Chris G. Koutures, MD, FAAP Pediatric and sports medicine specialist

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Comprehensive blend of general pediatric and sport medicine care with an individualized approach that enhances the health and knowledge of patients and their families



Proud physician:
USA Volleyball Mens/Womens National Teams
CS Fullerton Intercollegiate Athletics
Chapman University Dance Department
Orange Lutheran High School

Co-Author of Acclaimed Textbook

Pediatric Sports Medicine: Essentials for Office Evaluation

Orange County Physician Of Excellence, 2015 and 2016


Recommendations for Children and Distance Running

The risks of injury and illness in distance running may be related to the total mileage and number of hours training per week. There is no agreement amongst sports medicine professionals about distance limitations for children. Until further data are available concerning the relative risk of endurance running at different ages, the American Academy of Pediatrics recommends that if children who enjoy distance running and make the individual choice to train free of injury or ailments, there is no reason to preclude them from training for and participating in such events.

Let me re-emphasize that bold point.

Children should be the ones selecting to run, free of any pressure from peers, parents, coaches or other influences.

Most running injuries include overload injuries to muscles and bones of the legs and feet, and there is the real emotional "burnout" injury from excessive exposure to running.

Concerns have been raised over possible damage to bone growth plates from high amounts of running, but examples of this type of injury have not been consistently found in medical studies.

Looking at running injury patterns and statistics, it is fair to say that when the young athlete is generating the interest and eagerly participating in a sensible training progression, there is a fairly low risk of physical or emotional injury.

To help develop an appropriate program, many recommend using the 10 percent rule is an appropriate guide and considering certain variables:

  • Weekly running distance
  • Intensity (range includes long slow runs to hill training to speed work)
  • Number of training days per week

An athlete should only increase one of those three variables, and no more than a 10 percent increase from the previous week.

Not having number of training hours per week exceed the number of years in the child's age has also been shown to reduce the risk of overload injury.

A comprehensive program should also ensure adequate sleep and nutritional support that can assist with recovery from training.

Studies have shown that sleeping less than 8 hours per night may lead to an increased risk of injury or illness.

Consuming protein right after exercise (one gram of protein for roughly every 2 pound of body weight) can assist with muscle repair and recovery. Chocolate milk is a particularly good choice along with Greek yogurt or peanut butter.

Finally, putting more focus on developing the running experience and less on competitive outcomes (medals won, finish times) very likely will reduce the risk of injury and foster a more productive healthy outlook on running for the young athlete.