When Good Habits Turn Bad

By Alice Lesch Kelly

Overuse can leave you on the sidelines.  David Walberg

You gotta pay to play. For some athletes it's a misguided mantra. For swimmer Olivia Vamosiu it was an agonizing taunt: Shoulder pain was the price she paid for competing on her high school and club teams. "The pain was immense," says the 19-year-old, now a sophomore at the University of California, Berkeley. After two misdiagnoses -- and two failed rehab plans -- she visited a sports medicine specialist who diagnosed extensive tissue damage due to overuse. She had arthroscopic surgery in late 1997 and is now playing on Berkeley's water-polo team.

Vamosiu's story is not unique. In the past 10 years the number of girls playing high school sports has increased at nearly four times the rate for boys. Girls are joining school teams and community clubs, attending sports camps and working with coaches. The downside: More girls are getting hurt. Researchers estimate that as many as half of all sports injuries to boys and girls under age 16 can be attributed to overtraining (50% to 70% for adults).

When a part of the body is constantly overused -- and has insufficient time to recover -- small traumas develop, leading to weakness, loss of flexibility and pain, says Dr. John P. DiFiori, a sports medicine specialist and UCLA team physician. The good news? Half these injuries can be prevented. Here's how:

Frequently Asked Questions Q: How do you know when to ice an injury and when to use heat? A: Some doctors have a simple formula: Ice for the first 48 hours (a.k.a. phase one, or the pain phase), followed by "contrast therapy" -- alternately soaking the injury in ice- and hot-water baths. Trouble is, phase one doesn't always last 48 hours. Tissue damage causes bleeding and swelling; icing slows blood flow and reduces inflammation. Applying heat too soon may cause new swelling. How do you know when you're ready for heat? Unfortunately, trial and error is the only way. If you still notice swelling, go back to ice only. In phase two, when pain and swelling ease, apply heat to the area before activity. This helps warm the tissue and increase elasticity in the muscles and tendons, preventing further trauma. (Try moist heat, from a wet towel or moist heating pad: It penetrates the skin better. Skin irritants like topical "heat" creams don't penetrate at all.) Even during the recovery phase the area is still vulnerable to swelling, so be sure to ice down after any activity. Of course, don't forget to stretch well before and after. OUR EXPERT: STEPHEN RICE , sports medicine physician and injury prevention specialist, Jersey Shore Medical Center

Get a checkup
DiFiori recommends a physical six weeks before the start of your season. Ask your doctor for exercises to strengthen the body parts that will get the most use.

Build up strength
Weak muscles are primed for trouble. Work on overall fitness, flexibility and endurance before playing a sport, says Diane Wiese-Bjornstal, associate professor of kinesiology at the University of Minnesota.

Hone your technique
Faulty foot placement or improper arm, hand or torso movements can trigger trauma. A coach or trainer can get you going.

Update your gear
Ill-fitting equipment can cause chronic pain. If you're still growing, replace shoes, tennis-racket grips and other gear as needed.

Mix it up
Cross-training gives overused body parts a break. If you're a runner, for example, balance time on the road with cycling, swimming and weight training.

Easy does it
Sharp spikes in training frequency, duration or intensity can lead to injury, DiFiori says. So can a lack of rest. Limit increases to 10% a week and take some days off.

Eat smart
Girls ages nine to 18 should get 1,300 to 2,500 mg of calcium daily; women 19 to 50 need 1,000 to 2,500. (If you have an eating disorder, get help: Bulimics and anorexics are more likely to have suppressed bone mineralization, or premature osteoporosis.)

Avoid growing pains
If you're still in your teens, you're more susceptible to injury during a growth spurt (ages 10 to 13 are prime spurt years). Whenever yours occurs -- you'll know because of obvious changes in your body -- scale back on your training for a while.

If it hurts, stop!
Ignoring pain could sideline you forever. 'Nuf said.

Keep a healthy perspective
Don't focus on winning so much that you forget what's best for you -- and don't let anyone else do it either. "If you feel someone is pushing you," DiFiori says, "talk to someone you trust -- a parent, coach or school administrator.
 

 
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