Dr. Weidenbener webinar talk: Overuse Injuries in Adolescent Athletes

With school starting back and fall sports kicking into full gear, Midwest Center for Joint Replacement and other OrthoAlliance (OA) partner practices are providing a three-part webinar series on sports medicine. In the first webinar on August 28, our sports medicine physician Dr. Rick Weidenbener addressed overuse injuries in adolescents.

Below is a summary of Dr. Weidenbener’s talk, as well as the full webinar video if you would like to hear from other experts in the field.

Understanding Injuries in Adolescent Athletes

Adolescent athletes experience a unique set of challenges when it comes to injuries. Young athletes are not just smaller versions of adults; their physiological and anatomical differences significantly impact their injury risks and types. It is important to understand some of these differences so coaches and trainers don’t overwork their athletes.

Growth Spurts and Tissue Imbalance

One of the primary issues faced by teenage athletes is the disparity between bone growth and the development of tendons, ligaments, and muscles. Boys tend to grow in rapid growth spurts, leading their bones to outpace the growth of surrounding soft tissues. This can result in tightness and inflexibility, making injuries more likely. For girls, who tend to grow more steadily, the risk is less pronounced but still present.

The mismatch between bone and tissue growth creates a vulnerability in young athletes. For instance, during a growth spurt, the tendons and muscles may not lengthen at the same rate as the bones, causing increased stress and potential injury. This imbalance is exacerbated by training techniques.

Growth Plates and Skeletal Immaturity

Adolescent bones have growth plates, or epiphyseal plates, which are softer and more susceptible to injury compared to mature bones. These areas are where bone growth occurs, but they are also points of weakness. Stress and overuse can lead to conditions such as Osgood-Schlatter’s disease, which affects the tibial tuberosity where the patellar tendon attaches. Similarly, Severs disease affects the heel bone’s growth plate in young athletes.

Because peak bone density is not reached until around age 30, adolescent bones are more prone to stress fractures. For instance, runners might develop femoral neck stress fractures, which are particularly serious and often require surgery if not addressed early.

Common Injuries in Adolescent Athletes

Injuries in young athletes can vary by sport and activity. Common issues include:

• Shoulder Injuries: Often related to overuse, such as in baseball or swimming. Scapular winging and rotator cuff problems are frequent. Strengthening the muscles around the scapula and the rotator cuff can help prevent these injuries.
• Elbow Injuries: Throwing athletes may suffer from ulnar collateral ligament injuries, leading to conditions like Tommy John surgery. Proper technique and monitoring pitch counts can mitigate this risk.
• Wrist and Hand Injuries: Weight-bearing sports, such as gymnastics and weightlifting, often lead to wrist impingement and stress fractures. Proper technique and appropriate equipment can reduce these risks.
• Spinal Issues: Spondylolisthesis, a stress fracture in the spine, is common in athletes involved in hyperextension activities, like gymnastics or diving. This condition can cause significant pain and require careful management to prevent further injury.
• Lower Extremity Injuries: Shin splints, patellofemoral syndrome, and stress fractures in the feet and hips are very common. These are often due to overuse and biomechanical issues, such as improper footwear or excessive training loads.

Prevention and Management

Preventing injuries involves a multi-faceted approach:

1. Diverse Participation: Encourage young athletes to participate in various sports to avoid overuse injuries and allow different muscle groups to develop.
2. Proper Technique and Training: Ensure that coaches are knowledgeable about age-appropriate training techniques and emphasize proper form.
3. Adequate Rest and Recovery: Adolescent athletes need more recovery time than adults. Overlapping sports seasons and year-round training can lead to burnout and injury.
4. Nutrition: A balanced diet rich in protein, calcium, and vitamin D is essential for bone health and overall growth.
5. Biomechanics: Assess and address any biomechanical issues, such as improper gait or alignment, which can contribute to injuries.
6. Education: Coaches, parents, and athletes should be educated about the specific needs of growing bodies and how to manage training and recovery effectively.

Dr. Weidenbener sees patients of all ages for sports medicine and general orthopedics in our Bloomington office. If you or someone you know needs care, call our office to schedule an appointment with him at 317-455-1064.

View the entire OrthoInsights August 28 webinar below. Dr. Weidenbener talk begins at 14:30.