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: Knee pain and swelling. This condition can also cause elbow pain similar to Little Leaguers' elbow

Possible cause: A piece of the cartilage in the knee 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: Excessive running, running on hard surfaces (concrete), and improper shoe wear often cause shin splints.

Spondylolisthesis

Symptoms: Back pain

Possible cause: This condition is caused by excessive flexion and 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 is 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 is commonly seen in football linemen, gymnasts, and ice skaters. A stress fracture of 1 of the vertebrae is seen on X-ray.

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 usually is no swelling, but pain and tenderness often increase during movement.

Specific treatment for an overuse injury will be determined by your child's doctor based on:

• Your child's age, overall health, and medical history

• Extent of the condition

• Type of condition

• Your child's tolerance for specific medications, procedures, or therapies

• Expectations for the course of the condition

• Your opinion or preference

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).

Be sure to consult your child's doctor if there is a prolonged, visible deformity of the affected area, or if severe pain prevents use of the arm, leg, wrist, ankle, or knee.

Other treatment options may include:

• Medications

• Activity restrictions

• Splint or cast

• Crutches or wheelchair

• Physical therapy (to stretch and strengthen the injured muscles, ligaments, and tendons)

• Surgery (especially if the injury is reoccurring, there is persistent pain, or if a muscle, tendon, or ligament is badly torn)

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

Most sports injuries are due to either traumatic injury or overuse of muscles or joints. Many sports injuries can be prevented with proper conditioning and training, wearing appropriate protective gear, and using proper equipment.