Monday, March 30, 2009
During my flight to the US Youth Soccer TOPSoccer Region I symposium in Newark, Del., this weekend I read a report in Pediatrics, Official Journal of the American Academy of Pediatrics. The article, written by Dr. Joel Brenner, was Overuse Injuries, Overtraining and Burnout in Child and Adolescent Athletes. I want to share with you some excerpts from this article as they are directly applicable to our youth soccer scene.
"Overuse is one of the most common etiologic factors that lead to injuries in the pediatric and adolescent athlete. As more children are becoming involved in organized and recreational athletics, the incidence of overuse injuries is increasing. Many children are participating in sports year-round and sometimes on multiple teams simultaneously. This overtraining can lead to burnout, which may have a detrimental effect on the child participating in sports as a lifelong healthy activity. One contributing factor to overtraining may be parental pressure to compete and succeed.
"An overuse injury is microtraumatic damage to a bone, muscle or tendon that has been subjected to repetitive stress without sufficient time to heal or undergo the natural reparative process. Overuse injuries can be classified into four stages: (1) pain in the affected area after physical activity; (2) pain during the activity, without restricting performance; (3) pain during the activity that restricts performance; and (4) chronic, unremitting pain even at rest. The incidence of overuse injuries in the young athlete has paralleled the growth of youth participation in sports. Up to 50 percent of all injuries seen in pediatric sports medicine are related to overuse. The risks of overuse are more serious in the pediatric/adolescent athlete for several reasons. The growing bones of the young athlete cannot handle as much stress as the mature bones of adults. Other reasons include susceptibility to traction apophysitis or spondylosis, rotator cuff tendonitis, etc.
"How much training is too much? There are no scientifically determined guidelines to help define how much exercise is healthy and beneficial to the young athlete compared with what might be harmful and represent overtraining. However, injuries tend to be more common during peak growth velocity, and some are more likely to occur if underlying biomechanical problems are present.
"The American Academy of Pediatrics Council on Sports Medicine and Fitness recommends limiting one sporting event activity to a maximum of five days per week with at least one day off from any organized physical activity. In addition, athletes should have at least two to three months off per year from their particular sport during which they can let injuries heal, refresh the mind, and work on strength, conditioning, and proprioception in hopes of reducing injury risk. In addition to overuse injuries, if the body is not given sufficient time to regenerate and refresh, the youth may be at risk of 'burnout'."
The overtraining (burnout) syndrome can be defined as a series of psychological, physiologic, and hormonal changes that result in decreased sports performance. Common manifestations may include chronic muscle or joint pain, personality changes, elevated resting heart rate and decreased sports performance. The pediatric athlete may also have fatigue, lack of enthusiasm about practice or competition, or difficulty with successfully completing usual routines. Prevention of burnout should be addressed by encouraging the athlete to become well rounded and well versed in a variety of activities rather than 1 particular sport. The following guidelines are suggested to prevent overtraining/burnout:
1. Keep workouts interesting, with age-appropriate games and training, to keep practice fun.
2. Take time off from organized or structured sports participation one to two days per week to allow the body to rest or participate in other activities.
3. Permit longer scheduled breaks from training and competition every two to three months while focusing on other activities and cross-training to prevent loss of skill or level of conditioning.
4. Focus on wellness and teaching athletes to be in tune with their own bodies for cues to slow down or alter their training methods.