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Safety and Injuries > Sports Burnout and Overuse Injuries

Sports Burnout and Overuse Injuries

It is not just Johnson County that is experiencing the trend of pushing young children on competitive teams and multiple activities each week - it is a trend across the nation.

In the June 2007 issue of Pediatrics, a report was published to help pediatricians prevent and recognize children at risk for burnout and overuse injuries. It supports the American Academy of Pediatrics’ policy statement on sports medicine counseling, published in July of 2000 in Pediatrics. I will summarize the articles below.

Overuse Injuries

In the child and adolescent, overuse is the cause of up to half of all pediatric sports injuries. It is bone, muscle or tendon microtrauma caused by repetitive stress without adequate healing time. It begins with pain after activity, then pain during activity without affecting performance, followed by pain during activity that affects performance, and finally pain even at rest. Children are at increased risk because of their growing bones and inability to recognize or describe symptoms.

Overtraining Syndrome

Over training Syndrome (“burnout”) is the psychologic, physiologic and hormonal changes that lead to decreased performance. Symptoms include chronic muscle or joint pain, personality changes, increased heart rate at rest, decreased sports performance, fatigue, lack of enthusiasm, and inability to complete usual routines. Prevention includes encouraging a variety of sports throughout the year, making workouts interesting and fun and having athletes take 1-2 days off per week, plus 2-3 months off per year for other activities. Over training can lead to burnout in the early years, which can cause a child to end participation in sports altogether, which may cause inactivity and contribute to the obesity epidemic in our country.

Guidelines and Recommendations Include:

  • Athletes should take 1-2 days off per week from competitive athletics and competitive practice to allow physical and psychological recovery.
  • Athletes should be a member of only one sport per season.
  • Athletes should take at least 2-3 months away from a specific sport during the year. During this time another fun activity can be done to prevent loss of skills or conditioning.
  • The focus of participation should be fun, skill acquisition, safety, and sportsmanship.
  • Weekly training time, number of repetitions or total distance should not increase by more than 10% per week.
  • Watch for possible burnout if the athlete complains of nonspecific muscle or joint problems, fatigue or poor academic performance. Consider time off at that time to allow physical and psychological recovery.
  • Use caution for younger athletes who participate in multiple games during a short time period.
  • Ensure proper nutrition:
    • Proper caloric intake is based on body size and growth rate in addition to calories burned. Monitor for signs that the athlete is trying to lose weight to benefit performance (to the detriment of overall growth).
    • Balance nutritional elements based on the Food Guide Pyramid.
    • Adequate iron is needed. The amount of iron needed in the diet is highest during the growing years and sports may contribute to iron losses. Athletes need adequate iron to bring oxygen to tissues in the body.
    • Calcium intake is important for normal bone growth and possibly to help prevent and heal stress fractures (see also the archived New This Month Article on Vitamin D). Click here for many links to nutritional information, including calcium sources, vitamin D, sports nutrition, and more.
    • Click here for many links to nutritional information, including calcium sources, vitamin D, sports nutrition, and more.
  • Children should participate in a sport at a level consistent with their ability and interest.
  • Single sport specialization should be avoided before puberty. Young athletes who participate in different sports at various seasons have less burnout and fewer overuse injuries.
  • Parents should be aware of the coach’s knowledge of proper training techniques, equipment and training of a particular age group. Parents should encourage organizations to mandate coach training in these areas.
  • Never allow an injured athlete to participate in activities until completely healed or cleared by a physician.
  • Children are more at risk for heat injury. Proper hydration should be encouraged. Avoidance of prolonged activity in moderate temperatures or any activity in extreme temperatures should be enforced. (See also our page on Heat Injury.)

For more information on sports injury prevention, see this page and click on appropriate links to learn sport-specific injury prevention.

PEDIATRICS Vol. 106 No. 1 July 2000, pp. 154-157, AMERICAN ACADEMY OF PEDIATRICS: “Intensive Training and Sports Specialization in Young Athletes.” Committee on Sports Medicine and Fitness.PEDIATRICS Vol. 119 No. 6 June 2007, pp. 1242-1245, “Overuse Injuries, Overtraining and Burnout in Child and Adolescent Athletes.” Joel S. Brenner, MD, MPH and the Council on Sports Medicine and Fitness.

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