Currently, there are more options for youth sports participation than ever; from alpine skiing to whitewater rafting, and everything in between. Despite the innumerable possibilities, the amount of children involved in sporting activity has seen a fairly substantial decrease in recent years. According to a 2015 report from the Sports & Fitness Industry Association, the number of kids that played a team sport on a regular basis decreased from 44.5% to 40% from 2008 to 2013. This amounts to more than 2.6 million fewer kids over a five year period. Now, there are many potential reasons for this reduction, but one conceivable contributor to this decrease in participation may be an increase in overuse injuries in youth athletes.

Overuse-type injuries can be experienced throughout the body and are often a result of repetitive stresses placed on muscles, tendons, bones, and even nerves. These loads often build up and cause microscopic damage to the tissue. Injury occurs when the body cannot recover in time to repair the damage between periods of activity.

Two sports in which athletes often experience overuse injuries are baseball and swimming. There are parallels between these sports in that an athlete’s shoulders may be required to perform similar movements over and over, many times throughout a practice, game, meet, and season. Now, the shoulder itself is a very complex and fascinating joint. It is incredibly mobile, but unfortunately has less inherent joint stability and requires strong and indefatigable rotator cuff and scapular muscles. Due to adolescent maturation, often times the development of strength, endurance, and control in these muscle groups are not enough to keep up with the demands placed upon the joint with repetitive throwing and swimming. Regrettably injury may ensue. There are multiple potential mechanisms for this but here are just a few:

• Pitching repeatedly while fatigued
• Poor mechanics:
  1. Throwing
  2. Swim stroke
• Excessive volume
  1. Pitching too many innings
  2. Swimming too many yards or increasing volume/speed too rapidly
• Muscle weakness/tightness

It is important to understand that with the requisite amount of repetition that comes along with improving a skill, or playing a sport, it is not uncommon to experience muscle soreness. However, it is important to be aware of the difference between “muscle soreness” and “pain.” Some symptoms that are not “normal” include:

• Pain after practice that doesn’t go away with rest, ice, and/or training modifications
• Pain that interferes with performance/participation
• Pain at rest or at night
• Feeling of the shoulder being unstable, or having a “dead arm”
• Mechanical symptoms such as catching or popping in the shoulder

If your child is experiencing any of these symptoms, it would be prudent to consult a medical professional sooner rather than later. Many of these issues can be resolved in a short period of time if caught early, but waiting often only prolongs the return to normal participation. Here are some other things for parents and athletes to consider:

1. Excessive “Screen Time”
   • Spending too much time looking at a smartphone/tablet/computer can place the head, neck, upper back, and shoulders into less than ideal positions
2. Poor posture
   • Due to the nature of throwing a baseball or the type of swimming stroke, certain muscle groups are often preferentially over-developed. This can manifest as having rounded upper backs and forward shoulder posture. This can place increased stress on the tissues of the shoulder and neck and may contribute to injury.
3. Early sport specialization
   • Early exposure to a sport is a great thing, but be aware that the repetitive nature of both throwing and swimming can catch up with the athletes if there is overexposure, especially season after season without any rest.
4. Improper/excessive training
   • Weightlifting and dryland training are both important aspects of swimming and baseball, but it is important to note that adding more volume to already over-stressed muscles can speed up the process of overuse.

Despite our ever-expanding knowledge regarding injury prevention, there is still no guarantee of remaining injury-free while competing in athletics. However, due to the fact that many swimming and baseball injuries are due to overuse, the best way to manage the likelihood of recurrent pain is with early recognition and treatment.

Should you have any further concerns or would like to schedule an appointment with one of our sports medicine specialists at the Institute for Athletic Medicine or Fairview Sports and Orthopedic Care, please visit athleticmedicine.org or call: 612-672-7100 to schedule today!

Let’s work together to help keep kids playing sports and most importantly, keep them healthy!

By: Erika Sandell-Savor DPT, SCS