A parent’s guide from Bayshore Podiatry Center in South Tampa.
Quick take
- Overuse injuries are usually a load problem: the body is getting more stress than it can currently tolerate.
- The earliest sign is often pain that starts during activity and improves with rest.
- The mistake is “running through it” until pain becomes constant.
- If a stress fracture is suspected, early evaluation prevents bigger problems.
Table of contents
- Why overuse injuries happen in kids
- Early warning signs parents should not ignore
- Common sites and patterns in the foot and ankle
- What you can do at home (first 7–10 days)
- When to be evaluated
- How we evaluate and image suspected stress injuries
- Treatment options and return-to-sport
- Prevention
- FAQs
- Sources
Why overuse injuries happen in kids
Kids grow fast. Their bones, tendons, and growth areas adapt to training, but they need time.
Overuse injuries often show up after:
- A new sports season starts
- Practice intensity increases
- A child joins multiple teams at once
- Shoes change (or old shoes break down)
- A growth spurt changes mechanics and flexibility
The pattern is predictable: more load, less recovery, and the tissues fall behind.
Early warning signs parents should not ignore
- Pain that starts with activity and fades with rest
- Pain that returns at the same point during activity
- A focal “one spot” that is very tender
- Limping, even if your child tries to hide it
- Pain that persists the next morning
Pain that becomes constant, occurs at rest, or appears at night needs evaluation sooner.
Common foot and ankle overuse patterns
Depending on age and sport, we may see:
- Heel pain related to growth areas (common in running/jumping sports)
- Forefoot pain at the metatarsals (stress reactions)
- Midfoot pain that can be more serious if ignored
- Achilles or peroneal tendon irritation
- Bone stress injuries that may not show on early X-rays
You do not need to identify which one it is at home. You need to recognize the pattern and stop the “push through” cycle.
If you have concerns, you can book an appointment here!
What you can do at home (first 7–10 days)
1) Reduce impact immediately
Replace running and jumping with lower-impact movement (bike, swim, pool running) if your child is comfortable.
2) Support
Supportive shoes; avoid barefoot during the flare.
3) Pain is a guide
If the activity causes limping, it’s too much for that day.
4) Don’t self-prescribe a long shutdown
A short reduction in impact is reasonable, but if the pain is focal and persistent, evaluation is better than guessing.
When to be evaluated
Book an evaluation if:
- Pain persists despite a short period of reduced impact
- Your child is limping
- Pain is focal and sharp on one spot of bone
- Pain is worsening or returning immediately when sports resume
- There is swelling, bruising, or rest/night pain
You can book now here!
How we evaluate and image suspected stress injuries
History
We look at training load, recent changes, sport-specific demands, and the exact pain pattern.
Exam
We localize tenderness, assess mechanics, flexibility, and functional tolerance.
Imaging
X-rays can be helpful but can miss early stress injuries. If suspicion is high, advanced imaging may be appropriate to confirm diagnosis and guide return-to-sport.
Treatment options and return-to-sport
1) Relative rest and load management
The foundation is reducing impact enough for healing while maintaining fitness safely. This usually involves some type of active loading under the guidance of a professional. We often recommend specific exercises based on the condition and employ the guidance of skilled physical therapists we regularly work with.
2) Protection (selected cases)
A boot or brace may be needed when walking is painful or when the injury site requires protection.
3) Rehab and return-to-sport progression
The goal is to return gradually with:
- restored strength
- improved flexibility
- better movement control
- smarter load progression
Rushing back is the main reason these injuries recur.
Prevention
- Avoid sudden spikes in training volume.
- Build in recovery days.
- Address sleep, nutrition, and overall stress (kids are not immune to burnout).
- Use shoes that fit well and are appropriate for the sport.
- Treat pain early rather than waiting for a “breaking point.”
FAQs
Is pain during sports normal for kids?
Soreness can be normal. Persistent focal pain and limping are not. I like to say pain that is stopping them from playing is not normal. This can be difficult though as every kid is different. I know with my 3 children each one experiences pain and stops in different ways. Pain should not persist into the next day and that seems to be a key factor for my own determination with my kids.
Do stress fractures always show on X-ray?
Not always early. That’s why evaluation matters when the pattern fits.
When can my child return to sport?
When they can walk, jog, and perform sport-specific drills without pain or limping, and a clinician is comfortable with healing progress.
When to book an evaluation
If you suspect an overuse injury, getting the diagnosis early usually shortens the total downtime.Book an appointment now here!
Bayshore Podiatry Center serves families all over the bay area conveniently located in South Tampa near Hyde Park.
Medical disclaimer
This information is for educational purposes only. Seek urgent care for severe pain after injury, inability to bear weight, fever, significant swelling, or rest/night pain.
Sources
- Shelat NH, et al. Pediatric stress fractures: a pictorial essay.
- Pediatric sports medicine overuse injury references and clinical reviews
