Pediatric Sports Overuse Injuries

Jumper's knee (patellar tendonitis)

• Symptoms: Tenderness right below the knee or the upper shin area
• Possible cause: The patellar tendon in the knee joint is repeatedly pulled on, causing inflammation and pain, especially during jumping activities.

Little Leaguers' elbow or shoulder

• Symptoms: Pain in the elbow or shoulder area, especially after activity
• Possible cause: Repetitive overhead throwing maneuvers that cause damage and inflammation to the growth plates of the bones in the arm (or as a result of a fracture).

Osteochondritis dissecans

• Symptoms: Joint pain and swelling.
• Possible cause: A piece of the cartilage in the knee, elbow, or ankle joint that separates from the joint surface. Theories suggest that it may run in families or be caused by a metabolic problem.

Sever's disease

• Symptoms: Heel pain with limping, especially after running activities
• Possible cause: Repetitive running or jumping activities causes the Achilles tendon to pull on the heel bone.

Shin splints

• Symptoms: Pain and tenderness over the shin area
• Possible cause: Excessive running, running on hard surfaces (concrete), and improper shoe wear often cause shin splints.

Sinding-Larsen-Johansson disease

• Symptoms: Knee pain, especially after jumping activities
• Possible cause: This disease is caused by an irritation of the kneecap due to repetitive extension on the patellar tendon in the knee (the tendon pulls away from the bone).

Spondylolisthesis

• Symptoms: Back pain
• Possible cause: This condition is caused by excessive extension of the low back. X-rays show that a part of 1 vertebra in the low back slips forward on the vertebrae below it. It's commonly seen in football linemen, gymnasts and ice skaters.

Spondylolysis

• Symptoms: Back pain
• Possible cause: This condition is caused by excessive flexion and extension of the lower back. It's commonly seen in football linemen, gymnasts and ice skaters. A stress fracture of one of the vertebrae is seen on X-ray.

Stress Fractures

Overuse injuries can also lead to stress fractures. Stress fractures are weak spots or small cracks in the bone caused by continuous overuse. Stress fractures often occur in the foot after training for basketball, running, and other sports. There often is no swelling, but pain and tenderness often increase during movement.

The goal of treatment is to control the pain, promote healing, prevent complications and restore normal use of the injured area.

Initial treatment for overuse injuries includes R.I.C.E. (rest, ice, compression and elevation).

Talk with your child's doctor if the injured area has a prolonged, visible deformity or if severe pain keeps your child from using their arm, leg, wrist, ankle, foot or knee.

Other treatment options may include:

• Medicine
• Activity restrictions
• Splint or cast
• Crutches or wheelchair
• Physical therapy (to stretch and strengthen the injured muscles, ligaments and tendons)
• Surgery. Your child may need surgery if the injury happens again, they have pain that doesn't get better, or a muscle, tendon or ligament is badly torn.

Overuse injuries usually heal quite quickly in children. It's important that the child adhere to the activity restrictions and stretching and strengthening rehabilitation programs to prevent reinjury.

Most sports injuries are from traumatic injury or overuse of muscles or joints. Many sports injuries can be prevented with correct conditioning and training, wearing the right protective gear and using the right equipment.