July 2018

Guest Editorial: Youth Overuse Injuries and What Clinicians, Parents and Coaches Can Do

By Robert A. Weil, DPM

It’s one of the key issues in youth sports today: an epidemic of overuse and repetitive motion injuries. It affects both lower and upper extremities, across the board, in all sports at all ages. As the world of youth sports has grown dramatically, so have these injury problems. Overuse injuries cause a significant loss of time off the field, but more importantly, they threaten future sport participation which could inadvertently lead to increased obesity. This population is at increased risk because growing bones are less resilient to stress and children’s awareness of symptoms as signs of injury are limited.

Youth sports (age 6 – 18) has grown into a mega-business with traveling teams, club teams, training facilities and sports specific coaches annually serving upwards of 60 million youth, according to the National Council of Youth Sports. That’s in addition to our huge junior high, high school and college mania. Excessive pressure to play when hurt, overzealous parents, and Svengali-like coaches are part of this mix of overuse—both physical and mental. The explosive use and abuse of pain killers, both over-the-counter and prescription, is extremely alarming, especially in our “pills for everything” sports culture. The pressure from parents and coaches is on young athletes to “suck it up” and stay in the game. While this thinking has been around for years in high school and college, this pressure is starting at younger and younger ages. Adding to the burden is the parent- and coach-driven notion of specializing in a single sport which directly increases the risk of repetitive motion injuries in young growing bodies.

Most common overuse injuries in young athletes

  • irritation of the growth plate (apophysitis)
  • problems with tendons
  • stress fractures
  • patellofemoral (knee) pain.

Pain, decreased performance, limping and swelling should be evaluated as signs of possible overuse injuries.

While we all know that incorporating a multi-disciplinary approach to help deal with these problems is the gold standard of clinical care, we also know that medicine is a fragmented business. In this, its 9th anniversary issue, I’m pleased to be able to recognize the important role Lower Extremity Review and LER Pediatrics have played in creating a community where different specialties can come together to discuss a never-ending array of biomechanical, structural, muscle- and tendon-related problems, injuries, and challenges. I’m proud to have been able to contribute numerous articles, writing from the sports podiatry perspective. Getting additional information both to and from numerous specialties such as physical therapy, orthopedics, podiatry, chiropractic and athletic training, to name a few, really adds to the team approach needed to reduce this epidemic of youth sports overuse and repetitive motion injuries.

#HeySportsParents by Sharkie Zartman and Dr. Robert Weil is available on Amazon.com.

Keeping clinicians across the spectrum informed can help them help their patients by understanding some of these parental pressures and addressing those parents with sound guidance. That’s where the new book, #Hey Sports Parents: An Essential Guide for any Parent with a Child in Sports, can play a role. Whether your young athlete is serious and accomplished in their sport or just looking to participate and enjoy the experience, their safety and the prevention of injury—both overuse and acute, is very important. My co-author, Sharkie Zartman, knows a little about that. She’s a former All-American, National team member, and Hall of Fame volleyball player…she’s lived it! She is a kinesiology professor and long-time coach whose daughters were both D1 athletes. It’s a book for parents of athletes written by an athlete/coach and a sports podiatrist who’s treated them.

Our goal was to help parents understand their role as the parent of an athlete, how to determine a youth’s level of participation, and to provide criteria for how to choose a coach (and avoiding coach abuse, which has exploded as a national nightmare of late). We have a Sports Doctor section that addresses treatment and prevention of common acute and overuse lower extremity injuries, including what to tell your child’s various clinicians. We also discuss proper shoe selection, foot mechanics and orthotics, specialization concerns, youth sports and drugs, essential exercises and the challenges of youth tackle football. Following LER’s lead, we also include a team approach with expert commentaries:

  • Nutrition for young athletes by registered dietitian Kate Davis
  • Dr. Denise McDermott on athletics as mind medicine for life
  • Sports safety by Dr. Steve Horwitz, chiropractor for the 1996 US Olympic Team and founder of TeamSafe™

These and other experts also tackle physical training, sports psychology and mental training, coaching and parental behavior as well as concussion information and awareness of youth sports emergency criteria. And the Parent Perspectives section provides valuable insights, challenges, and experiences of real sports parents.

Athletic trainers, podiatrists, orthopedists and the community of clinicians who read Lower Extremity Review are key allies in the fight to limit overuse injuries in today’s youth sports. LER’s focus on keeping its audience informed on all aspects of research, treatment, and prevention of lower extremity problems in every sport imaginable is unmatched. Keeping the education and awareness of these huge challenges in our hyper youth sports culture is of ongoing importance to all of us. So glad to be part of the team…kudos to LER and LER Pediatrics!

Dr. Bob Weil is a sports podiatrist in private practice in Aurora, Illinois. He hosts “The Sports Doctor,” a live weekly radio show on bbsradio.com. For more information, go to sportsdoctorradio.com.

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