Overuse Injuries, Overtraining and Burnout Syndrome in Child and Adolescent Athletes

Are your children at risk?
Overuse is the leading risk for injury in the young athlete. Approximately 30-45 millions 6-18 year olds participate in sports and account for close to 50% of all pediatric sports medicine cases. The young athletes are also participating in sports year-round and on multiple teams for the same sport which may lead to burnout syndrome largely attributed to parental pressure on the athlete.

What determines overuse?
“An overuse injury is microtraumatic damage to a bone, muscle, or tendon that has been subjected to repetitive stress without sufficient time to heal or undergo the natural reparative process.” Overuse can be classified into 4 stages:
1) pain in the affected area after physical activity
2) pain during the activity, without restricting performance
3) pain during the activity that restricts performance
4) chronic, unremitting pain even at rest

How much training is too much?
There is no evidence based guideline to answering this question, but we know most of the injuries sustained occur during peak times of growth. The American Academy of Pediatrics Council on Sports Medicine and Fitness recommends the following:
1) limiting 1 sporting activity to a maximum of 5 days per week
2) at least 1 day off from any organized physical activity.
3) at least 2 to 3 months off per year from their particular sport during which they can let injuries heal, refresh the mind, and work on strength, conditioning, and proprioception in hopes of reducing injury risk.

What is “burnout”, or overtraining syndrome?
It can be defined as a “series of psychological, physiologic, and hormonal changes that result in decreased sports performance.” Common manifestations may include the following:
1) chronic muscle or joint pain
2) personality changes
3) elevated resting heart rate
4) decreased sports performance
5) fatigue
6) lack of enthusiasm about practice or competition
7) difficulty with successfully completing usual routines

The following guidelines should be followed to prevent burnout:
1) Keep workouts interesting, with age-appropriate games and training, to keep practice fun.
2) Take time off from organized or structured sports participation 1 to 2 days per week to allow the body to rest or participate in other activities.
3) Permit longer scheduled breaks from training and competition every 2 to 3 months while focusing on other activities and cross-training to prevent loss of skill or level of conditioning.
4) Focus on wellness and teaching athletes to be in tune with their bodies for cues to slow down or alter their training methods.

What is the goal of the athlete?
“The ultimate goal of youth participation in sports should be to promote lifelong physical activity, recreation, and skills of healthy competition that can be used in all facets of future endeavors.”

Brenner, J. S.. “Overuse Injuries, Overtraining, And Burnout In Child And Adolescent Athletes.” Pediatrics 119.6 (2007): 1242-1245. http://pediatrics.aappublications.org. Web. 15 Jan. 2014.