Understanding Overuse Injuries in Young Athletes

When you think of sports injuries, you might picture dramatic scenes—an athlete collapsing on the field, a tense moment as a coach rushes to assist, or the unmistakable sound of a bone breaking. But for many young athletes, the reality can be much less sensational and often overlooked: repetitive use injuries. Meet Madelyn Olympia, a 14-year-old volleyball player whose experience highlights the subtler side of sports injuries.

Madelyn’s Story

A few months ago, while diving for a ball, Madelyn began to experience back pain. “The first time it happened, I was just diving normally, but something sounded different,” she recalls. Shortly after, every time she bent forward or back, she felt discomfort. Recognizing that back pain at such a young age wasn’t typical, her parents took her to see Dr. Matthew Silvis, a sports medicine physician at the Penn State Bone and Joint Institute.

Dr. Silvis, who also serves as a physician for local ice hockey teams and has extensive experience in treating sports-related ailments, quickly suspected a musculoskeletal issue. An MRI confirmed his diagnosis: Madelyn had strained her back muscles, and his recommendation was straightforward—rest and physical therapy.

The Growing Concern of Overuse Injuries

While acute injuries like fractures or ligament tears get most of the attention, Dr. Silvis emphasizes the growing prevalence of overuse injuries. “Overuse injuries are really predictable,” he explains, referencing the ‘rule of toos’—too much, too fast, too often. Many student-athletes unknowingly push themselves into these injuries over time, often mistaking the signs for normal growing pains.

“Many parents and coaches think soreness is part of growing up,” Dr. Silvis says, warning that this dismissal can result in more severe injuries down the line. The challenge is recognizing early symptoms, which can include:

Swelling in joints or soft tissue
Tenderness in specific areas of the body
Missing practices or games due to pain

The Importance of Early Detection

Dr. Silvis believes that open communication is essential. Parents should listen to their children’s concerns and take them seriously. Addressing pain quickly can allow young athletes to continue participating in their sports while healing. For example, in baseball, adhering to pitch count guidelines can prevent shoulder or elbow injuries.

He advises monitoring athletes closely to avoid burnout and overuse. “For runners, decreasing mileage by 50% until they feel no discomfort can keep them active and engaged with their friends,” he suggests.

Encouraging Diversity in Sports

In recent years, there has been a surge in pediatric specialization—where young athletes commit to a single sport year-round. Dr. Silvis stresses that specialization can lead to overuse injuries. In his research involving elite ice hockey players, he found that those who avoided sports specialization had comparable success levels to early specialists.

The key remains diversity. Engaging in different activities not only builds varied muscle groups but also reduces the risk of injury. “If you golf in the fall, play basketball in the winter, and run track in the spring, you’re using different parts of your anatomy,” he explains, encouraging a balanced athletic life.

Navigating Recovery

Back on her journey to recovery, Madelyn began physical therapy focused on strengthening her core to support her back. “At physical therapy, I focus on exercises that strengthen my core so the muscles around it are stronger,” she says, noting that each session gradually increases in difficulty.

Dr. Silvis continues to work with Madelyn on setting boundaries in her training, especially regarding how often she dives during practices and games. “After her season is over, she’s promised me she’ll take a break for a season of rest,” he adds, underlining the importance of recovery.