Back in 350 BC, Aristotle commented that Olympic victors were those who did not squander their powers by early overtraining. Few have heeded these words; overuse injuries remain front and center in our sports populations.
In the 1980s when we were investigating wrist pain in competitive gymnasts, we noticed something strange: In many of these adolescent athletes, the distal radius was short in proportion to the ulna, creating an impingement of the triangular fibrocartilage.
These patients were training more than 24 hours per week. We soon realized that overuse can suppress the physis, and not only in the wrist. It's one reason that many of the best female gymnasts stand only about 4'10".
The Manifestation of Overuse Injuries
The experience taught me that overuse injuries can manifest themselves in unexpected ways, so sports physicians must constantly be on the lookout.
Improvement as an athlete requires applying the optimum training load to bring about adaptation without causing harm.
That formula changes with the athlete's age and varies from sport to sport. While gymnasts' growth is stunted, 14- to 16-year-olds may end up with longer arms. In these athletes, the adaptations may make them better at their sports.
But in others, overuse can cause injuries that stop them in their tracks.
