Overuse Injuries and Burnout Among Youth Athletes

With the start of what seems like an endless baseball season I figured it would be a good time to dig this blog post out of the archives. The American Medical Society for Sports Medicine (AMSSM) recently published a position statement on overuse injuries and burnout in youth sports. They found focusing on intensive training and competition at a young age, instead of skill development, lead to the aforementioned issues. Parents and coaches need to realize that readiness for sports is related to the match between an athlete’s level of growth development (motor, sensory, cognitive, and social/emotional) and the task/demands of the sport. Placing sport development on a chronological basis can lead to unrealistic expectations and leave youth athletes feeling like they are not making progress.

Overuse injuries occur due to repetitive sub-maximal loading of the musculoskeletal system when rest is not adequate to allow for structural adaptation to take place. These are more likely to occur during the adolescent growth spurt. There are many factors at play including: a decrease in age-adjusted bone mineral density, lack of lean tissue mass, an increase in joint hyper mobility and growth/strength imbalances. Burnout is part of the spectrum of conditions that includes overreaching and overtraining. It is a result of chronic stress that causes a young athlete to cease participation in previously enjoyable activity. Burnout can also occur from an emphasis on competitive success due to widespread, increased pressure to begin high intensity training at younger ages (example: early sport specialization). The research suggests that many athletes who had early specialized training withdrew from their sport due to either injury or burnout. Sport specialization is defined as an intensive year round training for a single sport at the exclusion of other sports. Diversified sports training during early and middle adolescence years may be more effective in developing elite-level skills in the primary sport due to skill transfer.

Prevention of burnout and early sport specialization can be as simple as limiting weekly and yearly sport specific repetitive movements (i.e. pitching limits).  A decade-long analysis of nearly 500 pitchers ages 9-14 found a 3.5 times greater likelihood of suffering an injury for those who pitched over 100 innings per year. Another study showed that youth baseball pitchers who pitch for greater than eight months a year are at an increased risk for shoulder and elbow surgery. These two baseball examples are what we refer to as an extrinsic factor (external forces are related to the sport, biomechanics) that contribute to overuse injuries. On the other hand, intrinsic factors are defined as biological characteristics and psychosocial traits.

According to research, children who have developed a foundation of strength, endurance and motor skills are at a decreased risk of injury. Strength and conditioning programs can also increase an athlete’s self-confidence, helping to reduce burnout. A program that does not account for the athlete’s sport workload will only contribute as an extrinsic risk factor and will not decrease the athlete’s risk factors. Sport and strength coaches must work together to insure that athlete’s workloads are monitored and tailored to fit the specific season they are in for them to achieve proper readiness for sports. Here at ProForce Sports Performance we integrated strength and conditioning program that help athletes who may choose to specialize at an early age by helping them learn motor skills that they have not been exposed to yet.