Pediatric Overuse Injuries

By Jon Stiffler, PTA, CPT, PES

Prevention of Pediatric Overuse Injuries

Prevention of pediatric overuse injuries is a hot topic among sports medicine professionals. This is due to the increase in pediatric overuse injuries in recent years. According to the National Athletic Trainers’ Association Position Statement: Prevention of Pediatric Overuse Injuries, evidence is indicative of approximately 50% of the pediatric athlete population attending sports medicine clinics for chronic, or overuse injuries. The pediatric population is defined as ages 6-18. Some of the overuse injuries include growth-related disorders and injuries resulting from repetitive microtrauma. Over half of all overuse injuries reported in the pediatric population can be prevented.


training to prevent pediatric overuse injuries

Training can prevent overuse injuries

Recommendations for the prevention of pediatric overuse injuries include:

  • injury surveillance
  • preparticipation physical examination
  • identification of risk factors for injury
  • proper supervision and education by coaches and medical professionals
  • sports alterations
  • training and conditioning programs

Injury Surveillance by Coaches and Sports Medicine Professionals

Coaches and sports medicine professionals should be on the lookout for injuries.  There also needs to be resources and training for health care professionals to aid in proper injury surveillance.

Preparticipation Physical Examination of Pediatric Athletes

The use of preparticipation physical examination to screen for injury risk factors. When risk factors or deficits are noted, the pediatric athlete should be referred to the proper healthcare professional.

Identification of Risk Factors for Pediatric Overuse Injuries

It is important for health care professionals to understand the risk factors that may increase the risk of pediatric overuse injuries. Health care professionals, athletes, coaches, and parents should also understand symptoms of overuse injuries. These symptoms include things such as:

  • arm pain
  • fatigue
  • decrease throwing performance

This also will help with monitoring the volume of throwing.

Coaches Education and Medical Supervision to Overuse Injuries

Baseball Injuries can occur from overuse

Injuries can occur from overuse

Pediatric athletes, parents, and coaches need to have a good understanding of the signs and symptoms of overuse injuries. The athletes should know that they need to speak up to coaches, parents, and the medical staff when such signs and symptoms occur. Coaches of pediatric athletes should have proper certification and training in relation to sports safety, growth and development, and common medical conditions or concerns. Additionally, all pediatric sports practices and events should be supervised by adults with an understanding of monitoring pediatric overuse injuries and health care professionals with training in pediatric sports injuries should be available for referral should such injuries occur.

Sports Alterations Can Reduce Injuries

To reduce pediatric overuse injuries, the limitation of repetitive sports activities should occur. There may need to be alterations to rules in youth sports to reduce overuse injuries where such rules are lacking. Additionally, it should be ensured that there is adequate time for recovery when performing repetitive activities such as throwing to prevent overuse injuries. It is recommended that limits for throwing and types of throwing are established to prevent overuse injuries.

Training and Conditioning Programs for Pediatric Athletes

Training programs should focus on:

  • neuromuscular control
  • balance
  • coordination
  • flexibility
  • strength

Prior to playing a sport, all pediatric athletes should begin a fitness program. The focus should be on flexibility, endurance, and strength. Each week, the athletes should have 1-2 days off from any training and conditioning or sports activities. Additionally, athletes should not be on more than one team in the same sport, in the same season. Also, proper progression of training intensity, load, time, and distance should occur. After any injury, pediatric athletes should gradually return to the sport through a structured return-to-sport program. The program should be completed before resuming sport at a full capacity.

Delayed Specialization Can Reduce Injury Risk

Pediatric athletes should participate in multiple sports to enhance general fitness and motor development. Pediatric athletes should take time off between different sports seasons.  They should also take 2 to 3 consecutive months off from a particular sport if the pediatric athlete performs that sport year-round. If participating in the same sport with a school and club team, they should adhere to constraints on cumulative time or volume to prevent overuse injury.

JOI Can Help

If your child has suffered a pediatric overuse injury, the Jacksonville Orthopaedic Institute can help! JOI offers the area’s top sports medical professionals experienced in the prevention of pediatric overuse injuries. JOI is ready to help you! Let JOI get you on the road to recovery!  Dr. Yorio of JOI can also provide a pre-participation physical for all ages.

Please read this article on hip exercises and Direct Access to Physical Therapy or call 904-858-7045. 


Finally, to schedule an appointment with a JOI Orthopaedic Specialist, call 904-JOI-2000, schedule online, or click the link below.

JOI Can Get YOU Back On The Road To Recovery

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Jon Stiffler, PTA, CPT, PES

Image of Jon Stiffler, PTA, CPT, PES

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