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High School Athletes: How Much is Too Much?

Devin Peck, D. P. T.
Appropriate Training for Middle School and High School Athletes

In the United States of America, about 30 million children age 6 to 18 years old participate in some type of organized sport. Recent analysis of date from Stanford Children’s Hospital reports about 3.5 million injuries per year which lead to some sort of loss of participation and nearly 1/3 of injuries in childhood are attributed to sports-related activities. Below you can find some of the injury rate statistics that are currently being reported for our youth.

  • More than 3.5 million children from ages 6 to 18 experience injuries annually participating in sports or recreational activities.
  • Leading cause of death from sports-related injury is head trauma/brain injury (eg. Concussion)
  • Highest rates of injury along with severity of injury were directly correlated with sports that involve contact or collisions.
  • Most organized sports-related injuries (62%) occur during practice or preparation for activity.
  • Up to 50% of all injuries in pediatric sports are related to overuse.

Every year, middle and high school sports become more demanding with the amount of time spent practicing/prepping for competition. When compared to the average high school athletes 10-20 years ago, the demands on time practicing and the type of activities performed during practice are very difficult on the human body, especially considering the amount of high school athletes still in the ‘growing stage’ of their life.

Legacy Medical Centers treats and trains High School Athletes

Overuse injuries have become a hot topic due to the amount of injuries occurring in our society with sports. According to Joel Brenner (Journal of the American Academy of Pediatrics), an overuse injury is ‘microtraumatic damage to a bone, muscle, or tendon that has been subjected to repetitive stress without sufficient time to heal.’ He describes four stages of overuse injuries:

  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.
  4. Chronic pain (that doesn’t stop) even at rest.

The question that arises from this discussion is ‘how much is too much training?’

Although there are no scientifically determined guidelines to define how much is too much, they have found a few different trends with overuse injuries. The first trend involves activity occurring during ‘peak growth velocity’, which involves times where the athlete is in a ‘growth spurt’. These vulnerable times cannot be prevented, as the body grows at a natural pace. Recognition of these time periods along with awareness of the vulnerability is very important. The other trend is underlying biomechanical problems, also known as restrictions, such as flat feet, or tight hamstrings.

These two trends can be closely tracked with medical professionals to ensure decreased injury occurrence by screening athletes on a regular, ongoing basis. When a physical therapist can provide screenings to patients, it also provides an opportunity to review the amount of training along with rest routines and possible overtraining syndrome (burnout).

Dr_Devin_Peck_with_high school patient

Our screenings occur either at our facility (on a case by case basis) or with a larger organization, such as a club sport or an organization. Our screenings are thorough and use the latest evidence-based data to address possible areas of concern. We also offer baseline concussion screening for athletes using both a computerized neurocognitive assessment along with a walking assessment using sensors to track abnormalities to increase sensitivity.

We already have multiple athletes using our screening systems to decrease their chance for injury while playing their sport(s) of choice, along with having a baseline concussion screen that serves as a definitive benchmark after a head injury.

Outside of making sure our youth continue playing a variety of sports and being aware of these trends, utilizing resources in your community (such as a physical therapist) can bring positive benefit to your experiences with sports and daily life.

If this sounds like something you or your children would be interested in, please do not hesitate to reach out to our physical therapist with one of the multiple options below.

Email: dpeck@legacymedicalcenters.com

Phone: (412) 367 -2165

Website: www.legacymedicalcenters.com



Brenner, Joel S. Overuse injuries, overtraining, and burnout in child and adolescent athletes. Pediatrics. June 2007, 119 (6) 1242-1245. https://pediatrics.aappublications.org/content/119/6/1242

Stanford Children’s Health. Sports Injury Statistics. Stanford Medicine. 2020. https://www.stanfordchildrens.org/en/topic/default?id=sports-injury-statistics-90-P02787