Pressure to perform in competitive, year-round sports is fueling a nationwide surge in 'overuse' foot and ankle injuries in young athletes, warned a panel of sports medicine experts recently at the American College of Foot and Ankle Surgeons (ACFAS) Annual Scientific Conference in Las Vegas.

"Trying to perform at peak levels day after day on a travel or high school team can exert excessive strain on growing bones, muscles and tendons. This can have a negative impact on overall performance and enjoyment of the sport if injuries in young athletes are not treated properly," says panelist Robert Duggan, DPM, FACFAS, a foot and ankle surgeon and sports medicine specialist in Orlando.

Duggan said heel pain is one of the most common athletic injuries in children and adolescents. "In soccer and other competitive sports that involve a lot of running, there is high risk for growth plate injuries and heel pain."

According to the ACFAS consumer Web site, www.FootPhysicians.com, the growth plate is a weak area at the back of the heel where new bone forms until the age of 14 or older. "The area becomes inflamed from too much stress, and the heel gets very sore as a result," says Duggan.

He said parents and coaches should be cautious when deciding if a young athlete should play with heel pain. "Growth plate trauma is the leading cause of pediatric heel pain, and reducing the level of physical activity, even for a few days, can ease the pain."

In most cases, heel pain in children and adolescents is treated with rest, shoe inserts to soften the impact on the heel, anti-inflammatory medications, stretching exercises, physical therapy and custom orthotics. Heel pain often returns after treatment and resumption of athletic activity because the growth plate is still developing. However, Duggan noted the rate of recurrence can be reduced by choosing well-constructed shoes with good support and limiting use of spiked athletic shoes, especially on hard playing fields.

Stress fractures are another frequent overuse injury experienced by young athletes. According to Duggan, they are caused by repeated stress on a bone and often occur when the intensity of training suddenly increases. Symptoms include pain during normal activity and when touching the area and swelling without bruising.

To help avoid overuse injuries, Duggan and other panel members advised parents to follow these simple tips:

• Be in condition to play. Start working out early and gradually.
• Pass a sports physical given by the family doctor.
• Buy the right shoes for the sport.
• Never allow a child to wear hand-me-down athletic shoes.
• Buy well-constructed shoes that don't bend in the middle of the sole.
• Wear spiked shoes only on appropriate playing fields.
• Select appropriate sports within a child's ability, overall stamina and fitness level.
• Help overweight children lose a few pounds to lessen pressure on the feet.

Source: American College of Foot and Ankle Surgeons