Overuse Injury Epidemic: How we're failing today's youth

Overuse Injury Epidemic: How we're failing today's youth


By Greg Bach

Years ago, a father from Minnesota brought his 12-year-old son with an achy elbow down to the famed Andrews Sports Medicine and Orthopaedic Center in Birmingham, Ala., to be examined by renowned surgeon Dr. Jeffrey Dugas.

The youngster was pushing 6-feet and firing fastballs in the low 80s; and his dad was happily reciting how many no-hitters his son had already thrown and savoring all the strikeouts he had recorded. 

“The dad pulled me aside and asked at what point I thought he should contact an agent,” Dugas recalled recently of that visit. “This was a sixth-grader and my thought was that maybe he ought to pass geometry before we talk to an agent.”

That conversation certainly isn’t surprising given the state of today’s youth sports climate, and it’s indicative of an ever-growing mindset that can be found planted in the bleachers of virtually every youth sports program across the country: Parental pushing, mixed with unrealistic expectations and year-round games and training, has resulted in the bodies of young athletes breaking down at mind-boggling rates.

“A 12-year-old that can throw it 80-something miles per hour, that’s a high risk for injury,” Dugas says. “Those are the kids that need the most protection and they’re the ones that end up throwing the most because they want to throw, the team wants them to throw, the coach wants him to throw and the parents want him to throw. There’s no impetus to say maybe that kid ought to play first base for a couple years until his body develops a little bit, and hit and become a better baseball player and not really pitch very much. There is nobody that will buy that – although that’s really what you need to tell these kids that are really talented at that age with throwing. You need to tell them not to throw as much.”

It’s a message that’s lost amid the frenzy of chasing scholarships and one that most parents are likely to ignore, and their young athlete, too.

“That’s a tough message, and that’s a tough message to hear as a kid,” Dugas says. “If I was a 12-year-old and I could do that I would want to be out there every day. It’s intoxicating to be that successful on the mound and to be able to do those kinds of things. But that’s really the best thing for the kid is to say, ‘You just shouldn’t throw that much right now.’”

It’s a remedy that has yet to gain traction, as more young athletes than ever are spending portions of their season in waiting rooms and rehab facilities. Here’s what else Dugas shared with us from his Birmingham office:

SPORTINGKID LIVE: Why are you so passionate about youth sports injuries and protecting kids?

DUGAS: I think in the sports medicine arena it’s our duty to try and prevent injuries, not just treat them. There are some things inherent to sport – you’ll never undo injuries because it’s the nature of sports that people are going to sustain injuries. But injuries that are sustained because of overuse that could be prevented or overuse that is senseless are things that we need to hammer home and it really gets down to the grassroots level of sports. You don’t see a ton of overuse injuries at the highest level of sports because they are knowledgeable and aware and they have all the data points.

SPORTINGKID LIVE: One of the big problems seems to be adults who want their kids playing schedules that mirror what is seen in the professional ranks?

DUGAS: We can’t look at the guys you see on TV and say that I can do that. They’re the finest athletes in the world and they’re all adults; they’re completely developed adults. You can’t extrapolate to anybody else. All you have to do is look at professional baseball. The Major League Baseball season is 162 games; the Triple A season is 140 games; the Double A season is 120 games; the Single A season is 100 games; and the college guys play 60 to 70 games. Why is that? It’s not because the sun isn’t shining, or the weather isn’t amenable. It’s because their bodies won’t hold up to it and so you can’t apply what you see on TV to a 12-year-old. That seems silly, but that’s what happens. We know kids that are playing more days of the year than guys that get paid $30 million dollars a year.

SPORTINGKID LIVE: Are these problems getting better or worse?

DUGAS: I think it has gotten worse. You know I think it’s kind of household knowledge that you shouldn’t throw curveballs when you are 8-years-old, and yet it still happens. I think it’s household knowledge that you shouldn’t throw 120 pitches when you are 12, but it still happens. If you asked any coach if they should have a 12-year-old throwing 120 pitches I don’t think any of them would say, ‘Yeah, that’s ok’ but yet it still happens. I’ve yet to meet a coach at any level that would intentionally hurt a kid so I don’t think that these things are intentional injuries. I don’t think it’s wanton disregard of the health of children, I think it’s in the name of competitiveness.

SPORTINGKID LIVE: We know kids love to compete, but does some of the responsibility fall on them to pull back and mix in a different sport or activity?

DUGAS: It’s the competitiveness of the parents as well as the kids, too. The kids have something to do with this just as the adults do. The kids want to be out there, and they drive this bus as well. They want the extra training, they want the extra throwing, they want to be on the mound, they want to compete and win and the parents want them to be there and the parents of the other kids want them to be there and the coaches want them to be there. So, there’s no force saying “don’t do this” except common sense injury prevention, which seems to be lower on the importance scale than some of the other things. And that’s why this is out of control is the risk of injury just seems to be not as important as other things.

SPORTINGKID LIVE: What’s the solution?

DUGAS: It’s realizing that it is better to play multiple sports, move from one season to the next, and periodize your overuse type of activity. If you’re a pitcher in the spring and you’re 12 years old you probably don’t need to pitch that much in the summer. If you’re a catcher you need to work on your hitting and your defensive skills – you just don’t need to do the same thing all the time. So, you almost want to do it in a wave form: if you’re a school pitcher and you’re 12 or 13 years old and you’re pitching for your junior high and you pitch 50 or 60 innings in your junior high spring season that’s a lot for a 12- or 13-year-old, so maybe you don’t want to pitch that much in the summer. Maybe you want to hit and work on your pickoff moves, and that’s not to say you don’t throw at all but maybe you throw an inning or two here and there but you’re working on something specific. And fall comes around and maybe you throw once a week or once every other week in a game and you take another break from Thanksgiving to Christmas and you rest your arm. And then you get it started for the spring again. So, it’s kind of this rest period in-between your performance periods – we call it periodization and that’s important. Meanwhile, you might be playing basketball or working on your leg strength or working on your mechanics. And it’s OK to take a break; your body needs rest and you have to do that. The best athletes in the world take a break. LeBron James doesn’t go play basketball the week after they’ve played in the NBA Finals. He rests his body and gets his knees feeling better. They just don’t go 12 months a year.

Andrews Sports Medicine Specialization Overuse Injuries Safety Training

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