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Too much of a
good thing can be harmful, especially when it comes to children playing sports. As more
children and adolescents participate in organized and recreational sports, pediatricians
are seeing an increasing number of children and adolescents with overuse injuries caused
by too much training and not enough rest.
A new American Academy of Pediatrics (AAP)
clinical report entitled “Overuse Injuries,
Overtraining, and Burnout in Child and Adolescent Athletes,” defines an overuse
injury as a micro traumatic injury to a bone, muscle or tendon that has been subjected to
repetitive stress without sufficient time to heal or undergo the natural healing process.
The risks of overuse are more serious in the pediatric/adolescent athlete because the
growing bone of the young athlete cannot handle as much stress as the mature bones of
adults.
The report recommends young athletes
limit training in one sport to no more than five days a week, with at least one day off
from any organized physical activity. In addition, athletes should take time off from one
sport for two to three months each year. Taking a break from a sport allows injuries to
heal and the opportunity to work on strength training and conditioning to reduce the risk
of future injuries. It also helps kids take a psychological break, which is necessary to
avoid burnout, or overtraining syndrome.
Symptoms of burnout include chronic
muscle or joint pain, personality changes, elevated resting heart rate, decreased sport
performance, fatigue, lack of enthusiasm about practice or competition, or difficulty
completing ordinary activities. It’s imperative that youth athletes are educated
about appropriate nutrition and fluids, and how to avoid hypothermia, hyperthermia,
overtraining, overuse injuries, and burnout. Additional recommendations the report
suggests include:
- Weekly training time, number of
repetitions, or total distance should not increase by more than 10 percent weekly.
- Focus of sports should be on fun, skill
acquisition, safety and sportsmanship.
- Join only one team per season.
- Be aware of risks associated with
weekend tournaments (soccer, baseball, tennis), such as heat-related illness, nutritional
deficiencies, overuse injuries and burnout.
- Multi-sport athletes who use the same
body parts for different sports especially need to take a break between seasons to avoid
overuse injuries.
- Getting caught up in making the
professional leagues or Olympics is unrealistic. Children and adolescents train year-round
on multiple teams of one sport often with the hope of earning a college scholarship in
that sport or becoming a professional athlete, but less than 1 percent of high school
athletes make it to the professional level.
The report also addresses youth
participation in endurance events such as triathlons, marathons and half-marathons.
Triathlons are reasonably safe as long as the events are modified to be age appropriate.
Specifically, such events should be of shorter duration/length, and careful attention
should be given to safety and environment conditions. It is fine for youth athletes to run
marathons as long as training involves gradually increasing total weekly mileage, and they
enjoy it. The report concludes that lifelong fitness and enjoyment of physical activity
should be the overall goal of participating in athletics.
The American Academy of
Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical
subspecialists and pediatric surgical specialists dedicated to the health, safety and well
being of infants, children, adolescents and young adults
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