Reduce Overuse Injury and Minimize Burn Out in Youth and Adolescent Athletes: Part 1

It is estimated that 60 million children and adolescence aged 6 to 18 years participate in team sports, with 44 million participating in more than 1 sport (The National Council of Youth Sports). Of those 60 million athletes approximately 45% to 54% will develop some type of overuse injury (Clin J Sport Med, 2014). An overuse injury occurs due to submaximal repetitive loading of the body (muscle-tendon unit, ligaments, joints, bone, bursa, growth plate) when rest is not adequate to allow for those structures to adapt and recover.

During the overload process (training or competition) it is normal for the body to fatigue and breakdown secondary to the micro-trauma of the physical stress. Following this degradation process the body responds by healing and remodeling those damaged tissues.

To optimize the physiological response and create positive physical adaptation (strength, flexibility, balance, power, speed, agility, quickness and reaction time), there must be a careful balance between training/competition dose and recovery.

The greater the physical stress put on the body, the longer the recovery time needed for remodeling (healing) and adaptation. This remodeling (healing) and adaptation process occurs during passive rest (sleep and sedentary activities) and active rest (stretching, good nutrition, massage, manipulation, foam rolling…) allowing the body to recover and prepare for the next training or competition event. The amount of time needed for adequate recovery is variable and depends much on the athletes; physical conditioning, genetics, volume of work load and or previous injury. Typically recovery from a bout of training or competition occurs in 48 to 72 hours.

Without adequate rest and recovery there will be excessive fatigue, breakdown and an inhibition of the bodies healing and adaptation process. This incomplete recovery leads to poor athletic performance, reduced physical development, overuse injuries and burn out. Thus, competition and training errors are the most common cause of overuse injuries.

Risk Factors for Overuse Injuries:

  • Higher training volumes (Children shouldn’t participate in sports more hours a week than their age.)
  • Overscheduling (multiple competitive events in same day or over several days)
  • Early specialization in a sport or activity (Specialization can occur in late adolescents or when growth plates have closed and the athlete has reached physical maturity)
  • Equipment/footwear
  • Prior injury
  • Adolescent growth spurt (growth plate and muscle-tendon injuries)
  • Amenorrhea (stress fractures)
  • Sports technique
  • Not enough free play (Less free play versus organized sports lead to a greater youth injury rate)

We can help!

Mishock Physical Therapy has 6 convenient locations in Gilbertsville, Skippack, Barto, Phoenixville, Limerick, and Stowe. Reach us via phone at (610)327-2600. Also, visit our website at to read more physical therapy related articles, learn more about our treatment philosophy, our physical therapy staff. Our mission is to exceed the expectations of our patients by providing excellence in care and service. We are here to serve you! Dr. Mishock is one of only a few clinicians with doctorate level degrees in both physical therapy and chiropractic in the state of Pennsylvania.

New patient scheduling: 610-327-2600