The Uncomfortable Truth about Pediatric Overuse Injuries


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      It is widely understood incorporating athletics in a child’s youth development is fruitful for physical, mental, and social development, but there is a possibility these beneficial traits can be undermined by the increased prevalence of overuse injuries. Today’s youth are subject to a modern idea of youth sports that has been “professionalized” in order to benefit the adults making money from pediatric athletics. The shocking truth is that parents are a part of this exploitation. Good news though, you do not have to be a part of this system that could hurt your child. This article will outline how your child may develop an overuse injury, how caregivers have become a part of the problem, what you can do to keep your child safe, and a special note to parents who have a daughter who plays sports.

Reasons for Overuse Injuries

            The specialization and professionalization of youth sports have been the main drivers to the rise in frequency of overuse injuries because children are not taking the time to sample different sports in childhood. Freelance writer Michele Wojciechowski quotes Dr. Casey Unverzagt, professor and director of admissions for the DPT program at Baylor University, in her article Not ‘Small Adults’ saying ‘“Encourage youth to sample sports and leave time for free play.”’ Not only does this encourage mental health, but it also reassures that your child does not have to rely on sports to have fun. Wojciechowski, in her article, offers a solution to decrease the possibility of overuse injury: “Integrative Neuromuscular Training” (INT). Simply put, INT is weight training specific to an athlete’s sport. However, this comes at a price since your child must participate in weight room activities since it requires resistance training. This alone comes with risks and hiring a professional trainer to teach your child can be costly. A more practical route would be to expose your child to multiple sports throughout the year. Wojciechowski quotes Teresa Shuemann, physical therapist, who expresses ‘“When athletes use different techniques, they use different parts of the body”’ and allowing for muscles to rest and rebuild is pertinent to living a healthy life as a child going through bodily changes. But as a matter of fact, children are not able to take time to heal because of the extrinsic pressure to specialize in one sport and play all year. On CBS’ hit news broadcast, 60 minutes reporter Sharyn Alfonsi interviewed Orthopedic surgeon Dr. Nirav Pandya saying “I’ve seen kids specialize as young as 7 or 8.” This unfortunate truth neglects Shuemann’s idea and reinforces that children need to sample sports in order to avoid overuse injury. No child as young as 7 or 8 should be seeing an orthopedic surgeon for an overuse injury.

Some Parents are a Part of the Problem

             One of the many tasks parents are given is to ensure the safety of their child, but in modern times, some caregivers are willing to jeopardize their child’s physical well-being. Sharyn Alfonsi, explains how “youth athlete ACL injuries are the new norm”, yet this phenomenon is not random, but the effect of parent pressure for their young athlete to succeed. Dr. Nirav Pandya spoke on his experience with parents of youth patients saying “the first thing they [the parents] are asking is when can they get back on the field… it tells me where parent’s priorities are.” These internal priorities may be exploitative of their child since they believe their “kid is on that path to become a professional athlete” Dr. Pandya says. In the same report by Alfonsi, Professor Jay Coakley, award-winning Sociologist, reminds parents of their unreasonable wager saying “if there was a horse that had 100/1 odds on it, you would never bet on it.” Sadly, for these parents, according to the NCAA “about 2 percent of high school athletes are awarded some form of athletics scholarship to compete in college.” Out of this very small percentage comes an elite group of professional athletes therefore making the odds slim to none that your child will be among these numbers. With this being the case, it is very unlikely a parent’s efforts to produce a professional athlete will be successful.

How to Prevent Pediatric Overuse Injury

             The first step to prevent the possibility of your child forming this injury is to inform yourself on the topic of youth athlete overuse injuries. Frequent contributor to Orthopedics today, Casey Tingle, explains that organizations such as “Sports Trauma and Overuse Prevention (STOP)… was established to investigate… the activities associated with an increase in overuse injuries.” Information to become educated on the topic can be found on the group’s website, After you become educated on the topic, it is time to form a plan to keep your child safe. One effective parameter is to set a limit on how many hours your child can participate in athletics per week. Explaining the benefits of possible regulation to child athletics Tingle quoted Kocher and colleagues stating ‘“specialization was associated with an increased risk of injury in multiple sports, but when you controlled for the number of hours participating in vigorous sports activity a lot of those effects went away.”’ To those parents pushing their child to the limit for athletic success at an early age, let it be known, Tingle quotes Dr. Shital Parikh, Orthopedic surgeon at Cincinnati Children’s hospital saying ‘“athletes who start to specialize at an earlier age are more likely to quit sports altogether than those who start at later ages of about 15 to 16 years old.”’

Special Note to Parents of Female Athletes

             Unfortunately, there is an expectation in today’s society for women to appear lean and athletic especially if you play sports. This affects females at the mental level, but most importantly at the physical level; especially growing women under 18. Tingle, discusses the “female athlete triad” explaining that it refers to the “imbalance between nutrition and exercise.” The consequences for not identifying this is detrimental to your child’s well-being as it results in “an increased risk of stress fractures and osteoporosis” Tingle adds. Young women need support more than ever in the world of sports and as a caregiver it is your responsibility to identify if your child is affected by “the triad.” The early identification of decreased bone density and unbalanced dietary habits are key to making sure your daughter does not fall prey to this life altering circumstance. A standard practice for increasing bone density is weight training, but as Dr. Brandon Bushnell, a board certified Orthopedic surgeon, notes in Tingle’s article, “female athletes often do not want to have that kind of manly bulk.” Consequently, adolescent women are deprived of gaining bone density and muscle mass that would protect their bodies from overuse injuries. In fact, Dr. Bushnell continues expressing “strength training is just as important if you are a female, maybe even more important.” Women are biologically different from men and require greater preparation for sport’s strenuous requirements therefore, the weight room is a necessity if females plan to have a long career in sports.

Gabriel Pate is attending East Carolina University majoring in exercise physiology with a concentration in exercise as medicine


National Collegiate Athletic Association. (March, 2018). NCAA Recruiting Facts. [PDF file]. Retrieved from

Tingle, C. (June, 2018). Weekly Hours Spent in Sports Activity Should not Exceed Young Athlete’s Age. Orthopedicstoday. 38(6), pp.10-12.

UCSF Benioff Children’s Hospital Oakland. (November, 2014). Youth Sports Injury Report – 60 Minutes Sports. [Video file]. Retrieved from, R. (Nov, 2018). Not ‘Small Adults’. PT in Motion. 10(10), pp.29-34

Beginner’s Guide to Weight Training (The Right Way)

Every success story must start with a humble beginning. No matter where you begin your strength and muscle building journey, you can accomplish wonderful things through time and effort. The greatest achievement on your journey to the top is starting. Many wish for a certain outcome, but only few will make it their reality. Typically beginners do not know how or where to start and the process can seem complicated and expensive. This article will help simplify the process of getting started and be free of charge by giving you basic knowledge on how to build muscle and gain strength in an easy to understand format.

First of all, there are three separate categories an exercise can fall under: Push, Pull, and Legs. Each day you workout, you should solely focus on one of the three categories previously listed.

  1. A Push workout recruits the use of your pectorals (chest), deltoids (Shoulders), and triceps (above the elbow).
  2. A Pull workout utilizes your upper and middle trapezius muscles (between and above the shoulder blades), latissimus Dorsi (below the shoulder blades), biceps (No explanation needed), and erector spinae (lower back).
  3. A leg workout is self explanatory on what it works out.

There are rules to structuring what workouts you perform in relation to the rest of your week within the gym.  

  1. Do not perform a workout two or more days in a row. For example, if you do a push workout, you are not able to do the same workout the next day. If you do, you are not allowing your body to recover. Remember, muscle is not built in the weight room, but through rest outside the gym once the work has been put in. Your body is not stupid, so after a hard workout it will build back up in order to be better suited for what it is asked to do.  
  2. Perform a Pull, Push, and Leg workout at least twice every week. This will give your body enough rest to recover, and enable you to work in enough volume to actually fulfill the requirements to make progress.
  3. DO NOT SKIP LEG DAY!!! Yes, leg day, due to its heavy load, can be daunting, but I guarantee once you put in enough work to strengthen your legs, it will become your favorite workout.

There is an important structure you must follow in order to correctly allocate your energy for each workout. To make it as simple as possible, you can split each movement into one of four categories.

  1. Compound Bilateral(CB)– ie: Barbell Bench Press. CB movements require both sides of the body to move the same weight. These movements need the greatest amount of energy because the body can lift the most when both sides of the body are acting on one mass.  
  2. Compound Unilateral(CU)– ie: Dumbbell Bench Press. CU movements are similar to CB movements, but the weight on one side of the body is independent from the weight on the other side. Because each side has its own task, you are not able to move as much weight as you would in a CB movement, but the pay off for these exercises are tremendous. First, you can test if you have any strength imbalances. For example, you are benching 30 pounds in each arm. The right side is pushed up faster than the left. You now know your right is stronger than the left and now this problem can be addressed. Second, if you do have an imbalance, the way to stop that imbalance is by doing more CU movements.  
  3. Isolation Bilateral(IB)– ie: Barbell Bicep Curl. IB movements are closely related to CB movements since both sides of the body are used to move one mass. The biggest difference is instead of incorporating multiple muscles in an exercise, it uses one muscle, sometimes two, to move weight. Because less muscles are recruited to work in an isolation movement compared to a compound movement, the weight moved each rep will be substantially lower. Since there is more responsibility on the one muscle used, it is worked greater than if it were aided in the movement. But DO NOT make the mistake and cut out compound movements from your workout because with heavier loads comes a greater hormone response, therefore increasing the amount of testosterone your body produces. Testosterone is extremely important for muscle growth.    
  4. Isolation Unilateral(IU)– ie: Dumbbell Bicep Curl. These exercises move the least amount of weight, but help break down muscle fibers when they are already fatigued. This is why they should be performed at the end of your workout in order to get the most out of each session.


This is a general lay out of what your week should look like inside the gym

Day 1-push workout

  • Compound Bilateral
    • 1 to 2 movements
    • 5 to 10 sets
    • 1 to 7 reps each set
  • Compound Unilateral
    • 2 to 3 movements
    • 5 to 7 sets
    • 5 to 15 reps each set
  • Isolation Bilateral
    • 3 to 5 movements
    • 3 to 4 sets
    • 10- 20 reps each set
  • Isolation Unilateral
    • 2 to 3 movements
    • 3 to 4 sets
    • 10 to as many reps as possible each set

For ideas of exercises to perform, you can find a great number of them online. Just use what you have learned to distinguish what category they fall into so you can get the most out of your workout! Remember, stay dedicated to your goals and do not stray from your path to greatness. Earn it!  #becomepremier


Written by: Premier Performance Training Coach Gabe Pate

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Benefits of the Hook Grip

No matter what type of lift you are performing, how you grip your weight is very important.  Especially when it comes to Olympic lifting, having dominant control over the bar is crucial for success. Due to the nature of Olympic lifting, the bar and its weight must be moved with specific form with speed and precision. Therefore, it is critical that you keep the bar secured firmly in your hands as you perform the different movements. One of the most popular and effective techniques for maintaining solid control of the bar is the Hook Grip.  Whether you performing a back squat or a power clean, the hook grip is a useful method for maintaining control of the bar no matter the lift. The hook grip is where you push the palm of your hand tight against the bar, grab the bar by wrapping your thumb around it, and then grasp your thumb and the bar tightly with your fingers.  Most people can grab the thumb with the first two fingers while their other two fingers directly grab the bar.  This technique really helps you lift more weight off the platform, especially when you accelerate for the second pull.  The hook grip is the best grip you can have without using straps due to its firm hold of the bar. United States Olympic Weightlifting Coach Jim Schmitz says that “It takes about two weeks for one to grow accustomed to and comfortable with the hook grip.  Everyone I teach tells me it feels unnatural and weird and I have to remind them to hook on all lifts—snatch, clean, and pulls”. With practice and commitment, the hook grip can become one of the most useful tools to help with your Olympic lifting.

How to Front Squat

Like the Back Squat, the Front Squat is also one of the best exercises for building powerful leg strength and explosive speed. Because of the different bar placement, front squats and back squats work different different leg muscles. Front Squats focus on the quads and upper back, while Back Squats focus more on the hips, glutes and lower back. Both lifts utilize all the muscles together, but the emphasis shifts from one lift to the other. A video of proper front squat form can be found here. Rather than placing the bar on your back, you place the bar on the top of your chest, right below your neck. The same principles apply as with back squats, but when front squatting take extra care into staying upright and keeping your elbows up for good posture and form. Performing this exercise with proper form will help prevent injury and help you work all the involved muscles efficiently.

How to Squat

The traditional back squat is one of the most popular exercises when it comes to building leg strength, speed, and power. It may seem like a pretty straightforward exercise, but as with every lifting movement, proper form is the key to success. A video tutorial of the proper back squat technique can be found here. When you are squatting, make sure to keep your back straight by maintaining an upward facing posture. When setting up your stance, make sure your feet are about a shoulder’s width apart. While performing the movement, don’t let your knees buckle inward and drive the bar up with your legs, hips, and glutes. If you are handling heavy weight, the use of a lifting belt and knee sleeves will help prevent injury and keep you safe as you increase the weight.

Gym Bag 101

Step 1: Grab a nice and sturdy duffel bag or backpack that can fit all of the following items.

Step 2: A water bottle. Your body will lose a lot of water from sweating so it is important to stay hydrated before, during, and after a workout.

Step 3: Pack a snack. A granola or protein bar will help stave off your hunger before you get your main source of protein.

Step 4: Bring an extra towel to help wipe off sweat or dry after a shower if your gym doesn’t have any.

Step 5: Have a plastic bag to put your sweaty gym clothes in if your are changing after your workout.

Step 6: If you need to go somewhere after the gym, make sure to pack your shower necessities and the clean clothes with the appropriate shoes that you’ll wear after.

Should You Take Supplements?

According to the U.S. Department of Health and Human Services, more than half of all Americans take one or more dietary supplements daily or on occasion. You can find a variety of different supplements at your local grocery store or pharmacy, and can be bought without a prescription. Many supplements are in the form of a small pill and are used to give the body additional nutrients that it may not have gotten in a normal day of eating. It is important for your body to receive the proper amount of nutrients it needs for good health, but not everyone needs to take supplements. According to Carol Haggans, a registered dietitian and consultant to National Institutes of Health, “It’s possible to get all of the nutrients you need by eating a variety of healthy foods, so you don’t have to take one.  But supplements can be useful for filling in gaps in your diet”. Dietary supplements are regulated by the U.S. Food and Drug Administration as foods, not as drugs. The label may claim certain health benefits. But unlike medicines, supplements can’t claim to cure, treat or prevent a disease. The answer to the question of should you take supplements is maybe. Whether or not you should take supplements depends on how good your diet is. You can always take supplements if you have doubt about how much nutrients you are consuming in a day, but supplements should not be taken with the expectation that they will cure diseases. If you feel like your diet is lacking a certain vitamin or mineral, or a doctor says that your intake of some nutrients is low, then supplements will help your diet and your overall health.

Be Active Everyday?


The USDA recommends that Adults (18-64 years)  should do at least 2 hours and 30 minutes each week of aerobic physical activity at a moderate level OR 1 hour and 15 minutes each week of aerobic physical activity at a vigorous level. Being active 5 or more hours each week can provide even more health benefits. Spreading aerobic activity out over at least 3 days a week is best. Also, each activity should be done for at least 10 minutes at a time. Adults should also do strengthening activities, like push-ups, sit-ups and lifting weights, at least 2 days a week. This may seem easier said than done. However, here are some tips to help you stay active during your busy work or school week:

  1. Plan your activities ahead of time
  2. Take breaks during your work day
  3. Use a Fitbit or other activity tracker
  4. Have a variety of different activities
  5. Exercise with a partner
  6. Have fun by choosing exercises you enjoy

These six tips will help you reach your exercise goals and help you remain active during the week, and prevent you from falling into a mundane sedentary lifestyle.



Benefits of Knee Sleeves

Knee sleeves are a common accessory to lifters of all disciplines. Not to be confused with knee braces, knee sleeves help provide protection and support for your knees during strenuous activity, such as weightlifting. A good pair of knee sleeves will provide compression, which will help increase the blood flow in the knees which will result in the reduction of swelling and pain. Knee sleeves do not need to be worn for all weightlifting exercises. If the knee is not involved as a primary lifting source, they are not necessary. They do however provide the support necessary for performing squats, the snatch, or the clean and jerk. Any time the knee is left weak or vulnerable, it is at great risk for damage, and usually long-term damage. Wearing knee sleeves during exercises involving the knee, especially during squats and Olympic lifts, will help prevent injury and keep you healthy so that may continue to lift.

Are Lifting Straps Bad?

Lifting straps are one of the many tools used by weightlifters to help them in the gym. Some people in the fitness community see the use of lifting straps as controversial. As with everything, there are pros and cons. Lifting straps help keep the weight firm in your hands, and because the forearm and wrist are relieved, it usually leads to better execution of the exercise. They can be helpful for those looking to target their back muscles, as the relieved pressure on the arms allows you to focus more on the pulling motion. Lifting straps also help prevent the weight from moving around and falling from your hands when you don’t want it to. Even when your hands are sore and the skin is torn up, lifting straps can help you crank out a few extra reps. Some argue that the use of  lifting straps prevents you from improving your grip strength. This is true, so it is important to not use lifting straps for every lift and whenever they are not necessary.

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