Bone Density is a Leading Factor in the Development of Common Overuse Injuries in Young Athletes

Posted on 
June 21, 2023

No pain equals no gain, right?

Well, not necessarily.

In adolescent and teenage athletes, there’s a chance pain, in combination with performance issues, could signal an overuse injury.

An overuse injury happens when bones, muscles, ligaments or tendons are damaged by repetitive stress to the body. Left untreated, these injuries can lead to chronic pain, cartilage damage and stress fractures.

While overuse injuries can happen to people of any age, they’re especially common in young athletes, mainly due to a lack of bone density. Human bones don’t reach peak density until we are about 30 years old.

“If you look at the average 15- to 16-year-old athlete, even those who seem to be physically mature, their bone density, at least in males, is maybe half of what it is going to be,” says Dr. Rick Weidenbener, orthopedic sports medicine specialist at Forté.

After reaching their peak, human bones begin to decline in mass, with females at a greater risk for osteoporosis, a condition causing weak and brittle bones. A visual tool, such as a bone density chart, shows young female athletes most closely resembling an older population.

“A 15- to 16-year-old girl has the bone density of a 70- to 80-year-old woman,” says Weidenbener. “No one would ask a 70- to 80-year-old woman to run 50 miles a week, but somehow, we do that with girls who have equal bone density.”

Weidenbener says the first step to preventing common overuse injuries in adolescents and teens is viewing them differently than adults, especially professional athletes. He recommends avoiding single sport specialization until after the age of 12 or even 14.

“Today, we see kids who are on two or three travel teams,” says Weidenbener. “They’re playing one sport year-round and not cross-training. These kids are not just miniature adults. Their tissues and physiology are quite different from adults, and they will not stand up to this very well.”

He says rest and recovery periods are critical in the fight against overuse injuries.

“Coaches should embrace an athlete who wants to do other sports because your focused body parts are going to get a little bit of a break while your athlete stays in good shape,” says Weidenbener.

Proper nutrition can also help prevent overuse injuries.

“Calcium and vitamin D are helpful, whether through dairy products or supplements,” says Weidenbener. “Adequate protein for muscle recovery is also critical.”

Coaches can take the lead in protecting athletes from overuse injuries by keeping parent expectations in check and utilizing an athletic trainer.

“If there is a painful joint or a painful limb, the first step would be to have it evaluated by your athletic trainer, who can decide whether it needs rehabilitation, rest or further evaluation by a physician,” says Weidenbener.

“Don’t ignore the pain,” he adds, “because there are a lot of things that can happen to young athletes.”

These recommendations have been excerpted from Coaches Corner, a free monthly webinar series for coaches, athletic directors and athletic trainers. The series, developed and presented by Forté, in partnership with IHSAA, aims to arm coaching and support teams with helpful information to consider when working with their athletes. Subscribe online so you don’t miss an episode.

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