Kathy Jones was once New England's number one 12 and under tennis player. She was pretty, powerful and possessed a huge all-court game. She could run all day and hit winners from virtually any area of the court. Even with immeasurable talent, Kathy's greatest skill was her determination and dedication. She would take lessons before school, practice after, work with a personal trainer three times a week, and travel to tournaments on weekends. She had it all and her potential was unlimited. That was three years ago.

Today, Kathy wears braces on both knees, has endured a shoulder operation and her doctors fear arthritis will eventually set in. Kathy now spends more time with ice on her shoulder and knees than with a racket in her hand, more time with her physical therapist than she does her coach. Tournament aspirations and rankings are a thing of the past. Kathy's goal right now is just to get healthy enough to play for her high school team.

What happened? Quite simply, Kathy's body said "enough." Enough to the running, the weights, the stretching, straining and pounding that it was forced to endure during Kathy's intense training. The injuries were Kathy's body's way of rebelling to it being overused.

A recent article by Nancy Hellmich in USA TODAY stated that " it used to be that overuse injuries- stress fractures, tendinitis, and bursitis- plagued professional athletes, weekend warriors and die-hard exercisers. Now, those injuries are skyrocketing among children and teenagers, as more of them participate in competitive, organized sports year-round."

Kathy Jones is a fictional tennis player but her story hits home for millions of today's young athletes. Hellmich quoted the National Youth Sports Safety Foundation (NYSSF) estimates that state that more than 3 million children a year experience sports or recreation-related injuries.

There are no official statistics as to how many of these injuries are from overuse because they often go unreported, however, orthopedic doctors across the country are noticing an increase in injuries related to the body breaking down from overuse. One doctor in Boston said that approximately 80% of the young athletes that come to his clinic are suffering from overuse injuries to the shoulder, elbow, back and knees, and only 20% come in for acute injuries, a "complete reversal from 20 years ago," said the doctor.

The NYSSF define an acute injury as something along the lines of broken bones, sprains, strains, brain and eye injuries. These are injuries that are caused by a "single blow or twist" as opposed to overuse injuries that are the result of an "accumulation of repetitive traumas."

Traumas such as consistent pounding of the knees on a hard tennis court, shoulder trauma from too much serving or back trauma from too much twisting, turning and lunging. "Children are especially vulnerable to overuse injuries because of the softness of their growing bones and the relative tightness of their ligaments and tendons during growth spurts" says Hellmich.

For the lucky ones, overuse injuries require simply rest, a bit of physical therapy and then the player can return to their normal activities. However, for others the "overuse has damaged or killed part of a bone or growth-plate cartilage, requiring surgery to fix the injury and prevent further pain or damage," says Dr. Lyle Micheli, one of the nation's leading sports medicine doctors for children. In addition, "a person could suffer off and on for a lifetime from an injury that occurs during childhood, or the overuse injury could put the youth at risk for osteoarthritis when he or she is older."

Why the increase in overuse injuries? Several reasons according to the experts. "Improper footwear, changes in playing or running surfaces, lack of fitness, obesity, anatomical misalignments, such as abnormal position of the kneecap, bow legs, knock knees, flat feet and different length legs" all can contribute to injuries however, one of the most common reasons is "a sudden increase in the intensity, duration or frequency of training."

Gone are the days of the neighborhood pick-up games or hanging around the tennis courts to grab a game. Youth sports have become extremely regimented and the training much more intense. In addition, children today feel a tremendous pressure to keep up, so that when they do get tired or feel a slight pain, they may be afraid to quit because they don't want to disappoint their parents or coaches, or look weak in front of their friends.

For many young players, their self-image is so thoroughly wrapped up in their performance on the tennis court (see last month's column), that they will push themselves way beyond what is safe and subject themselves to a tremendous amount of physical (and psychological) stress in order to live up to their, and others, expectations.

Plus, there is also the parent factor, which I have spoken often about in the past. We've all seen the stereotypical tennis parent who pushes their child, not for the child's sake, but rather for their own personal reasons. Add this to the feeling among many parents today that a child must excel at a sport at an early age, and you've got a recipe for disaster.

What's the answer? It begins with the parents and the coaches. The parents must be able to push aside their (and their children's) drive to excel, in order to see when the child is pushing, or being pushed, too hard. Plus, it is up to the parents to put their children in the hands of qualified coaches who are educated in training-related injuries and can spot the warning signs of overuse.

The Medical College of Physicians (MCP) in Wisconsin says that "A child who has a pain that persists or affects athletic performance or the ability to move or put pressure on a limb should be examined by a doctor. A child should never be allowed or expected to work through the pain."

"Children who participate in athletic activity often experience some discomfort as their bones and muscles grow and they practice new movements," continues the MCP. "Some aches and pains can be expected, but a child's complaints always deserve careful attention. Some injuries, if left untreated, can cause permanent damage and interfere with proper physical growth.

Forget "NO PAIN--- NO GAIN." If you're a junior player and something hurts, tell your coach or your parent. If you are a coach or a parent----PAY ATTENTION!!