At just 13 years of age, Mikkyla Worthing is, already, too familiar with knee pain. The South Middle School athlete participates in three sports, which means she has games, meets, or practices that last 90 minutes up to four times a week. Repetitive drills on the basketball court, constant switchbacks in soccer, and the pounding of joints during cross country began to take a toll on her body recently. Worthing suffered from overuse – a typical culprit when it comes to kids and sports, said Michael Erickson, doctor of physical therapy at Centers for Rehabilitation Services, a service line of HSHS Sacred Heart and St. Joseph’s hospitals. 

“Looking back, I realized that I wasn’t taking time to reduce or prevent the pain,” Worthing said. “I would feel muscle soreness during or after practices or games, but would choose to ignore it.” When it got to be too much, she went to HSHS St. Joseph’s Hospital for rehabilitation therapy, where she met Erickson.

He suggested the Athletes in Motion program, which helps student athletes with improper movement mechanics and muscle imbalance that can lead to overuse injuries like that suffered by Worthing. Erickson said Worthing’s situation has become the rule, not the exception. “Winter sports are starting up soon, and it’s important to recognize that a lot of these kids have been playing these sports for long periods of time,” he said. “Too much time on the court in youth can lead to overuse injuries.”

The “practice-makes-perfect” theory shouldn’t be taken literally, Erickson said. Some practice is good, but too much probably won’t lead to perfection. Instead, it can cause injury. An athlete training for one particular sport should max out at 16 hours of practice per week. Ten hours of practice a week is a good goal, he said. Sixteen could cause fatigue and body breakdown. Another way to cut down on injuries is to play many different sports. Athletes use certain muscles for each sport. If students play multiple sports throughout the year, instead of one sport year-round, the risk of injury decreases, Erickson said.

“Kids are still developing,” he said. “Growth plates, muscles and tendons are adapting. When you stress the muscles and tendons, they adapt to the overload of stress and it causes injuries. Bones start to pull apart from the muscles.”

Tendons attach muscles to bones. Muscles typically do OK under a bit of stress, but the tendons get irritated, which could lead to changes in that tendon if growth plates aren’t closed yet, he said. Tendons go through degradation. Erickson said he sees “jumper’s knee” – boney prominence below the kneecap that causes pain – often with middle and high school athletes. Depending on the sport, shoulder and elbow overuse may also be prevalent. 

Coaches typically are educated in overuse, but Erickson recommends that parents and their young athlete inventory how the student’s body is feeling from time to time. “At any age, if the body is not feeling right, it is time for the athlete and parent to step back,” he said. “As a physical therapist, we use certain screening tools that help us look at the entire body. We make sure the foot through the head is moving all in conjunction. Deficiencies in certain areas can cause pain as well.”

That’s where Athletes in Motion comes in. Erickson works with student athletes on stretching, jumping, running, and other common moves. He films them. Then he shows them corrections they can make for better body mechanics to ward off injuries.

“A lot of these kids have trouble understanding how their body is moving as they are growing,” he said. “Students who go through Athletes in Motion start critiquing their teammates. They’re noticing it in everyone else besides themselves. They’re more in tune with those correct patterns.”

Worthing, the South Middle School athlete, said she makes time for stretches, warm-ups, and cool-downs after seeing Erickson for knee pain. 

“I made the mistake of ignoring the pain in my knees, and I wish I would have known how bad they can get,” she said. “This is my call-out to any young kids to even college level and older to slow down and stretch it out. It will bring them relief, satisfaction, and the pleasure of knowing that they can prevent a lifetime of pain and struggles.”

Adult Athletes Must Also Listen to Their Bodies

Chippewa Falls native Liz Lemke jokes that she’s not a spring chicken anymore. At the age of 33, she’s much more careful when she plays volleyball and exercises than she used to be. A back injury, likely from working out two to three days a week, was her wake-up call.

“Yes, I’m getting older,” she said. “Things hurt worse as you get older. For me, pushing myself hard but not too hard is important. I have to push myself enough to get my heart beating. A little sweat is good, but there’s a fine line between working hard and overdoing it.”

Michael Erickson, doctor of physical therapy at Centers for Rehabilitation Services, a service line of HSHS Sacred Heart and St. Joseph’s hospitals, said adults are not immune to sports-related injuries.

“Adults will endure more injuries to tendons as their bones are fully mature, unlike the student athletes,” he said. “The weekend warrior likely has mobility issues with flexibility and joint mobility.”

Now, because of past injuries, Lemke makes sure she uses proper technique when lifting weights and doing other physical activity.

“I take a day off from activity if I’m feeling strained,” she said. “And I get up from my desk and walk around once an hour.”