Overuse injuries and effective return to sport

What causes an overuse injury?

An overuse injury is damage to a bone, ligament or tendon caused by stress from a repetitive movement, such as running. Although these types of injuries are common in athletic children and young people, they can be managed or completely avoided by promoting efficient recovery and managing the amount of physical activity they participate in each week.

What factors can contribute to an injury or slow down recovery?

Young people can get injured for lots of reasons. Your physiotherapist will discuss with you how you were injured, and what other factors might have contributed to you getting injured. Please see below for some of the main influences on injury occurrence.

Risk factors

• Growth spurts
• Training errors
• Too little recovery time
• Lack of sleep
• Overtraining
• Low levels of vitamin D
• Low energy intake
• Lack of strength
• Stress

How can you promote efficient recovery?

Parents and carers

• Encourage your child or young person to eat a balanced diet which includes fruits, vegetables and protein. This includes at least 8 cups of water a day
• Ensure your child gets at least 8 hours of sleep a night.
• Consider vitamin D tablets to supplement for Scottish winters
• Manage the total amount of physical activity your child or young person is participating in each week.

Coaches

• Encourage regular stretching during training sessions (some examples are shown below)- particularly during a young person’s growth spurt
• Add some full-body strengthening exercises into training (e.g. squats, lunges and push-ups)
• Ensure that children and young people are given enough time to recover after an intense training session or game.

Stretches

Hamstring stretch

• Lie on the floor with both legs bent.
• Lift one leg off of the floor and bring the knee toward your chest.
• Clasp your hands behind your thigh below your knee.
• Straighten your leg and then pull it gently toward your head, until you feel a stretch.

If you have difficulty clasping your hands behind your leg, loop a towel around your thigh.

Hold for 30 seconds and repeat 2-3 times and repeat 2-3 times on each leg.

Stretch Quads prone self

• Lie face down.
• Reach back and grasp the ankle.
• Relax your leg and gently pull your ankle towards your buttocks.

Hold for 30 seconds and repeat 2-3 times and repeat 2-3 times on each leg.

Knee to Chest

• Lie on your back on the floor with your legs extended straight out.
• Bend one knee and hold below your knee with your hands.
• Gently pull your knee toward your chest as far as it will go.

Hold for 30 seconds and repeat 2-3 times and repeat 2-3 times on each leg.

Wall push-ups or stretches for Achilles Tendon

• Stand to face a wall with one leg forward with a slight bend at the knee.
• Keep the leg behind you straight with the heel flat on the ground.
• With both heels flat on the floor, press your hips forward toward the wall.

Hold for 30 seconds and repeat 2-3 times and repeat 2-3 times on each leg.

Managing physical activity levels

Managing the amount of high-intensity exercise your child or young person participates in each week will allow their bodies to properly recover.

A useful guide is to limit high-intensity activity to no more than 4 sessions per week and try not to participate in high-intensity activities 2 days in a row.

Download a table for managing physical activity levels  (Word)

Download a table for managing physical activity levels  (PDF)

Return to sport journey

Getting back after injury may take some time, and might involve ups and downs. Your physiotherapist will discuss with you things you can work on throughout your rehabilitation.

The body often needs a break after an injury, and your injured part may be ‘grumpy’ or sensitive for a while. It is ok to rest. Your physiotherapist can give you ideas of how to stay active and strong whilst you cannot do your chosen sports.

Think about what is it you want to be able to do again (your goal) and let your physiotherapist know so we can help you get there.