A fine line between dedication and overuse

GREENFIELD — It’s a subject Darcie Huber knows well.

The recent author of a high school research paper on sports specialization, Huber needed only to glance at the inside of her right elbow while typing to be reminded of the costs: physical, mental and financial.

For the Greenfield-Central junior softball ace, it was the ulnar nerve in her arm that became pinched and twisted after years of use on the summer and travel softball circuit. Surgery corrected the issue in December of 2012 during her freshman year, and today Huber is in peak form as one of the area’s top pitchers and sluggers.

“Looking back on it, I would have listened to my parents more,” said Huber, who pitched seven complete innings in a season-opening win against Speedway on Monday. “Icing, that was something when I was younger I just kind of shook my head at my parents, like, ‘It’s not that big of a deal. I feel fine, I’m young. Whatever.’ And now I’m 17 and I wake up the next day and I’m feeling it.”

Use, don’t abuse

In addition to making sure to ice her pitching arm to keep swelling down, the Ball State softball commit is careful these days during warmups between innings, as well. Huber limits herself to five or six good “snaps” of the arm from the pitching rubber, before easing off. 

“Making sure you have the quality, not the quantity,” Huber said of all sports. “That’s the key.”

According to The American Academy of Orthopaedic Surgeons (AAOS), overuse injuries can include elbow issues for baseball and softball pitchers, shoulder problems for swimmers, wrist fractures for cheerleaders and gymnasts and stress fractures for running sports.

High school athletes account for an estimated 2 million injuries each year, with more than half of the injuries due to overuse. And those overuse injuries are on the rise, the AAOS noted.

It’s a statistic that doesn’t surprise Gabe Muterspaugh. The Mt. Vernon boys and girls tennis coach for the better part of two decades notices a clear trend.

“I see the major problem as kids now have to specialize and are working the same muscle movements, which will then bring on injuries more and more,” he said. “You have kids at 11 years old playing 75 baseball games. When I grew up, we played baseball in the summer, football or tennis in the fall and basketball in winter. We would play all three in one day with different movements.”

“Today, it’s play the same sport every day.”

The AAOS recommends that parents do not allow their student-athlete to play only one sport. Multiple sports participation is essential for skill development and injury prevention, the group notes.

Another warning is that teens and pre-teens do not participate on more than one team at a time. The opposite of specialization, but just as potentially dangerous, it’s not unusual for today’s high school athlete to play on a varsity basketball team in the winter, for example, and with a club volleyball team on a Sunday, or even after weekday basketball practice.

This spring, many kids are doing similar double duty.

“We have kids who participate in multiple sports at the same time,” Greenfield-Central track and field coach Jan Hacker said. “We have to pay very close attention to these athletes. Rest is just as important as working hard.”

Mt. Vernon track and field coach Tim Leonard said female athletes are particularly vulnerable.

“A great majority of injuries we have had with girls is when they try to do a club sport while competing in track,” he said. “They go to track and then try to practice their club sport after track practice, therefore they develop overuse injuries. Girls’ anatomy and physiology is not suited for two intense workouts in a day. Our girls always do 70 percent of what the boys do in practice, to keep their injuries to a minimum.”

Multiple-sport benefits

Kelli Whitaker was a four-year volleyball standout at Indiana State University after graduating from New Palestine. Given her talent, Whitaker could have easily focused year-round on developing her net skills and dominating the club ranks. Instead, she contributed not only to the Dragons volleyball team, but also to the softball and track and field squads.

Although not the star of the softball team, Whitaker enjoyed a 2004 state title with the Dragons.

“I got to be part of some awesome teams, played for an awesome coach,” Whitaker said of softball coach Ed Marcum. “Playing more than one sport taught me life lessons, like working hard, making priorities, multi-tasking. And I made great friends, people I wouldn’t have known as well if I only played volleyball.”

Recent studies have shown that specialization can actually be counterproductive to young athletes. David Epstein, author of The New York Times bestseller “The Sports Gene,” discovered that athletes who go on to perform at an elite level practiced less in their main sport through at least age 12 than athletes who leveled off at sub-elite levels.

Whitaker, now the New Palestine volleyball head coach, is proof of the theory. And it’s one Whitaker, a former all-state high school volleyball selection and Missouri Valley Conference All-Academic, subscribes to. In many instances, the coach believes, a player could gain just as much from a second sport as they could from offseason work in their main sport.

“In softball, you are put in high pressure situations,” Whitaker explained. “You have to be able to produce for your team. Same thing in volleyball. In my case, I was often the one to put the ball away and scored. 

“Mental toughness is something you learn by participating in multiple sports.”

Still loving it

Huber, despite the permanent elbow scar, is one of the lucky ones. Her smile was evident before and after softball games this week, partly because her team is 2-0, with the help of her two home runs. Even more, however, Huber still has a sincere enjoyment for softball.

She credits her parents for not making the sport the singular focus of her daily life. Avoiding mental fatigue was one of the major tenets of Huber’s research paper on sports specialization.

“Specializing in a sport doesn’t always help you in the long run, because burnout is a huge thing,” Huber said, while offering advice. “Making sure when you’re young, you enjoy it. Don’t let anyone ever push you.

“Because I’ve seen great athletes, pitchers better than me when I was younger, and today they don’t even want to play. They’re like, ‘It’s not fun anymore. I feel like I have to do it.’ You want to make sure you keep that feeling that you want to do it.”

Huber noted that a travel softball fee for a single summer can range upward of $2,000, not including hotels, airfare, and so on. It’s a fee typical of basketball, volleyball and other club programs.

Muterspaugh cautions his tennis families to not get caught up in making their son or daughter a one-sport star.

“I encourage my athletes to play other sports: Go swim, go dance, as opposed to the same thing over and over,” he said. “I think you will see more burnout coming up in the next five years. Most kids aren’t next-level kids, but parents sure think so.”

The Adolescent Athlete

The breakdown on high school sports injuries, from the American Academy of Orthopaedic Surgeons.

The Adolescent Athlete

Teenage athletes are injured at about the same rate as professional athletes, but injuries that affect high school athletes are often different from those that affect adult athletes. This is largely because high school athletes are often still growing.

Growth is generally uneven: Bones grow first, which pulls at tight muscles and tendons. This uneven growth pattern makes younger athletes more susceptible to muscle, tendon, and growth plate injuries.

Types of High School Sports Injuries

Injuries among young athletes fall into two basic categories: overuse injuries and acute injuries. Both types include injuries to the soft tissues (muscles and ligaments) and bones.

Acute Injuries

Acute injuries are caused by a sudden trauma. Examples of trauma include collisions with obstacles on the field or between players. Common acute injuries among young athletes include contusions (bruises), sprains (a partial or complete tear of a ligament), strains (a partial or complete tear of a muscle or tendon), and fractures.

Overuse Injuries

Not all injuries are caused by a single, sudden twist, fall, or collision. Overuse injuries occur gradually over time, when an athletic activity is repeated so often, parts of the body do not have enough time to heal between playing.

Overuse injuries can affect muscles, ligaments, tendons, bones, and growth plates. For example, overhand pitching in baseball can be associated with injuries to the elbow. Swimming is often associated with injuries to the shoulder. Gymnastics and cheerleading are two common activities associated with injuries to the wrist and elbow.

Stress fractures are another common overuse injury in young athletes. Bone is in a constant state of turnover — a process called remodeling. New bone develops and replaces older bone. If an athlete’s activity is too great, the breakdown of older bone occurs rapidly, and the body cannot make new bone fast enough to replace it. As a result, the bone is weakened and stress fractures can occur — most often in the shinbone and bones of the feet.

Catastrophic Sports Injuries

Many sports, especially contact sports, have inherent dangers that put young athletes at special risk for severe injuries. Even with rigorous training and proper safety equipment, children are at risk for severe injuries to the head and neck with damage to the brain or spinal cord.

Catastrophic injuries have been reported in a wide range of sports, including ice hockey, wrestling, football, swimming, soccer, pole vaulting, cheerleading, and gymnastics. It is important for coaches, parents, and athletes to be aware of the guidelines and regulations developed for each sport to prevent head and neck injury.


Concussions are mild traumatic brain injuries. They are caused by a blow to the head or body that results in the brain moving rapidly back and forth inside the skull.

Although some sports have higher instances of concussion—such as football, ice hockey, and soccer—concussions can happen in any sport or recreational activity.

Growth Plate Injuries

Growth plates are areas of developing cartilage tissue near the ends of long bones. When a child becomes full-grown, the growth plates harden into solid bone.

Because growth plates are the last portion of bones to harden (ossify), they are vulnerable to fracture. Growth plates regulate and help determine the length and shape of adult bone, therefore, injuries to the growth plate can result in disturbances to bone growth and bone deformity.

Growth plate injuries occur most often in contact sports like football or basketball and in high impact sports like gymnastics.


Many high school sports injuries can be prevented through proper conditioning, training, and equipment.

High school athletes require sport specific training to prevent injury. Many injuries can be prevented with regular conditioning that begins prior to the formal sports season. Injuries often occur when athletes suddenly increase the duration, intensity, or frequency of their activity. Young athletes who are out of shape at the start of the season should gradually increase activity levels and slowly build back up to a higher fitness level.

Using proper technique for the position being played is also key to preventing injury. Proper equipment—from the right shoes to safety gear—is essential. In addition, injuries can be prevented when athletes understand and follow the rules of the game, and display good sportsmanship.

Because many young athletes are focusing on just one sport and are training year-round, doctors are seeing an increase in overuse injuries. The American Academy of Orthopaedic Surgeons has partnered with STOP Sports Injuries to help educate parents, coaches, and athletes about how to prevent overuse injuries. Specific tips to prevent overuse injuries include:

* Limit the number of teams in which your child is playing in one season. Athletes who play on more than one team are especially at risk for overuse injuries.

* Do not allow your child to play one sport year-round—taking regular breaks and playing other sports is essential to skill development and injury prevention.

Source: The American Academy of Orthopaedic Surgeons