Overuse injuries are common in sports, perhaps no more so than in track & field. In addition to shin splints, which is the number one overuse injury in track, some of the most common injuries are:

• Chondromalacia a/k/a "Runner's Knee": this painful knee ailment occurs when the kneecap (patella) rubs against one side of the knee joint irritating the surface of the undersurface of the patella and causing pain. Runner's knee is more often seen in female athletes, the thinking being that a woman's wider hips increase lateral forces on the kneecap.

• Patellar tendonitis a/k/a "Jumper's Knee": When the patellar tendon, which connects the kneecap (the patella) to the shin bone, becomes inflamed, an athlete has patellar tendonitis. While most often seen in athletes participating in jumping-types of sports such as basketball or volleyball, this injury is also common in track and field. It can result from overuse but also when the kneecap does not move up and down (i.e. track) properly in its natural groove, causing friction leading to inflammation leading to chronic pain.

• Stress fractures. Perhaps the ultimate overuse injury. Left untreated a sore spot on a bone (also known as a hot spot) leads to a hairline fissure in the bone, which leads to a fracture, which can lead to the bone completely breaking in two. Bottom line: don't ignore and continue running when there is pain and soreness in a bone. Treat it while it is a hot spot.

Three Primary Causes

Overuse is the cause of most chronic, nagging injuries. Track & Field lends itself to these problems because of the repetitive motion in most events. There are several primary causes of overuse problems:

1. Biomechanical imbalance
2. Running too much
3. Running on hard surfaces

Treatment

According to Laura Ann Christopher, MS, ATC, an athletic trainer for the University of Maryland track team, these types of injuries usually respond to the following types of treatment:

• Rest. The best antidote for overuse injuries. Cross training such as pool running or other aerobic exercise that doesn't use the affected area can maintain your fitness while your child rests in order to avoid aggravating the injury and allowing it time to heal.

• Anti-inflammatory medications. Non-steroidal anti-inflammatory medications (NSAIDs) such as Ibuprofen, Motrin®, Naprosyn, Celebrex® or similar products are typically used. Be sure to check with a medical care provider for the proper dosage because sometimes the most effective dose for reducing inflammation is different from the dose recommended for pain relief.

• Ice. Ice should definitely be applied to the inflamed area as soon after a training session as possible because the more you can ice the more quickly you will get better. Icing throughout the day, 20 minutes out of each hour (20 minutes with ice on, then a 40 minute break) will promote healing. Icing through the whole day will lead to frostbite, so ice frequently but not steadily. A slightly damp paper towel will allow the cold to do its work while protecting the skin from freezer burn.

All of these treatments can be done by the athlete. An athletic trainer or physical therapist may also use some of the following to promote healing:

• Ultrasound machine. Sound waves penetrate the affected area bringing deep heating which can increase circulation and decrease inflammation.

• Electrical stimulation units use low level electrical currents to provide pain relief. They block pain signals to the brain or may promote the production of endorphins which are the body's natural pain relievers.

These machines should only be used in athletic training rooms and physical therapy lclinics by trained professionals. The improper usage of units marketed for home use can be harmful.

Prevention

Overuse injuries usually occur due to a biomechanical imbalance in the way the person runs, causing excess stress to one area of the body. Remove the imbalance and strengthen the weakness and injuries will be less likely to occur.

According to Christopher, the three most important things an athlete can do to prevent inflammation and overuse injuries are:

1. Don't over train. More volume is not always better training or good for your child's body. Ideally, each athlete will find the training volume that is the most effective for her but allows her to maintain her health. Any increase in volume should be done gradually. For example, increase training volume by 5% and then take several weeks to adjust before adding more.

2. Don't change training techniques abruptly. In general, training on softer surfaces will produce less wear and tear on a young athlete's joints and bones. This is good for both the short term and long term health. If he loves to run and want to still be doing it later in life, he needs to do what he can to preserve his joints when he is young. Some athletes can go back and forth between grass, trails, roads and tracks with no problems. But if your child can't, he needs to keep that in mind when planning his training.

3. Wear appropriate footwear. Different shoes are made for different kinds of feet and varying foot placements. Before beginning, or if she is having any foot or leg pain, visit a running store to have her feet evaluated and get recommendations for running shoes that will give her the best fit and support.