Bismarck, North Dakota - News

Injury hasn't - and probably will never - stop Heather Fisher from playing softball.

Last season, the 17-year-old centerfielder's right shoulder started hurting.

"It sucked," she said. "It was so painful. There were days I couldn't lift my arm high enough to throw anything."

Her doctor told her to take the year off. Fisher refused. Two cortisone shots and a number of physical therapy sessions later, the pain only got worse. Another doctor told her that overusing her arm had torn her rotator cuff and labrum.

For many teen athletes, like Fisher, summer is no vacation. It's the time they step up their training with traveling teams, overnight sports camps and practice twice a day.

No wonder, doctors say, they are seeing a substantial growth in overuse injuries, raising questions about how hard parents, coaches and young athletes themselves are pushing bodies that aren't ready for such stress. Muscle, bones, tendons and ligaments in teens are being stressed beyond their physical limits.

"It's an epidemic to me," said Dr. Sally Harris of Palo Alto Medical Foundation's sports medicine department. "The training for kids is more and more intense."

This past summer, she saw nearly twice as many overuse injuries in teenagers than the previous summer - or even the recent school year, she said.

Overuse injuries account for nearly half of all sports injuries in teens, according to Safe Kids Worldwide, an organization dedicated to preventing accidental childhood injury.

These young athletes are not sleeping till noon, watching daytime television and gorging on junk food.

"The concept is seen as utter weakness," said Dr. Scott Hoffinger, an orthopedic surgeon at Children's Hospital and Research Center in Oakland, Calif. "It's like the Marines. But you're not storming beaches of Normandy. You don't need to be bloody and dragging along."

A decade ago, overuse injuries were an adults-only problem, Harris said. Now damage and inflammation caused by repetitious motion - such as a swimming stroke - are now common among younger athletes.

Girls going through puberty are especially at risk, as their legs and hips begin to change, Harris said.

And some injuries are unique to teens.

Harris said she treats stress fractures of the spine - an uncommon injury she had previously seen only once a month - at least twice a week this summer. High-impact sports twist and hyperextend the spine.

Damage can usually heal in a month or two. But untreated, like other high-impact injuries, Harris said, such stress fractures can lead to a slipped disc or damaged nerves.

Who's to blame? Parents, coaches and athletes all play a part.

Hoffinger recalled a mother who broke down crying when she was told her baseball-playing son wouldn't be able to pitch for a year.

"Sports are everything to us - that's the pronoun she used," Hoffinger said.

Some coaches believe young athletes can play in pain like professional athletes do, doctors said. But while it's OK for adults to push through discomfort, like tennis elbow, it's detrimental to growing teens.

"It's hard to tell people to cut back," Harris said. "It's not what they want to hear. They want the problem fixed quickly without affecting participation."

Harris said she has a hard time convincing families to skip summer sports camps before a minor injury turns into something more permanent.

"It seems like common sense, but athletes and parents lose perspective when they're wrapped up in it and put money out for it," Harris said. "It's hard to sit back and say it doesn't matter if my kid can't do a camp for one week."