Injury Prevention for Youth and Teen Runners

Fall is here, school has started, and so has the cross-country season! Many Oregon Running Clinic patients are high school and college cross-country runners, and we are uniquely equipped to provide physical therapy to youth and teen runners. How can young runners avoid injury and keep running all season long? By cross-training, emphasizing proper nutrition and sleep, and avoiding over-training. It’s important for young runners to develop correct running form and behaviors now, to remain injury-free.

Common Injuries for Youth Runners

The most common injuries for youth and teen runners are stress fractures—brought on by under-fueling and overtraining—and injuries of the growth plates, both apophysis and epiphysis.

For middle school runners, tibia, metatarsals and fibula are the most common locations for bone stress injuries. Additionally, girl runners often suffer from injuries to the pelvis and femoral neck (the top of the femur where it connects to the hip bone).

For high school runners, 5.4% of girls and 4% of boys have sustained a stress fracture, and the tibia is the most common location in girls and the metatarsal in boys.

Sometimes, a child’s injury will be incorrectly classified as a more common adult injury. For example, a teen may have what appears to be a sprained ankle, but in reality is a fractured growth plate.

How to Reduce Risk of Youth Running Injury

Understand the Risks

Evidence strongly supports girls are at higher risk for running related injury and greater time loss from injury than boys. Girls with a low BMI are also at an increased risk for stress fractures compared to boys. It’s important for female athletes to take measures to avoid injury and follow proper training regimens.

What is not a risk factor for adolescent injury in runners? Height or weight!

Allow Full Recovery from Previous Injury

Just like in adult athletes, one of the easiest ways to get injured is by never fully healing a previous injury. Teen and youth runners need to spend time resting after an injury, and avoid getting back into their sport too quickly.

Depending on how the injury occurred, working with a physical therapist can be beneficial to understand whether a change in technique or additional strength training can help the athlete avoid a similar injury in the future.

Avoid Youth Sport Specialization

These days, it’s common for children to begin specializing in one sport from a young age, then spend many hours a week training in that sport. While this is key for sports like gymnastics and diving, it is problematic for most other sports. Why? There is no evidence to support that youth sports specialization results in:

  • Improved later success such as collegiate participation

  • Improved physical function

Instead, specialization is often associated with increased risk of overuse injury and can actually result in reduced physical activity in older ages. This is true even for runners.

In fact, some studies have found a 60-80% reduction in bone stress injuries for runners who participated in soccer or basketball.

Make sure your child spends time playing sports other than running, particularly sports like soccer and basketball that involve jumping and lateral movements.

Avoid Over-Training

Doctors have long recommend that kids practice one hour per their age of sports per week. So a 12-year old should not train more than 12 hours per week. Unfortunately, as sports training has become more elite, many children are exercising far more than the recommendation.

If your teen is exercising more than the recommended limit, try cutting back in some areas. Perhaps eliminating an extra training group or working with their coach can help.

Not only will reduced training help avoid injury, it can also prevent burnout, an all-too-common occurrence for busy athletes.

Emphasize Proper Nutrition

Many of the top increased risk factors for youth runners particularly girls, is not eating enough. Eating less than three meals per day and generally not consuming enough calcium or calories can be detrimental. Runners with eating disorders are also at an increased risk.

Experts recommend high levels of calcium intake (at least 1500 mg/day) and 800 IU of Vitamin D may be protective against development of stress fractures. Women who consumed less than 800 mg of calcium per day had nearly 6 times the rate of stress fracture than women who consumed more than 1500 mg of calcium.

Teens who follow vegetarian diets can also be at increased risk for injury, so supplements may be necessary.

Make sure a teen runner is getting enough food throughout the day, especially when they have practices or races.

Get Enough Sleep

Inadequate sleep has been found to contribute to increased bone turnover and risk for injury in other populations. It’s important for youth runners to get the recommended amount of sleep each night (Age 6–12 years should sleep 9–12 hours per night and ages 13–18 years should sleep 8–10 hours).

Kids are not just “tiny adults”, and their overall health and wellness must be prioritized in order to keep them injury free. If you’re concerned about your teen or youth runner, or what specialized techniques to help them throughout the cross-country season, contact Oregon Running Clinic for a consultation.

Charlotte Spangler