The majority of injuries in exercising children affect the musculoskeletal system. These injuries result from two mechanisms: single, acute macrotrauma or repetitive microtrauma. The injuries resulting from repetitive microtrauma—overuse injuries—appear to be occurring with increased frequency in this age group. A number of risk factors for overuse injury from exercise have been identified, including training error, muscle imbalance, anatomic malalignment, footwear, surface, nutritional factors, and cultural factors. The development of scientific criteria for exercise prescription in this age group that will enhance fitness and avoid injury awaits techniques for noninvasive assessment of musculoskeletal tissue fitness. In the interim, many of these injuries can be prevented or decreased in severity by slow progression of exercise intensity and qualified adult supervision.
This paper was developed from a presentation at the 1989 annual meeting of the American College of Sports Medicine in Baltimore, in a symposium titled “Training Adaptations and Cautions in Pre- and Post-Pubescent Children” organized and chaired by Bo Fernhall.
Lyle J. Micheli, M.D., is Director of the Division of Sports Medicine at Children’s Hospital in Boston, and is with the Department of Orthopaedic Surgery at Harvard Medical School, Boston, MA 02115.