Puberty also brings a growth spurt, which, for girls, usually ends at about age 14. A study that began in 1979 and spanned more than a dozen years showed that, of 18 high school sports including football, girls cross-country had the highest injury rate. Injuries may also occur because their muscles, bones, ligaments, and tendons are not ready for the demands of the sport. Injuries fall into two categories, acute and overuse. Overuse injuries, such as stress fractures, come from repetitive stress on the muscles and bones.
Overuse injuries can be tricky to detect.
Pain can be intermittent, and doesn't always occur during play or practice. It can show up later, hours after a workout, when a child is doing other things. I took her to Peter F. Sturm, M.D., a pediatric orthopedic surgeon in the Washington, D.C., area. Interestingly, she wasn't overdoing anything. She simply was predisposed to this particular ailment and became symptomatic because she was physically active.