FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

PROPER PREPARATION BEST PREVENTION FOR OVERUSE INJURIES

Question: My children are active in sports, particularly spring sports. My daughter plays soccer and my son plays baseball. Both seem to complain of sore feet, legs and shoulders for most of the season. Is this anything to worry about?

Answer: Participation in sports offers a wide variety of health and social benefits. It is good that your children are involved in these activities.

Aches and pains are one of many signals the body sends to inform our brains about the state of our various body parts. The process of "getting in shape" improving the strength, flexibility and endurance of muscles is often associated with some minor discomfort. With a proper training schedule this muscle soreness should, indeed, be very mild. Typically, this is described as nothing more than, "My muscles are a little stiff this morning!" Since both your young athletes complain of pain, I am suspicious that their conditions are something a little different; I think it's likely they have what's called "overuse injuries."

Overuse injuries result from repeated activities that exceed an individual's level of training and ultimately produce microscopic tears of soft tissue or fractures in bone. About 50 percent of all sports injuries in children are of this type.

There are a number of factors that can lead to overuse injuries. Muscle weakness and poor flexibility are common, particularly early in the training season. Conditions such as flat feet, a leg-length difference or other variations from the "ideal" arrangement of bones and joints make the individual more susceptible.

Improper fitting equipment is often a factor in overuse injuries. Among my patients, shoes that are worn out or don't fit right seem to be the most common equipment-related problem. This can result in foot, ankle, knee or hip pain. Of course, other types of equipment can cause or fail to prevent injury to other parts.

Training technique and training schedule are frequently responsible for, or at least contribute to, many overuse injuries. My experience is that most coaches and trainers below the college level know little about optimizing a training program to bring the athlete to peak condition as quickly as possible while minimizing the risk of injury. Most seem to work the kids until half of the group has dropped from exhaustion, then repeat the same practice the next day. Fortunately, most young athletes are quite resilient. They do recover quickly and are ready to go again the next day. Some of the group, however, develop aches and pains like your children because of overuse injury.

Little league elbow is seen in baseball players, particularly pitchers. Popping, clicking and locking of the elbow are typical of the condition. Sever's Disease is common in running sports, including soccer. It causes heel pain with limited ankle motion and strength. Stress fractures, painful cracks in the bone, typically occur in the legs or feet of distance runners and basketball players.

Not all doctors are skilled in treating sports-related overuse injuries, but many are. I'd have your family doctor examine your children for overuse injuries if their discomfort is more than a mild muscle ache. And as with most injuries, the best treatment is prevention! In other words, a proper training schedule with proper equipment.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.