running and the next weight training. It should be a mix for every sport."Also important, Grudziak said, is coaches must make sure to emphasize proper nutrition and hydration."There are guidelines for each sport, and coaches, parents and athletes can go to sports association Web sites and look those up," he said, using the American Academy of Pediatrics' Sports Section as an example.That site, for example, offers a formula for the number of pitches young baseball players can safely throw."That formula is age minus 1 times 10 equals the number of pitches a player should throw per week, and that includes practices and games," Grudziak said."Overall, all athletes should have fun, but at the same time, they and those around them need to be smart about what they are doing," he said.
