Overuse Injuries in Young Athletes: When Is Pain a Red Flag?

Youth sports participation continues to rise across the U.S., with many children and teens training year-round in a single sport. While regular physical activity provides clear health benefits — from improved fitness to stronger social connections — the increase in intensive training has also led to a growing number of overuse injuries among young athletes.

Unlike sudden traumatic injuries such as fractures or ligament tears, overuse injuries develop gradually. They occur when repetitive stress is placed on muscles, tendons, bones or growth plates without enough time for recovery. Because these injuries often begin as mild soreness, they are frequently dismissed by athletes, parents or coaches as “normal pain.”

Sports medicine specialists say that assumption can sometimes delay important care.

“Pain is the body’s way of signaling that something isn’t right,” said Alejandro Centurion, M.D., a primary care orthopedics sports medicine physician with Baptist Health Orthopedic Care. “While some muscle soreness is expected with training, persistent or worsening pain should never be ignored, especially in growing athletes.”

Why Young Athletes Are Vulnerable

Children and adolescents are particularly susceptible to overuse injuries because their bones and tissues are still developing. Growth plates — areas of cartilage at the ends of long bones — are weaker than mature bone and can become irritated when exposed to repetitive stress.

High training volume, limited rest and early sport specialization all increase risk.

“When kids focus on a single sport year-round, the same parts of the body absorb repetitive stress without enough time to recover,” said Jason Perry, M.D., primary care sports-medicine physician at Baptist Health Orthopedic Care. “Over time, that repetitive load can lead to inflammation, stress injuries or growth plate problems.”

Common overuse injuries in young athletes include:

• Little League elbow from repeated throwing
• Osgood-Schlatter disease, causing knee pain below the kneecap
• Sever’s disease, a heel injury often seen in young soccer or basketball players
• Stress fractures, tiny cracks in bones caused by repetitive impact
• Tendinitis, inflammation of tendons from repeated motion

These conditions typically develop slowly and may start as mild discomfort during or after activity.

The Misconception: “Playing Through Pain Builds Toughness”

One of the most persistent myths in youth sports is that playing through pain builds resilience. In reality, ignoring symptoms can allow a minor issue to progress into a more serious injury.

“There’s a big difference between normal muscle fatigue and pain that signals tissue damage,” Dr. Perry said. “If a young athlete has pain that changes the way they run, throw or move, that’s a warning sign that something more serious may be developing.”

Athletes who try to push through discomfort may unconsciously change their mechanics, which can place additional strain on other joints or muscles.

“Compensating for pain often shifts stress to other parts of the body,” Dr. Centurion explained. “That’s when we start to see secondary injuries develop.”

When Pain Becomes a Red Flag

Not every ache requires a doctor’s visit, but sports medicine physicians say certain symptoms should prompt evaluation.

Warning signs include:

• Pain that persists for several days after activity
• Pain that worsens with continued play
• Swelling or tenderness in a specific area
• Pain that interferes with normal movement
• Pain that occurs at night or during rest

“If pain keeps coming back every time a child participates in a sport, that’s a clear signal the body hasn’t recovered,” Dr. Perry said. “Continuing to push through that cycle can turn a manageable condition into a long-term problem.”

Early evaluation can often prevent more serious injury.

“In many cases, addressing the issue early means we can treat it with rest, physical therapy or small adjustments in training,” Dr. Centurion said. “Waiting too long sometimes leads to injuries that require longer recovery.”

The Role of Rest and Recovery

Another common misconception is that more training always leads to better performance. But recovery is a critical part of athletic development.

Sports medicine experts often recommend that young athletes take at least one to two days off from organized sports each week and consider taking a break from a primary sport for several months each year.

“Rest isn’t lost time,” Dr. Perry said. “It’s when the body adapts, repairs and becomes stronger.”

Cross-training — participating in multiple sports or activities — can also help reduce repetitive strain by engaging different muscle groups.

“Kids who play a variety of sports tend to develop more balanced strength and coordination,” Dr. Centurion said. “That diversity of movement can actually lower the risk of overuse injuries.”

Listening to Young Athletes

Recognizing injury risk also requires open communication. Younger athletes may hesitate to speak up about pain because they worry about disappointing coaches, missing games or losing playing time.

Parents and coaches play an important role in encouraging athletes to report symptoms early.

“We want young athletes to understand that reporting pain isn’t weakness,” Dr. Centurion said. “It’s an important step in protecting their long-term health.”

Dr. Perry agrees that early conversations can make a significant difference.

“When kids feel comfortable talking about discomfort, we can intervene earlier and prevent small problems from becoming major injuries,” he said.

Keeping Sports Safe and Enjoyable

Despite the rise in overuse injuries, experts emphasize that sports remain a valuable part of childhood development. Physical activity supports cardiovascular health, mental well-being and social growth.

The goal, physicians say, is not to discourage participation but to promote safer training habits.

“Youth sports should help kids build lifelong habits of physical activity,” Dr. Perry said. “The key is balancing training with recovery so the body has time to adapt.”

For parents and athletes, the most important takeaway may be simple: pain is information.

“Listening to the body is one of the most important skills any athlete can learn,” Dr. Centurion said. “Addressing pain early helps keep young athletes healthy and allows them to stay active in the sports they love.”

As youth sports continue to evolve, understanding the difference between normal soreness and warning signs of injury may help protect the next generation of athletes — and ensure that participation remains both safe and rewarding.