There is a trend in youth sport to push our young athletes hard. At CSSM we often see young athletes who participate in sport between 6-8 times per week. There is an emphasis on sporting competitiveness from a young age, which sometimes comes at the price of overuse injuries.

An overuse injury can be defined as ‘an injury occurring as the result of repetitive submaximal loading of the musculoskeletal system when rest in not adequate to allow for structural adaptation to take place’ (2).

These injuries do not occur as the result of a single acute event, rather they occur more insidiously over a period of time when repeated stress and load is placed on the body. These injuries can affect any part of the musculoskeletal system including joints, muscles, bone and cartilage. Some overuse injuries are lower risk than others (but still sore!). Common low risk examples include Osgood-Schlatter disease and Sever’s disease. Others are higher risk including stress fractures to the lower back (pars fractures) and femoral neck stress fractures.

Young athletes are at high risk of overuse injuries for a number of reasons:

  • Prior injury to the area is a strong predictor of future overuse injury
  • They have a higher rate of sports participation compared with an adult population (1)
  • They are more likely to have high training volumes and high training workloads
  • They are vulnerable during adolescent growth spurts
  • Their immature bones are less resistant to compressive and tensile forces
  • They may be over-scheduled in regards to training load
  • They are more likely to out grow sports and training equipment
  • They often have a lack of lean tissue mass

What can parents, coaches and young athletes do to reduce the risk of overuse injury?

A position statement by from the American Medical Society for Sports Medicine regarding overuse injuries in sport recommends:

  • Placing time limits on participation in sports. This relates to weekly and yearly participation.
  • Ensuring that young athletes get enough down time between sporting sessions for their body to recover.
  • Scheduled rest periods from high intensity sports should be encouraged.
  • Monitoring and if necessary reducing high intensity sport specific repetitive movement.
  • Modifying each young athletes training load taking into account their injury history, age and growth rate.
  • Closely monitoring young athletes training regimes at times of rapid growth.
  • Ensure equipment is well fitted.
  • Monitored strength and conditioning training including pre-season conditioning programs can be a good way of preparing young athletes for the season ahead.
  • Sport diversification should be encouraged rather than sports specialisation from an early age.

It is important for persistent ‘niggles’ in young athletes to be assessed by an appropriate clinician. These niggles can sometimes be serious underlying overuse injuries that may hinder long-term sports involvement. If these injuries are assessed, diagnosed and appropriately managed early on, the young athlete has far better prospects of a pain free return to sport.



(2) DiFioroi, J.P., Benjamin, H.J., Brenner, J., Gergory, A., Jaynthi, N., Landry, G., Luke., A. Over use injuries and burnout in youth sports: a position statement from the American Medical society for sports medicine. British Journal of Sports Medicine 2014; 48:287-288.