National Athletic Trainers' Association Position Statement: Prevention of Pediatric Overuse Injuries

This statement gives athletic trainers, physicians and other clinicians recommendations for preventing overuse injuries in young athletes aged 6 to 18. Overuse injuries make up roughly half of youth sports injuries, and the authors argue many could be prevented with simple measures.

It covers screening (using the preparticipation exam to look for risk factors and referring children with deficits), recognizing early warning signs such as arm pain, fatigue and declining performance in young throwers, limiting pitch counts, and educating coaches, parents and athletes.

On training load, it recommends at least 1 to 2 days off a week from competitive sport, playing on only one team in a sport per season when two would mean practices or games more than 5 days a week, increasing training by no more than about 10% a week, a general fitness program before the season, and neuromuscular training. It encourages playing several sports rather than specializing early, with time off between seasons and 2 to 3 nonconsecutive months a year away from any sport played year-round.