Overuse conditions

An increasing number of boys and girls are playing recreational and organized sports. As a result, there is a rise in the number of overuse injuries seen among children and adolescents. The majority of sports and overuse injuries are due to minor trauma involving soft tissue injuries - injuries that affect the bone, muscles, ligaments, and/or tendons.

What are the most common types of overuse injuries?

Type of overuse injury Symptoms  Possible cause

Jumper's Knee
(Patellar Tendonitis)

Tenderness right below the knee cap

The patellar tendon in the knee joint is repeatedly pulled on, causing inflammation and pain, especially during jumping activities 

Little Leaguers' Elbow or Shoulder

Pain in the elbow or shoulder area, especially after activity

Repetitive overhead throwing maneuvers that cause damage and inflammation to the growth plates of the bones in the arm

Osteochondritis Dissecans

Knee pain and occasionally joint fluid

A piece of the joint surface in the knee that separates from the surrounding surface

Sever's Disease

Heel pain with limping, especially after running activities

Repetitive running or jumping activities causes excessive pull on the heel growth area

Shin Splints

Pain and tenderness over the shin area

Excessive running, running on hard surfaces (concrete), and improper shoe wear often cause shin splints

Osgood-Schlatter Disease

Inflammation of the shin growth center

The most common type of overuse injury

Sinding-Larsen-Johansson Disease

Knee pain, especially after jumping activities

This condition is caused by repetitive traction at the tip of the knee cap where the patellar tendon attachment is over stretched

Spondylolysis

Low back pain

This is a stress fracture caused by excessive flexion and extension of the lower back. It is commonly seen in football linemen, gymnasts and ice skaters.

Spondylolisthesis

Low back pain

This condition is caused by excessive flexion and extension of the low back. X-rays show that one vertebra in the low back slips forward on the vertebrae below it. It can result from having a spondylolysis. It is commonly seen in football linemen, gymnasts and ice skaters.

Overuse injuries can also lead to stress fractures. Stress fractures are small cracks in the bone caused by overuse. Stress fractures often occur in the foot after training for basketball, running and other sports. There may not be swelling, but pain and tenderness often increase during movement.

Treatment of an overuse injury:

Specific treatment for an overuse injury will be determined by your child's physician based on:

  • Your child's age, overall health and medical history
  • Extent of the condition
  • Type of condition
  • Your child's tolerance for specific medications, procedures or therapies
  • Expectations for the course of the condition

The goal of treatment is to control the pain, promote healing, prevent complications, and restore normal use of the injured area.

Initial treatment for overuse injuries is rest.

Other treatment options may include:

  • Medications
  • Activity restrictions
  • Splint/cast
  • Crutches/wheelchair
  • Physical therapy (to stretch and strengthen the injured muscles, ligaments and tendons)
  • Surgery (rarely)

Long-term outlook for children with overuse injuries:

Overuse injuries can heal fully if the physician's recommendations are followed. It is important that the child adhere to the activity restrictions and/or stretching and strengthening rehabilitation programs to prevent re-injury.

Most sports injuries are due to either traumatic injury or overuse of muscles or joints. Many sports injuries can be prevented with proper conditioning and training, wearing appropriate protective gear, and using proper equipment.