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Overuse Injuries, Overtraining, and Burnout in Young Athletes

January 31, 2024

Editor’s Note: Jenny is the mother of two children with special healthcare needs and a Patient & Family Advisor at her local children’s hospital. In addition to her lived experience, Jenny calls upon her professional experience as a social worker to help her write blogs from her home in Wisconsin. - Cara L. Coleman, JD, MPH, Associate Editor, Pediatrics

Family Connections with Pediatrics

The other day I was playing keep-away with my two children. The 5-year-old joyfully bounced around, not a care in the world. However, the 8-year-old came ready to win. She has always had a competitive spirit, but she is also tall, strong, and naturally athletic.

As a college athlete myself, sports were a huge part of my identity. I found a great sense of belonging on my teams and loved the confidence and skills I gained from playing all those years. However, sports also had a darker side—the fear of failure, crippling anxiety, ongoing injuries, family stress, and body image issues all played a part in my athletic journey as well.

As a parent, part of my job is to support my children to find activities that help them to feel happy and healthy. Youth sports are a great way to do both. Being an athlete shaped me into the person I am today, but do I really want my kids to follow in my footsteps? I’m not sure. Youth sports are more intense than ever and young athletes face so much pressure. This month’s Pediatrics addresses these concerns in a clinical report titled, “Overuse Injuries, Overtraining, and Burnout in Young Athletes” (10.1542/peds.2023-065129).

What are Overuse Injuries?

Overuse injuries are defined as damage to bones, muscles, or joints due to repeated stress to the body. Overuse injuries are more common when the athlete:

  • Only plays one sport, but at a very high level;
  • Plays a sport or specific position with lots of repetition (e.g. running, pitching);
  • Does not eat a healthy, balanced diet with the right vitamins and nutrients.

According to the report, the best way to prevent overuse injuries is to get enough rest between games or practice sessions to allow the body to heal.

What is Overtraining Syndrome?

Overtraining syndrome occurs when an athlete does too much training with not enough recovery. Youth athletes may feel more tired, have trouble sleeping, notice changes in mood, and play poorly. Overtraining syndrome is more common when the athlete:

  • Plays the same sport all year round without a break;
  • Has several games or events in one short period of time (e.g. weekend tournaments);
  • Experiences extra stress from other areas of life like finances, family, or friends.

When it comes to the prevention of overtraining, the authors suggest that youth athletes should not play more than one sport each day. They also encourage youth athletes to take at least one day of rest each week, and to have at least a couple months off from each sport per year.

What is Burnout?

Burnout occurs when an athlete feels physically and emotionally exhausted. This can be diagnosed by a doctor and is marked by fatigue, loss of interest, worry, and no longer enjoying sports. Burnout is more likely when the athlete:

  • Has too many activities scheduled in the day, week, month, or year;
  • Feels extra pressure from parents, coaches, and peers;
  • Is afraid of failure or disappointing others.

The best way to prevent burnout is to make time for rest and other activities that feel fun, especially if those include supportive family members and friends.

What can you do with this article?

If your child is showing any signs of overuse injuring, overtraining syndrome, or burnout, encourage them to take some time off. Although this may be hard given the demands they face, the risk is not worth it. In addition, consider these next steps.

  1. Discuss this article with your child’s health care providers during their annual well-child visit. Ask them to look out for these warning signs and help rule out other causes.
  2. Share this article with your child’s coaches. Work with the coaches and other parents on the team to build a culture of health, safety, and well-being for all of the youth athletes.
  3. Advocate with school athletic boards and other local sports leagues. Ask about the policies and practices in place to protect youth athletes.
  4. Ask your child what motivates them to play sports. Notice if these factors seem positive and core to their identity, or if these factors seem based more on negative pressure from others.
  5. If your child does play at a high level, help them eat healthy, drink enough water, and get enough sleep. If needed, ask for a referral to see a nutritionist or sports medicine specialist.
  6. Perhaps the most important thing we can do as parents is to remind our kids that we love them and support them, no matter what.
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