Summary
As sports participation increases so too does the incidence of injuries, both acute and overuse. The growing skeleton is particularly susceptible due to the presence of growth cartilage at 3 locations; the epiphyseal plate, the joint surface and the apophysis. The risk of injury is most pronounced during the rapid growth spurt of adolescence when other factors, such as muscle tightness across joints, also become important in the aetiology of sporting injury. Overuse injuries seen in this age group may reflect the growth characteristics of the immature skeleton or may be of the type seen in adult athletes undergoing rigorous training schedules.
Recent developments in organised competitive sport have seen growing individuals undertake prolonged and intensive training programmes when they are particularly at risk of sustaining an overuse injury. The training programme is one of a number of risk factors important in the generation of injury, many of which can be modified or controlled to an extent. Other factors such as growth deformities or malalignments are peculiar to the individual and preparticipation evaluation of the young athlete helps to identify those at risk.
Whilst long term disability rarely eventuates, the loss of enjoyment and temporary incapacity resulting from this type of injury is significant. It is apparent that many of these injuries are preventable, and given the information available concerning the factors involved in their aetiology, it is the responsibility of coaches and health professionals alike to become involved in their early diagnosis, treatment and prevention.
Similar content being viewed by others
References
Aegerter E, Kirkpatrick JA. Orthopaedic Diseases, 4th ed., WB Saunders & Co, Philadelphia, 1975
American Academy of Pediatrics. Risks on long distance running in children. Physician and Sports Medicine, 10(8): 82–86, 1982
Backx FJG, Erich WBM, Kemper ABA, Verbeek ALM. Sports injuries in school-aged children. An epidemiologic study. American Journal of Sports Medicine 17 (2): 234–240, 1989
Bond JW, Miller BP, Chrisfield PM. Psychological prediction of injury in elite swimmers. International Journal of Sports Medicine 9 (5): 345–348, 1988
Brady TA. Weight training related injuries. American Journal of Sports Medicine 10 (1): 1–5, 1982
Bright RW, Burstein AH, Elmore SM. Epiphyseal plate cartilage: a biochemical and histological analysis of failure modes. Journal of Bone and Joint Surgery 56A: 688–705, 1974
Burkett LN. Causative factors in hamstring strains. Medicine and Science in Sports 2: 39–42, 1970
Clancy Jr WG, Foltz AS. Iliac apophysitis and stress fractures in adolescent runners. American Journal of Sports Medicine 4 (5): 214–218, 1976
Dalton SE, Lachmann S. Overuse injuries in the adolescent athlete. British Association of Sport and Medicine, Congress 1986 Abstract. British Journal of Sports Medicine 20 (4): 182, 1986
Davidson R, Kennedy J, Kennedy M, Vanderfield GK. Competitive sport in Australian schoolboys. Australian Journal of Sports Medicine 11(4): 100–102, 1979
Dugdale TW, Barnett PR. Historical background: patellofemoral pain in young people. Orthopaedic Clinics of North America 17: 211–219, 1986
Ekstrand J, Gillquist J. Soccer injuries and their mechanisms: A prospective study. Medicine and Science in Sports and Exercise 15: 267–270, 1983
Ficat RP, Hungerford DS. Disorders of the patellofemoral joint, Williams and Wilkins, 1977
Francis R, Bunch T, Chandler B. Little League elbow: a decade later. Physician and Sports Medicine 88–94, 1978
Garrick JG, Gillien DM, Whiteside P. The epidemiology of aerobic dance injuries. American Journal of Sports Medicine 14: 67–72, 1986
Garrick JG, Reque RH. Injuries in high school sports. Pediatrics 61: 465–469, 1978
Godshall RW, Hansen CA, Rising DC. Stress fractures through the distal femoral epiphysis in athletes. A previously unreported entity. American Journal of Sports Medicine 9 (2): 114–116, 1981
Goodfellow JW. Chondromalacia patella: a mythical disease. Journal of Bone and Joint Surgery 66B: 455, 1984
Goodfellow JW, Hungerford DS, Woods C. Patellofemoral joint mechanics and pathology: 2. Chondromalacia patellae. Journal of Bone and Joint Surgery 56B: 291–299, 1976
Gortmaker SL, Dietz Jr, WM, Sobol AM, Wehler CA. Increasing pediatric obesity in the United States. American Journal of Diseases of Children 141: 535–540, 1987
Kannus P, Nittymaki S, Jarvinen M. Athletic overuse injuries in children. A 30-month prospective follow-up study at an out-patient sports clinic. Clinical Pediatrics 27 (7): 333–337, 1988
Kujala UM, Kvist M, Heinonen O. Osgood Schlatter’s disease in adolescent athletes: Retrospective study of incidence and duration. American Journal of Sports Medicine 13 (4): 236–241, 1985
Larson RL. Epiphyseal injuries in the adolescent athlete. Orthopaedic Clinics of North America 4: 839–851, 1973
Larson RL, McMahon RO. The epiphyses and the childhood athlete. Journal of the American Medical Association 196 (7): 602–612, 1966
Legwold G. Does lifting weights harm a prepubescent athlete? Physician and Sports Medicine 10 (7): 141–144, 1982
Lloyd T, Triantafyllou S, Baker ER, et al. Women athletes with menstrual irregularity have increased musculoskeletal injuries. Medicine and Science in Sports and Exercise 18: 374–379, 1986
Lysens RJ, Ostyn MS, Auweele YV, Lefevre J, Vuylsteke M, et al. The accident-prone and overuse-prone profiles of the young athlete. American Journal of Sports Medicine 17 (5): 612–619, 1989
Malina R. Exercise as an influence upon growth. Clinical Pediatrics 8: 16–26, 1969
Malina RM. Menarche in athletes: A synthesis and hypothesis. Annals of Human Biology 10: 1–24, 1983
Malina RM, Bouchard C, Shoup RF, Demirjian A, Lariviere G. Age at menarche, family size, and birth order in athletes at the Montreal Olympic Games, 1976. Medicine and Science in Sports 11: 354–358, 1979
McKeag DB. Preseason physical examination for the prevention of sports injuries. Sports Medicine 2: 413, 1985
Micheli U. Overuse injuries in childrens’ sports: the growth factor. Orthopaedic Clinics of North America 14: 337–360, 1983
Micheli LJ. Paediatric and adolescent sports injuries: recent trends. In Pandolf K (Ed.) Exercise and sports sciences reviews, vol. 14, pp. 359–374, Macmillan Publishing, New York, 1986
Micheli Li. The traction apophysitises. Clinics in Sports Medicine 6 (2): 389–404, 1987
Micheli LJ, Hall JE, Miller ME. Use of modified Boston brace for back injuries in athletes. American Journal of Sports Medicine 8: 351–356, 1980
Micheli Li, Slater JA, Woods E, et al. Patella alta and the adolescent growth spurt. Clinical Orthopaedics 213: 159–162, 1986
Micheli LJ, Smith AD. Sports injuries in children. Current Problems in Pediatrics 12: 54, 1982
Mubarak S, Carroll N. Juvenile osteochondritis dissecans of the knee. Clinical Orthopaedics 157: 200–211, 1981
Mueller F, Blyth C. Epidemiology of sports injuries in children. Clinics in Sports Medicine 1: 343–352, 1982
Nathan M, Goedeke R, Noakes TD. The incidence and nature of rugby injuries experienced at one school during the 1982 rugby season. South African Medical Journal 64: 132–137, 1983
National Strength and Conditioning Association: Position paper on prepubescent strength training — official document. NSCA Journal 7 (4): 27–31, 1985
Nelson ME, Clark N, Otradover C, Evans WJ. Elite women runners: association between menstrual status, weight history, and stress fractures. medicine and Science in Sports and Exercise 19: 13, 1987
O’Neill DB, Micheli LJ. Overuse injuries in the young athlete. Clinics in Sports Medicine 7 (3): 591–610, 1988
Orava S, Hulkko A, Jormakka E. Exertion injuries in female athletes. British Journal of Sports Medicine 15 (4): 229–233, 1981
Orava S, Puranen J. Exertion injuries in adolescent athletes. British Journal of Sports Medicine 12: 4–10, 1978
Outerbridge RE. Further studies on the aetiology of chondromalacia patellae. Journal of Bone and Joint Surgery 46B: 179–190, 1984
Padilla ER, Damaris J, Rohsenow DJ, et al. Predicting accident frequency in children. Pediatrics 58: 223–226, 1976
Rooks DS, Micheli LJ. Musculoskeletal assessment and training: the young athlete. Clinics in Sports Medicine 7 (3): 641–677, 1988
Roy S, Caine D, Singer KM. Stress changes of the distal radial epiphysis in young gymnasts: a report of twenty-one cases and a review of the literature. American Journal of Sports Medicine 13 (5): 301–308, 1985
Ryan JR, Salciccioli GG. Fracture of the distal radial epiphysis in adolescent weightlifters. American Journal of Sports Medicine 4: 26–27, 1976
Salter RB, Harris WR. Injuries involving the epiphyseal plate. Journal of Bone and Joint Surgery 45A: 587–622, 1963
Sandow MJ, Goodfellow JW. The natural history of anterior knee pain in adolescents. Journal of Bone and Joint Surgery 67B (1): 36–38, 1985
Shaffer TE. The uniqueness of the young athlete: introductory remarks. American Journal of Sports Medicine 8 (5): 370–371, 1980
Speer DP, Braun JK. The biomechanical basis of growth plate injuries. Physician and Sports Medicine 13: 72–78, 1985
Stanitski CL. Common injuries in preadolescent and adolescent athletes: recommendations for prevention. Sports Medicine 7: 32–41, 1989
Steele VA, White JA. Injury prediction in female gymnasts. British Journal of Sports Medicine 20 (1): 31–33, 1986
Tanner JM. Growth at adolescence, 2nd ed., Blackwell Scientific Publishers, Oxford, 1962
Tursz A, Crost M. Sports-related injuries in children: a study of their characteristics, frequency, and severity, with comparison to other types of accidental injuries. American Journal of Sports Medicine 14 (4): 294–299, 1986
Walsh WM, Huurman WW, Shelton GL. Overuse injuries of the knee and spine in girls’ gymnastics. Orthopaedic Clinics of North America 16 (2): 329–350, 1985
Watson AW. Sports injuries during one academic year in 6799 Irish schoolchildren. American Journal of Sports Medicine 12: 65–71, 1984
Wilkins KE. The uniqueness of the young athlete: musculoskeletal injuries. American Journal of Sports Medicine 8 (5): 377–382, 1980
Zito M. The adolescent athlete: A musculoskeletal update. Journal of Orthopaedic and Sports Physical Therapy 4 (1): 20–25, 1983
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dalton, S.E. Overuse Injuries in Adolescent Athletes. Sports Medicine 13, 58–70 (1992). https://doi.org/10.2165/00007256-199213010-00006
Published:
Issue Date:
DOI: https://doi.org/10.2165/00007256-199213010-00006