Overuse Overload

As girls’ participation in youth sports has risen, so, too, have their rates of overuse injuries.

A recent study of overuse injuries — damage to bones or soft tissues that develops over time instead of from a single event — among American high school athletes illuminated the scope of the overuse problem among female athletes. Thirteen percent of injuries experienced by girls in the study cohort were the result of overuse, whereas only 5.5 percent of injuries to boys were overuse injuries. Girls’ rates of overuse injury per 10,000 athletic exposures — defined as “one athlete participating in one practice or competition” — were higher than boys’ (1.88 to 1.26).

A Combination of Causes

A number of factors contribute to girls’ susceptibility to overuse injuries.

“Different hormone levels and less muscle mass in female athletes are partly to blame for girls’ vulnerability to overuse injuries,” says Damond Blueitt, M.D., sports medicine physician at Orthopedic Specialty Associates, a Texas Health Physicians Group practice, and on the medical staff at Texas Health Harris Methodist Hospital Fort Worth. “Girls usually are more flexible than boys, but they do many of the same things in sports as male athletes, which can set them up for stress injuries.

“Female athletes also often struggle more than male athletes to get enough calories and nutrients to stay healthy while playing sports,” Dr. Blueitt continues. “Insufficient nutrition can lead to menstrual dysfunction and low bone density — a troubling problem given that girls acquire most of their bone mass during adolescence.”

Common overuse injuries Dr. Blueitt sees in young female athletes include stress fractures to bones and stress-related damage to soft tissues, such as patellar tendonitis. These are common in runners; girls’ track and field produced the highest rates of overuse injuries of any girls’ or boys’ sport in the aforementioned study. Other frequent sources of girls’ overuse injuries in Dr. Blueitt’s patients are basketball, soccer and cheerleading.

Practice Prevention

Use these tips to help your daughter avoid overuse injuries and stay in the game.

  • Branch out. Encourage your daughter to play multiple sports throughout the year and vary her workouts. Both allow her to strengthen different parts of her body and avoid constantly repeating the same motions. The American Academy of Pediatrics (AAP) advises limiting participation to one sport per season.
  • Give the body a break. Athletes need short- and long-term rest from a given sport — at least one day per week and two months per year, according to the AAP. Resting an injured area, along with modifying activities, is typically the first line of treatment sports medicine physicians recommend for overuse injuries, Dr. Blueitt says.
  • Pay attention to the basics of good health. Helping your child eat a nutritious diet, get adequate sleep and manage stress will reduce her risk for overuse injury.

Encourage your athlete to speak up about even the most seemingly minor aches and pains so you can seek help together.

“Most schools in Texas have athletic trainers, and athletes should speak to them about overuse injuries first,” Dr. Blueitt says. “Primary care physicians also can be excellent resources. They will refer patients to sports medicine physicians for higher levels of care, if needed.”

If your daughter shows signs of an overuse injury, the sports medicine physicians at Texas Health Sports Medicine can devise a plan to help her rest and strengthen the injured area so she can return to the sport she loves safely and quickly.

Physicians employed by Texas Health Physicians Group practice independently and are not employees of the hospital or Texas Health Resources

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