March 25, 2002

Inspired by Olympic gold medallists like Sarah Hughes and Jim Shea, many teens may be training extra hard in gyms and ice rinks these days. But for young athletes, orthopedic surgeon Carl Nissen has a word of caution.

"The old saying, 'no pain, no gain,' just isn't true," says Dr. Nissen, a Health Center surgeon with expertise in treating teens with sports injuries. "Playing sports should not be painful. And when it is, that's the body's way of saying something needs to be changed."

An estimated $800,000 is spent on children's sports injuries every year, Nissen said, and the severity of these injuries increases as athletes enter their teen years. Children and teens are particularly vulnerable to injuries because they are still growing, he explains. "Over-training can damage the growth plates, which are the relatively soft areas of development where bone growth occurs on children. Growth plates are susceptible to injury because they can be weaker than the nearby ligaments and tendons," he says.

To help prevent injuries in teens and children, Nissen recommends:

• Young athletes should start new sports slowly and gradually. They should participate in pre-season training and slowly prepare for a sports season. "Try not to go from zero to 100 overnight," he says. Nissen encourages parents to schedule pre-participation physical exams for their children each year. These are more extensive than regular physical exams and are specifically geared toward young athletes.
  
  
• Make sure equipment is in good repair. Without appropriate equipment, the risk of injury increases.
  
  
• Parents and coaches need to watch for early signs of injury. Some examples include complaints about pain and fatigue, or a sudden, decreased interest in a sport. For young children under the age of 10, Nissen recommends at least one day off from their sport per week. Older athletes, ages 10 to 15, who are focusing on one sport, should take a month or two away from that sport over the course of a year. During this time, Nissen recommends cross-training.
  
  

He says teen athletes are more likely to sustain injuries to knees and ankles. One of the most common problems, patellofemoral malalignment, is marked by sharp pain in the joint between the knee-cap and the thigh bone. It is usually resolved with conservative therapy, such as rest and the use of anti-inflammatory medicines.

Younger athletes and baseball players are more prone to elbow and shoulder injuries. Damage is caused to muscles and tendons around the shoulder by repetitive over-arm motions, such as swimming or throwing.

Osteochondritis dissecans, also known as Little League Elbow, is a complication caused by repetitive stress to the skeletally immature elbow. Treatment often includes rest and anti-inflammatory medicines. Surgery is only considered when other measures fail to bring relief.

"Although it's not always a popular choice for teens or their coaches," says Nissen, "the key to recovery for many of the overuse injuries is adequate rest."