Sports & Overuse Injuries

What are overuse sports injuries?

Overuse injuries happen when a young athlete’s body is asked to do more than it can safely recover from—too much, too hard, too often, without enough rest. Instead of one big fall or collision, these injuries build up slowly over time.

Common examples:

  • Growth plate stress: Pain around knees, heels, or elbows (Osgood–Schlatter, Sever’s disease).

  • Tendon and muscle irritation: Patellar tendonitis (“jumper’s knee”), Achilles tendonitis, hamstring or hip flexor pain.

  • Stress reactions and stress fractures: Shin pain in runners, foot pain in dancers or gymnasts.

  • Shoulder and elbow pain in throwers: “Little league shoulder” or “little league elbow” in baseball and softball.

Signs your child may have an overuse injury:

  • Pain that worsens with activity and improves with rest

  • Swelling, stiffness, or limping

  • Pain that changes how they run, jump, throw, or land

  • Needing more pain medicine to “get through” practice or games

  • Loss of interest in a sport they used to enjoy

If pain lasts more than 7–10 days, changes how your child moves, or wakes them at night, it’s time to get it checked.

Why growing bodies are at higher risk

Kids and teens are not “small adults.” Their bones, muscles, tendons, and growth plates are still developing, which makes them more vulnerable to repetitive stress.

Key risk factors:

Rapid growth spurts: Bones grow faster than muscles and tendons can adapt, leading to tightness and imbalance.

Early sport specialization: Playing one sport year-round, especially with high training volume, increases overuse risk.

High training load: Multiple teams, long practices, tournaments, and extra lessons with little true rest.

Poor movement mechanics: Weak core/hip muscles, poor landing technique, or inefficient running/throwing patterns.

Inadequate recovery: Not enough sleep, rest days, or off-seasons; playing through pain.

External pressure: Fear of losing a spot, college dreams, or adult expectations that make kids hide pain.

Healthy sports participation should support lifelong activity—not cost a child their future health or joy in movement.

Prevention: keeping young athletes safe and strong

1. Smart training habits

  • Follow the “10% rule”:  Avoid increasing training volume (time, distance, intensity) by more than about 10% per week.

  • Build in rest days:  At least 1–2 full days off from organized sport each week.

  • Limit total weekly hours: A helpful guideline: total hours of organized sport per week should not regularly exceed the child’s age.

  • Protect the off-season: At least 2–3 months per year away from a single sport, spread across the year.

2. Age-appropriate sport participation

  • Delay early specialization when possible: Multi-sport participation in childhood builds broader skills and reduces overuse risk.

  • Match level to readiness: Consider physical, emotional, and social readiness—not just talent—when moving up in competition.

3. Strength, mobility, and movement quality

A pediatric physical therapist can:

  • Screen movement patterns:  Identify inefficient running, jumping, landing, cutting, or throwing mechanics.

  • Build foundational strength: Focus on hips, core, shoulders, and feet—key areas for injury prevention.

  • Improve flexibility and mobility:  Address tight muscles that develop during growth spurts.

  • Teach safe landing and cutting: Techniques that protect knees, ankles, and hips.

  • Guide sport-specific conditioning: Progress training in a way that matches the athlete’s age and development.

4. Recovery, nutrition, and sleep

  • Sleep: Aim for recommended hours for age; sleep is when tissues repair and grow.

  • Hydration and nutrition: Regular meals and snacks with protein, complex carbs, and healthy fats support recovery.

  • Listen to pain: “Sore” muscles after a new workout can be normal; sharp, persistent, or worsening pain is not.

When to seek pediatric physical therapy

Reach out to a pediatric PT if:

  • Pain lasts more than a week or keeps returning with sport.

  • Your child changes how they move (limping, favoring one side, avoiding certain skills).

  • There’s swelling, catching, or locking in a joint.

  • Pain is at or near a growth plate (knee, heel, elbow, shoulder).

  • Your child is anxious about losing their spot and is trying to play through pain.

Early evaluation can:

  • Confirm what’s going on and whether imaging or medical referral is needed.

  • Prevent a minor issue from becoming a stress fracture or chronic problem.

  • Support a safe, confident return to sport with a clear plan.

How parents and coaches can support healthy sport participation

  • Create a “pain is information” culture: Kids should feel safe saying, “My knee hurts,” without fear of punishment or lost opportunity.

  • Value rest and stretching as part of training:  Celebrate recovery days and off-seasons as essential, not optional and establish a program for stretching and mobility that can be done after practices/games and on “off” days

  • Watch for burnout: Loss of joy, irritability, fatigue, or dread before practice can signal overtraining.

  • Model balance: Encourage school, friendships, family time, and non-sport activities.

  • Partner with professionals: Pediatricians, sports medicine physicians, and pediatric PTs can help build a sustainable plan.


Call Now