Transcription:
Overuse Injuries in Youth Athletes

Introduction: Here's another edition of the BayCare Health System’s podcast series, BayCare HealthChat with Melanie Cole.

Melanie Cole: Welcome to BayCare HealthChat. I'm Melanie Cole and today we're discussing overuse injuries in athletes. Joining me is Dr. Kevin Elder. He's Board Certified in Sports Medicine and Family Medicine at BayCare. Dr. Elder, it's a pleasure to have you on in this series for athletes and weekend warriors. One of the most common things we see are chronic overuse and even in our young athletes that are sports specific training. What are some of the most common overuse injuries you see in our youth athletes?

Dr. Elder: We do see commonly various youth athlete injuries that you can see these overuse injuries and these can be grouped into a couple of different categories. By sport really and with baseball for example, we see a lot of growth plate injuries. We can see some what's referred to as little league, shoulder or little league elbow, which are involving growth plants, either the shoulder or the elbow. We can see also around the elbow, the ulnar collateral ligament, sometimes referred to as Tommy John ligament can be strained or torn. Many times it's going to be a partial strain, not a full thickness tear. Also we can see various other injuries around the heel in baseball, but then also getting into running, jumping sports such as Severs condition, which is a growth plate injury at the heel. Osgood-Schlatter is a similar type injury at the knee. Most people have heard of that term: Osgood-Schlatter. Big name really means a growth plate issue at the knee. Then you get into dancing, jumping sports where there can be these very same injuries we had just described. But then sometimes more tendonitis, Achilles tendon, patella tendon, stress fractures come into play, IT band issues. And then I guess finally you can see some pelvic injuries from running type sports. There's pelvic growth plates so sometimes athletes will present with groin pain and it's actually a growth plate issue. Soccer athletes get this sometimes, also track and running athletes.

Host: Thank you for that answer. And now what about the weekend warrior? People that like to golf and play tennis and go running and we have done another podcast on running injuries that people can listen to if they go to the BayCare website. So for regular people that are working out and playing tennis and doing all of these things, they can have overuse injuries as well. Yes?

Dr. Elder: Absolutely. We certainly can see these weekend warrior, so-called normal people like all of us out there trying to get some exercise. In an adult, obviously you're not going to have all these growth plate injuries that you see in youth athletes. What we're going to see in an adult is we're going to see more generally tendon based issues, tendinitis, and you can have a tendonitis anywhere, of course, from your Achilles to your rotator cuff and everywhere in between. Obviously the other things that can fall sort of into the overuse category can be various back issues and arthritis of certain joints and sometimes it's too much activity or it could be an imbalance or it could be just kind of you're working muscle groups but the core is not there. And we're getting some weakness and it's causing some instability in the system.

Host: Well, it certainly does. So let's talk about what we can do to prevent these injuries, whether it's in youth athletes or in adults that are playing golf and tennis. Anything that we can do because especially with our youth athletes, they do this specific training. They stick with one sport and that can contribute as well. Give us your best advice for prevention. Let's start right there.

Dr. Elder: If we start with prevention for a youth athlete, the best thing we can do is number one to try to not focus on sports specializing a youth athlete at too young of an age. There's a tendency in the United States especially I think to think that we're going to have the next pro athlete. We have the next starting middle reliever or we have the next Pele or whatever it is. I think making sports fun, playing different sports, sports specializing in practicing too much, you can overload the growth plates. There's a lot written across the board about playing one sport all the time. Tends to have higher rates of injury and high rates of burnout. So keeping sports fun. I mean the statistics are that only one in 14 kids are going to play in college and of those only one in 54 are going to play division one, and then of those less than 2% of the NCAA athletes are going to go pro.

So that's 0.04%. So I think we should keep sports fun. They're good. Everyone needs to move and be active and there's already way too much screen time. So keeping sports fun. For the athlete that is an older athlete, a non youth athlete, the mature athlete, we'll call them. I think we also want to keep it fun and people can overdo it. Also we want to mix it up. Maybe knowing where your comfort zone is not going crazy and signing up for extreme boot camp class, working through it and having a plan, paying attention to your core. People, an adult or mature athlete, they sometimes will not do anything and then they'll go overboard and get injured. The truth is somewhere in between. You want to try to have a structure, follow it and mix it up.

Host: Great advice. Now, if we take your advice, we don't need the next bit of advice, but it's important that we discuss it. If we're starting to feel those overuse injuries or we're starting to notice it in our children, what do you want us to do? What home care can we do to hopefully relieve some of the pain, whether it's NSAIDS or bracing, ice and heat. I mean, there are a lot of methods and so give us some of those modalities that we can try to relieve some of that pain.

Dr. Elder: Sure. For our youth athletes, a lot of that's going to involve making sure they're properly hydrated and really for the mature adult athlete, that would be the same thing. If we're dehydrated, we're more prone to injuries. So we always want to make sure we have proper hydration. Anti-inflammatories, NSAIDS do serve a purpose acutely for relieving pain and sometimes decreasing some inflammation and helping a function. Stretching, ice and heat are also very useful. Once we extend beyond those initial things, people tend to these days will try some home exercise. They might look up some stretches, look up some exercises, and I think that's reasonable. I think it's when it's, we've gone to the next level where it's preventing us from exercising or we're waking up in the morning or we're seeing our child walk around with a limp, for example. That's not normal and that's not good, and that's where it's maybe time to go see a professional. And get a proper assessment and maybe get some imaging and figure out what's going on, and what specifically needs to happen to try to fix the problem.

Host: When we're talking about things that we can do to keep strong. And you mentioned the sports specific training and that was a really great explanation because a lot of parents have this unrealistic expectation that their kids are going to play through college. Go pro. I mean it's really, it's pretty common among parents who have children in sports when we're cross training, when we're doing these other sports, trying to do something a little different so we don't get those overuse. Is weight training a plus or a minus when you have joint pain and tell us a little bit about what you would do with somebody when they come to you because they've tried all of those other things and it just isn't working.

Dr. Elder: First of all, I think weight training and strength training is a plus in general pretty much across the board. I think if you're talking about a youth athlete, it's important. If we're talking about an adult athlete, casual weekend warrior athlete or we're talking about an older athlete, someone who's still playing tennis and they're in their eighties. Some aspect of strength training with that population, for example, it's a matter of use it or lose it. If you don't continue to use those muscle groups, you're going to have progressive loss of strength that we all get naturally and you will in fact get weaker. Now if we have our youth athlete, they are on the other end of the spectrum and so they're trying to learn proper form. They're trying to learn how do they compensate for the field getting bigger, the plate moving back further, the people on the tennis court are hitting harder, so they have to do some strength training to compensate for their growing body.

And a lot of their work is in neuromuscular recruitment and coordination. So even with a young athlete, we can do some strength training. They're not going to stunt their growth by doing some strength training. That's kind of a common misconception. Now obviously we shouldn't have a 10 year old doing power lifting. That's kind of ridiculous, but we might have a 10 or 12 year old doing some very simple low weight sport type specific exercises to work on things that are going to help them in their sport. And again, this is neuromuscular recruitment. So really these things are particular to the age category you're dealing with and I think that kind of ties into where somebody in this field, a sports medicine specialist, maybe a good quality physical therapist can help guide the patient or guide the parents. What do they need to do? What are ways to try to prevent injury? How do we help solve the problem, the injury we're presented with, so that's where that ties in.

Host: Great information, really something we can all use. Dr. Elder, as we wrap up, your best advice for preventing overuse injuries, whether it be a youth athlete or a mature athlete and how we can stop those little aches and pains by just changing it up a little bit.

Dr. Elder: I think that variety, as they say, the spice of life. It's kind of a generic saying that you hear thrown around, but variety really keeps things fun. This should be fun. This should be a diversion. Most of us are not professional athletes and even professional athletes might do some other sport on a casual basis for fun, but certainly for the lion's share of the world. Youth, adult, mature athletes, mixing it up and making it fun and not making exercise be a chore, that's the key to doing it and enjoying it. It should be something we look forward to. Maybe you have to schedule it in your day and if we're having something that's getting in our way of continuing, then we want to seek out a specialist and there's resources we can get for that. Look online, American medical sites, sportsmedicine.org look up for a sports medicine in your zip code and city. You can look in your local review in your area. I mean everybody searches things on Google these days and you can find who's recommended by whatever various other apps people have. But the bottom line is having mixture, have fun with it, and if you can't do what need to do or you're noticing a limp or something else, then it's time to seek out some extra help.

Host: Thank you so much, Dr. Elder. As always, your expert advice is so excellent. It really is and you put it so clear for us. Thank you again for joining us. To learn more about BayCare sports medicine services, please visit our website at BayCare.org for more information and to get connected with one of our providers. That concludes this episode of BayCare HealthChat. Please remember to subscribe, rate, and review this podcast and all the other BayCare podcasts. Share this show with your friends and family on social media. That way we're learning from the experts at BayCare together. I'm Melanie Cole.