We had a pediatric orthopedic surgeon on our show recently and we discussed overuse injuries in adolescent athletes. I see more and more kids coming in with complaints of back pain, knee pain, ankle and elbow pain often secondary to repetitive motion from sports. They usually don't have a lot of swelling, and they complain of pain with their activity, but otherwise are fine. When taking a history, their biggest complaints occur during the sport or immediately after, and they usually feel better after resting overnight. The pain recurs once they resume their workout the next day. The cycle is continuous.

The best treatment for overuse injuries is to follow the pneumonic RICE: Rest, Ice, Compression and Elevation. For further relief of pain, add an anti-inflammatory medication such as Aleve, Motrin or Advil. If athletes can play through the pain, it doesn't awaken them throughout the night and they're fine attending school and other activities, they're probably fine to continue in the sport. If the pain becomes persistent during the day, disrupts their sleep, etc., they will need further evaluation.

For persistent stress-related injuries, rest may be the next step. Many times, it's just necessary to let the body have some "time off" and may also involve stretching exercises to strengthen core muscles, or yoga and Pilates to improve flexibility and strength. This usually involves a 4- to 6-week period away from a sport.

One caveat discussed on the show was the importance of watching for depressive symptoms in an athlete who has had to take time off from an activity. Parents need to recognize not only the physical pain their child is experiencing, but also the child's emotional pain related to stopping his/her sport.

Many of these kids have such a passion for their sport and also gain a great deal of self-worth from their participation. To take that away from them is emotionally devastating, and their young minds are not cognitively developed enough to deal with the loss of their athletic endeavors, even for a short time. Watch closely and be supportive and acknowledge their feelings. It's just as important to seek help for their mental health if that seems necessary.

Dr. Sue Hubbard is a nationally known pediatrician and co-host of "The Kid's Doctor" radio show.

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