Too Much, Too Fast: Overuse Injuries in High School Athletics

John M. Neidecker, DO, ATC
Cooper Bone and Joint Institute Sports Medicine

Fall sports are in full swing and sports medicine offices are busier than ever. This is because of the inherent risk of injury associated with sports. When most people think of injuries in sports, dislocations, fractures and sprains come to mind. These injuries are known as acute injuries. However, there is another group of injuries known as overuse injuries. These occur when there is repetitive micro trauma to a part of the body over time. Overuse injuries usually involve bone and tendons, which result in stress fractures and tendinitis.

The body has an amazing ability to adapt to the physical demands that are placed on it, but if a person trains too hard and too often, breakdown occurs more rapidly than buildup, resulting in an overuse injury.

Errors in training are the most common cause of overuse injuries. These errors include rapidly increasing training intensity, duration, or frequency. Poor form and technique in training can also cause overuse injuries. This places parts of the body in undue stress, accelerating breakdown.

Other causes of overuse injuries are a person’s body alignment and biomechanics. Flat or high arched feet, or having unequal leg lengths, can place one at risk, as can muscle imbalances in strength and flexibility. Environmental factors such as equipment and training surface also have an impact on overuse injuries.

Treating overuse injuries is a two-step process. First, we need to treat the injury itself. This is done by a combination of medications, a period of immobilization and activity modification. The second step is to modify the risk factors that could have led to the overuse injury.

When it comes to training, it is recommended to not increase intensity of workouts by more than 10 percent a week. Athletes can also cross train with different types of activities. Sometimes orthotics or over-the-counter shoe inserts are indicated. We also correct muscle imbalances through physical therapy and/or stretching routines.

When it comes to running shoes, they should be changed every 350-500 miles, depending on a person’s running style and weight. We also recommend staying off the pavement and training on a soft surface if possible.

If an athlete experiences pain with exercise, he/she should suspect an overuse injury. Athletes should not try to play through pain because they can potentially make the problem worse. Use common sense and listen to your body.


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