University of Cincinnatti

UC HEALTH LINE: Overtraining Can Sideline Young Athletes

CINCINNATI—“It’s that time of year again,” says Keith Kenter, MD, and he’s not talking about back-to-school shopping.

What he’s referring to is the increased number of children and young adults he sees in the clinic due to injuries as a result of overtraining for fall sports programs.

Millions of children and young adults are now training for fall athletics programs, some as early as kindergarten. With school sports, club sports, select and recreational teams, Kenter says “it’s become easier to identify injury patterns” inherent to overtraining. Shin splints, stress fractures and muscle swelling in the lower extremities are historically associated with preparation for football, soccer, cross country and volleyball season.

That line is starting to blur, however, as the seasonal aspect of youth athletics is changing. While it was once popular to participate in a variety of sports, most young athletes now stick with the same sport year round, which can lead to overtraining and repetitive use injuries.

“These kids are using the same muscles over and over again and there’s not enough down time. There’s more and more of a push to get in as many games as possible at as many facilities as possible and you lose sight of what is happening to the athlete,” says Kenter, who is also an assistant professor and residency director for UC's orthopedic surgery department.

While Kenter says he strongly believes the overall health benefits of playing sports greatly outweigh the risks, the influx of patients, he says, is part and parcel of a modern, albeit unhealthy, “more is better” mentality—especially when training for the high cardiovascular sports such as football, soccer, cross country and volleyball.

“It’s hard to control how much is too much,” when at the elementary school level most coaches are parent volunteers with little or no expertise aside from having been an athlete themselves at one point.

“It’s estimated that about 3 million kids under age 15 are injured every year in playing youth sports,” says Tim Hewett, PhD, associate professor of pediatrics, orthopaedic surgery, biomedical engineering and rehabilitation sciences at UC. He is also the director of the Sports Medicine Biodynamics Center at Cincinnati Children’s Hospital Medical Center.

Those numbers, says Hewett, are high for a combination of reasons: the number of young athletes has increased dramatically since the 1950s; more girls are playing sports than at any time in history; kids are playing at higher, more reckless levels and they play more often, and they basically take no breaks due to year-round play.

While there is no current data that breaks overtraining injuries out from, say, a collision with an offensive lineman, Kenter says he sees the effects of overtraining over and over again, including from personal experience. His 14-year-old daughter suffered a stress fracture when overtraining for soccer.

“We’re losing the concept of what youth sports are about: It should be about fun,” says Kenter.
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