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Serious Overuse Injuries Linked To Athlete's Socioeconomic Status

Those from families with private insurance more likely to be injured than those from families on Medicaid

Advice for parents 

Serious overuse injuries can force young athletes to the sidelines for one to six months or longer. Such injuries include stress fractures in the back, leg, ankle, foot, knee, shoulder/arm, elbows or wrist, elbow ligament injuries and osteochondral injuries (injuries to cartilage and underlying bone) (DiFiori, 2014)

To reduce the risk of such overuse injuries, Jayanthi recommends that youth athletes:

  • Increase the amount of unstructured free play while limiting the amount of time spent in organized sports and specialized training. In a 2012 research paper, Jayanthi reported that elite tennis players who suffered sport-related injuries spent an average of 12.6 hours per week in tennis and only 2.4 hours per week in free play or recreation, while the uninjured players spent only 9.7 hours Teenagers playing pick up basketballper week in organized tennis and 4.3 hours in unstructured free play.  A good rule of thumb, says Jayanthi, is not to spend more than twice as much time playing organized sports as spent in unstructured play. 
  • Not spend more hours per week than your age playing sports. For example, a 10-year-old should not spend more than 10 hours per week playing sports. Higher training volumes have consistently been shown to increase the risk of overuse injury in multiple sports. (DiFiori, 2014) In a study of 2721 high school athletes, for instance, there was a linear relationship between hours of sport participation and risk of injury. Specifically, training more than 16 hours per week was associated with a significantly increased risk of injury requiring medical care. (Rose, 2008)
  • Not specialize in one sport before late adolescence (there is evidence that children are particularly vulnerable to overuse injuries during the adolescent growth spurt (DiFiori J, 2014).
  • Not play sports competitively year round, but instead take a break from competition for one to three months each year (not necessarily consecutively). One study found a 42% increase in self-reported overuse injuries in high school athletes who participated all year versus 3 or less seasons per year. (Cuff, 2010)   
  • Take at least one day off per week from sports training.

Jayanthi expressed frustration that the message about the link between overuse injuries and sport specialization did not appear to be getting through to parents.  It is "hard to tell parents the truth: that there is a genetic limit to what an athlete can become, no matter how much they train," he said.

For additional tips on how parents can help reduce the risk that their youth athlete will suffer an overuse injury, click here.

For more about the reasons against early specialization, click here 


Loyola University Chicago Press Release
Cuff S, Loud K, O'Riordan MA. Overuse injuries in high school athletes. Clin Pediatr. 2010;49:731-736.  

DiFiori JP, Benjamin HJ, Brenner J, Gregory A, Jayanthi N, Landry GL, Luke A. Overuse Injuries and Burnout in Youth Sports: A Position Statement from the American Medical Society for Sports Medicine. Clin J Sports Med.2014;24(1):3-20.

Ginsburg KR, Committee on Communications, and the Committee on Psychosocial Aspects of Child and Family Health. The Importance of Play in Promoting Healthy Child Development and Maintaining Strong Parent-Child Bonds. Pediatrics. 2007; 119(1):182-191

Jayanthi N. Injury risks of sport specialization and training in junior tennis players: a clinical study. Paper presented to the Society for Tennis and Medicine Science North American Regional Conference, Atlanta GA. December 2012. 

Rose MS, Emery CA, Meeuwisse WH. Sociodemographic predictors of sports injury in adolescents. Med Sci Sports Exerc. 2008;40:444-450.