Bone Stress Injuries in Little Athletes: A Physiotherapist's Guide for Parents and Coaches

Bone stress injuries (BSIs) are often a concern in young track and field athletes, particularly those engaged in high-impact or repetitive events. In physiotherapy, these injuries may come from certain factors such as training loads, biomechanics, and growth-related vulnerabilities.

In this blog, we’ll investigate what BSIs are, why little athletes may be at risk, and how they can be addressed.

What Are Bone Stress Injuries?

Bone stress injuries occur due to repeated stress over time without adequate recovery. This stress can lead to microdamage in the bone structure, resulting in pain, inflammation, and, in severe cases, stress fractures. Unlike acute fractures from sudden trauma, BSIs develop gradually and are often overlooked in their early stages.

Why Are Little Athletes at Risk?

Young track and field athletes are particularly vulnerable to BSIs for several reasons:

1. Growing Bones: Children’s bones are still developing, making growth plates at the ends of long bones particularly susceptible to overuse injuries.

2. High Training Loads: Events like middle- and long-distance running, hurdles, and jumps demand repetitive impact forces. Coupled with intense training schedules and limited rest, this significantly increases injury risk.

3. Biomechanical Challenges: Poor running form, inadequate landing mechanics, or improper footwear can create uneven stress on developing bones.

4. Nutritional Gaps: Insufficient intake of calcium, vitamin D, or overall calories can impair bone strength and recovery, leaving young athletes more prone to injuries.

Common BSIs in Track and Field Athletes

Here are some of the most common BSIs we encounter in young track and field athletes:

1. Tibial Stress Fractures: The shinbone bears the brunt of impact during running and jumping, making it a frequent site for stress-related pain.

2. Navicular Stress Fractures: This small bone in the foot often suffers in athletes engaged in sprinting or jumping events due to the high forces transmitted through the foot.

3. Femoral Neck Stress Fractures: Though less common, these can arise in athletes who engage in long-distance running or excessive drills without adequate rest.

4. Lumbar Spine Stress Injuries: High jumpers and pole vaulters who repeatedly hyperextend their spines may develop stress injuries in the vertebrae.

5. Growth Plate Injuries: Stress on growth plates, such as at the knee (Osgood-Schlatter disease) or heel (Sever’s disease), is particularly common in track and field athletes during growth spurts.

How to Prevent BSIs in Track and Field Athletes

Preventing BSIs requires a combination of proactive training, proper recovery, and attention to biomechanics. Here’s our recommended approach:

1. Gradual Training Progression: Avoid sudden increases in training volume or intensity. We advise following the "10% rule," increasing workload by no more than 10% per week.

2. Cross-Training: Introduce low-impact activities like swimming or cycling into training schedules to minimize repetitive stress on bones and joints.

3. Focus on Biomechanics: Regular assessments by a physiotherapist can ensure proper running, jumping, and landing techniques, reducing uneven stress distribution.

4. Optimized Nutrition: Encourage a balanced diet rich in bone-supporting nutrients like calcium and vitamin D. Consider consulting a sports nutritionist for tailored advice.

5. Structured Recovery: Build in regular rest days and discourage year-round specialization in one event. Rest is as important as training.

6. Encourage Early Reporting: Teach young athletes to recognize and report pain or discomfort. Addressing issues early can prevent minor stress injuries from escalating.

7. Appropriate Gear: Ensure proper footwear for running and event-specific spikes that provide adequate support and cushioning.

When to Seek Physiotherapy or Medical Help

If a young athlete experiences persistent pain that intensifies with activity and eases with rest, it’s time to consult a healthcare professional. Physiotherapists can provide a thorough assessment, while imaging like X-rays or MRIs can confirm a diagnosis and guide treatment.

Conclusion

Bone stress injuries in young athletes are preventable with the right approach to training, recovery, and care. As physiotherapists, our goal is to help little athletes stay active, healthy, and injury-free. By working together with parents and coaches, we can foster a safe and enjoyable environment for track and field athletes to thrive. Remember, movement is medicine, and building strong, resilient bodies today lays the foundation for a lifetime of activity and wellness.