{"id":432,"date":"2026-08-24T15:00:23","date_gmt":"2026-08-24T12:00:23","guid":{"rendered":"https:\/\/tatd.org.tr\/sportibbi\/?p=432"},"modified":"2026-08-24T17:32:55","modified_gmt":"2026-08-24T14:32:55","slug":"asiri-kullanim-yaralanmasi-overuse-injury","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/sportibbi\/genel\/asiri-kullanim-yaralanmasi-overuse-injury\/","title":{"rendered":"A\u015f\u0131r\u0131 Kullan\u0131m Yaralanmas\u0131 (Overuse Injury)"},"content":{"rendered":"\n

Yazar: Uzm. Dr. Muhammed Ali \u00dc\u00e7e\u015f<\/p>\n\n\n\n

Edit\u00f6r: Dr. \u00d6\u011fr. \u00dcyesi \u00d6mer Yusuf Erdurmu\u015f<\/p>\n\n\n\n

Giri\u015f<\/h2>\n\n\n\n

En basit tan\u0131m\u0131yla overuse yaralanmas\u0131; kas ve iskelet sistemini etkileyen tekrarlayan, k\u00fc\u00e7\u00fck y\u00fcklenmelerin birikerek kronik bir hasara d\u00f6n\u00fc\u015fmesi olarak tan\u0131mlanmaktad\u0131r. V\u00fccudumuz muazzam bir adaptasyon yetene\u011fine sahiptir: spor yapt\u0131k\u00e7a kemikler, kaslar, tendonlar ve ba\u011f dokular\u0131 bu y\u00fcke uyum sa\u011flamak i\u00e7in kendini yenilemektedir. Ancak bu yenilenmenin i\u015fleyebilmesinin tek \u015fart\u0131, dokular\u0131n yeterince dinlenebilmesidir. Gerekli s\u00fcre tan\u0131nmad\u0131\u011f\u0131nda mikro d\u00fczeydeki hasarlar birikir ve kronik bir sakatl\u0131k tablosu ortaya \u00e7\u0131kar. Yani asl\u0131nda \u00f6nemli olan sadece \u201c\u00e7ok \u00e7al\u0131\u015fmak\u201d de\u011fil, \u201cyeterince dinlenmemektir\u201d\u00a0[1]. Overuse yaralanmalar\u0131n\u0131 di\u011fer sakatl\u0131klardan ay\u0131ran en kritik \u00f6zellik ise belirgin ve ani bir travman\u0131n olmamas\u0131d\u0131r: tekrarlayan mekanik stres, dokular\u0131n kapasitesini a\u015fan bir h\u0131zda mikrotravma birikimine yol a\u00e7arak inflamasyon, a\u011fr\u0131 ve sonunda fonksiyon kayb\u0131yla sonu\u00e7lanmaktad\u0131r.<\/p>\n\n\n\n

\u00c7ocuk ve Ergenlerde Overuse Yaralanmalar\u0131: Eri\u015fkinden Farkl\u0131 Neden Bu Kadar \u00d6nemli?<\/h2>\n\n\n\n

\u00c7ocuk ve ergen sporcularda overuse yaralanmalar\u0131, eri\u015fkin hastalarda g\u00f6r\u00fclenlerden hem patofizyolojik mekanizma hem de klinik seyir a\u00e7\u0131s\u0131ndan belirgin bi\u00e7imde ayr\u0131\u015fmaktad\u0131r. H\u0131zl\u0131 b\u00fcy\u00fcme d\u00f6neminde hen\u00fcz tam olgunla\u015fmam\u0131\u015f b\u00fcy\u00fcme k\u0131k\u0131rdaklar\u0131 (fizis) ve apofizler, tekrarlayan \u00e7ekme ve kompresyon streslerine kar\u015f\u0131 \u00e7ok daha savunmas\u0131zd\u0131r. Bu nedenle eri\u015fkinde kas-tendon birle\u015fkesinde g\u00f6r\u00fclen yaralanmalar, pediatrik grupta b\u00fct\u00fcnl\u00fc\u011f\u00fc daha zay\u0131f olan bu yap\u0131larda kendini g\u00f6stermektedir\u00a0[2]. Epidemiyolojik veriler konunun boyutunu a\u00e7\u0131k\u00e7a ortaya koymaktad\u0131r: ABD\u2019de 6-18 ya\u015f aras\u0131ndaki yakla\u015f\u0131k 60 milyon \u00e7ocu\u011fun organize sporlara kat\u0131ld\u0131\u011f\u0131 bilinmektedir. \u00dcstelik overuse yaralanmalar\u0131 bu gruptaki t\u00fcm spor yaralanmalar\u0131n\u0131n %45,9 ile %54\u2019\u00fcn\u00fc yani neredeyse yar\u0131s\u0131n\u0131 olu\u015fturmaktad\u0131r\u00a0[2, 3]. Acil servisler ve spor hekimli\u011fi poliklinikleri ise son y\u0131llarda bu yaralanmalar\u0131n hem s\u0131kl\u0131\u011f\u0131nda hem ciddiyetinde belirgin bir art\u0131\u015fa tan\u0131kl\u0131k etmektedir\u00a0[4]. Bu art\u0131\u015f\u0131n \u00f6z\u00fcnde, \u00e7ocuklar\u0131n anatomik ve fizyolojik kapasitelerinin \u00e7ok \u00f6tesinde \u201ck\u00fc\u00e7\u00fck eri\u015fkin\u201d gibi yeti\u015ftirilmesi yatmaktad\u0131r. Rekabet\u00e7i bask\u0131 ortam\u0131 fizyolojik haz\u0131rl\u0131klar\u0131 tamamlanmadan y\u00fcksek yo\u011funluklu antrenman programlar\u0131na \u00e7ekerek dokular\u0131n iyile\u015fme kapasitesini a\u015fan kronik bir y\u00fcklenme zemini haz\u0131rlamaktad\u0131r\u00a0[1, 4].<\/p>\n\n\n\n

Overuse yaralanmalar\u0131n\u0131n arkas\u0131ndaki en g\u00fc\u00e7l\u00fc zorlay\u0131c\u0131lardan biri erken spesiyalizasyondur. G\u00fcncel veriler, gen\u00e7 sporcular\u0131n %17 ila %41’inin \u00e7o\u011fu zaman antren\u00f6r, aile ve rekabet ortam\u0131n\u0131n bask\u0131s\u0131yla tek bir bran\u015fta y\u0131l boyu yo\u011funla\u015fan bir antrenman modeline y\u00f6nlendirildi\u011fini g\u00f6stermektedir [5]. \u00dcstelik yaralanma insidans\u0131n\u0131n zirve yapt\u0131\u011f\u0131 nokta ortalama 14,1 ya\u015f, yani b\u00fcy\u00fcme ata\u011f\u0131n\u0131n tam ortas\u0131na denk gelmektedir; haftal\u0131k aktivite saati, spesifik antrenman\u0131n serbest oyuna oran\u0131 ve tek bran\u015fa erken y\u00f6nelim bu d\u00f6nemde ba\u011f\u0131ms\u0131z ve istatistiksel olarak anlaml\u0131 risk fakt\u00f6rleri olarak \u00f6ne \u00e7\u0131kmaktad\u0131r [5].<\/p>\n\n\n\n

Klinik \u0130lerleme: D\u00f6rt Evreli Bir Tablo<\/strong><\/h2>\n\n\n\n

A\u015f\u0131r\u0131 kullan\u0131m yaralanmalar\u0131 sinsi bir ba\u015flang\u0131\u00e7la seyreder ve belirgin bir evre s\u0131ras\u0131n\u0131 takip eder. Evre 1\u2019de a\u011fr\u0131 yaln\u0131zca aktivite sonras\u0131nda ortaya \u00e7\u0131kar; sporcunun performans\u0131 etkilenmez. Evre 2\u2019de a\u011fr\u0131 aktivite s\u0131ras\u0131nda da ba\u015flar ancak hen\u00fcz k\u0131s\u0131tlay\u0131c\u0131 de\u011fildir. Evre 3\u2019te a\u011fr\u0131 hem performans\u0131 hem hareket a\u00e7\u0131kl\u0131\u011f\u0131n\u0131 k\u0131s\u0131tlar d\u00fczeye ula\u015f\u0131r. Evre 4’te yani en ileri evrede ise istirahat a\u011fr\u0131s\u0131 g\u00fcnl\u00fck ya\u015fam aktivitelerini de etkileyecek boyuta ula\u015f\u0131r. Rehabilitasyon s\u00fcreci evre ne kadar ilerlemi\u015f olursa o kadar uzad\u0131\u011f\u0131ndan erken d\u00f6nem tan\u0131 kritik \u00f6nem ta\u015f\u0131r\u00a0[1]. Risk fakt\u00f6rleri ise intrinsik ve ekstrinsik olmak \u00fczere ikiye ayr\u0131l\u0131r: antrenman hacminin ani art\u0131r\u0131lmas\u0131, yetersiz dinlenme ve yanl\u0131\u015f teknik kullan\u0131m\u0131 ba\u015fl\u0131ca ekstrinsik nedenlerdir; kas zay\u0131fl\u0131\u011f\u0131, anatomik dengesizlikler ve erken spesiyalizasyon yani sezon d\u0131\u015f\u0131 dinlenme periyodu tan\u0131nmaks\u0131z\u0131n y\u0131l boyunca tek bir bran\u015fa odaklanma ise intrinsik zemini olu\u015fturmaktad\u0131r\u00a0[1, 3].<\/p>\n\n\n

\n
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A\u015f\u0131r\u0131 kullan\u0131m yaralanmalar\u0131 evreleri<\/figcaption><\/figure>\n<\/div>\n\n\n

Bu risk fakt\u00f6rlerinin klinik a\u011f\u0131rl\u0131\u011f\u0131 literat\u00fcrde g\u00fcncel \u00e7al\u0131\u015fmalarda giderek daha net ortaya konmaktad\u0131r. Gen\u00e7 futbolcularda y\u00fcr\u00fct\u00fclen prospektif bir \u00e7al\u0131\u015fmada y\u00fcksek haftal\u0131k y\u00fck, y\u00fck monotonlu\u011fu ve ani y\u00fck de\u011fi\u015fimleri yaralanma i\u00e7in anlaml\u0131 belirleyiciler olarak saptanm\u0131\u015ft\u0131r\u00a0[5]. Benzer \u015fekilde tek bran\u015fa yo\u011funla\u015fan sporcularda patellofemoral a\u011fr\u0131 g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131 1,5 kat, ekstans\u00f6r mekanizma yaralanmalar\u0131 (Sinding-Larsen-Johansson sendromu, patellar tendinopati, Osgood-Schlatter hastal\u0131\u011f\u0131) ise 4 kat daha y\u00fcksek bulunmu\u015ftur\u00a0[5]. Bununla birlikte baz\u0131 \u00e7al\u0131\u015fmalar erken spesiyalizasyon ile yaralanma aras\u0131nda anlaml\u0131 ili\u015fki g\u00f6sterememi\u015ftir; bu tutars\u0131zl\u0131k, riskin tek bir nedene indirgenemeyece\u011fini; denetim d\u00fczeyi, biyolojik olgunla\u015fma ve toparlanma pratikleri gibi \u00e7ok say\u0131da de\u011fi\u015fkenin devreye girdi\u011fini hat\u0131rlatmaktad\u0131r\u00a0[5].<\/p>\n\n\n\n

Anatomik Da\u011f\u0131l\u0131m ve S\u0131k G\u00f6r\u00fclen Klinik Tablolar<\/h2>\n\n\n\n

Overuse yaralanmalar\u0131 b\u00fcy\u00fcme plaklar\u0131n\u0131n ve apofizlerin anatomik lokalizasyonuna, uygulanan biyomekanik strese ve ya\u015f grubuna g\u00f6re spesifik b\u00f6lgelerde yo\u011funla\u015f\u0131r\u00a0[6]. Bu topografik \u00f6r\u00fcnt\u00fcy\u00fc tan\u0131mak, semptomdan tan\u0131ya giden s\u00fcreci belirgin bi\u00e7imde k\u0131saltmaktad\u0131r.<\/p>\n\n\n\n

Diz B\u00f6lgesi: <\/strong>Pediatrik overuse yaralanmalar\u0131nda en s\u0131k etkilenen eklemdir. <\/p>\n\n\n

\n
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Diz a\u015f\u0131r\u0131 kullan\u0131m yaralanmalar\u0131<\/figcaption><\/figure>\n<\/div>\n\n\n

Ayak ve Ayak Bile\u011fi:\u00a0<\/strong>Sever Hastal\u0131\u011f\u0131 (Kalkaneal Apofizit), t\u00fcm pediatrik overuse yaralanmalar\u0131n\u0131n yakla\u015f\u0131k %8\u2019ini olu\u015fturan ve gen\u00e7 sporcularda topuk a\u011fr\u0131s\u0131n\u0131n en s\u0131k nedenidir. A\u015fil tendonunun kalkaneal apofize uygulad\u0131\u011f\u0131 tekrarlayan traksiyon mekanizmas\u0131yla a\u00e7\u0131klanmaktad\u0131r\u00a0[4]. Iselin Hastal\u0131\u011f\u0131 ise peroneus brevis tendonunun 5. metatars taban\u0131na tekrarlayan inversiyon stresleri sonucu uygulad\u0131\u011f\u0131 \u00e7ekme kuvvetiyle olu\u015fan apofizit tablosudur\u00a0[6].<\/p>\n\n\n\n

\u00dcst Ekstremite:\u00a0<\/strong>Little League Elbow (Medial Epikondil Apofiziti), 9-14 ya\u015f aras\u0131nda \u00f6zellikle beyzbolda tekrarlayan valgus stresiyle geli\u015fir; dirsek medialinde a\u011fr\u0131 ve f\u0131rlatma h\u0131z\u0131nda progresif d\u00fc\u015f\u00fc\u015f en belirgin semptomlard\u0131r\u00a0[7]. Little League Shoulder, omuz b\u00fcy\u00fcme pla\u011f\u0131na binen rotasyonel stresle ortaya \u00e7\u0131kar; radyolojik de\u011ferlendirmede fizeal geni\u015fleme tan\u0131y\u0131 destekler\u00a0[6]. Gymnast\u2019s Wrist (Distal Radius Epifiziti), jimnastik\u00e7ilerin %80\u2019ine varan k\u0131sm\u0131nda kar\u015f\u0131la\u015f\u0131labilir ve klinik \u015f\u00fcphe e\u015fi\u011fini y\u00fcksek tutmay\u0131 zorunlu k\u0131lmaktad\u0131r\u00a0[6].<\/p>\n\n\n\n

Omurga ve Alt Bacak:\u00a0<\/strong>Spondilolizis, pars interartikularisin tekrarlayan hiperekstansiyon ve rotasyon y\u00fcklenmesiyle geli\u015fen stres k\u0131r\u0131\u011f\u0131d\u0131r. Jimnastik, dans ve futbol ile ili\u015fkilendirilmekte olup \u00e7ocuk sporcularda mekanik bel a\u011fr\u0131s\u0131n\u0131n \u00f6nde gelen nedenlerinden biridir\u00a0[6]. Medial Tibial Stres Sendromu ise tibian\u0131n posteromedial korteksindeki periostu etkileyen inflamatuvar bir tablodur; a\u011fr\u0131 istirahatte de s\u00fcryorsa ya da odak palpasyon hassasiyeti belirginse stres k\u0131r\u0131\u011f\u0131 d\u0131\u015flanmal\u0131d\u0131r\u00a0[4].<\/p>\n\n\n\n

Acil T\u0131p Hekiminin Rol\u00fc: Tan\u0131dan \u00d6tesi<\/h2>\n\n\n\n

Acil servis, spor yaralanmas\u0131 ge\u00e7iren gen\u00e7 sporcular i\u00e7in \u00e7o\u011funlukla ilk t\u0131bbi temas noktas\u0131d\u0131r. Bu noktada acil t\u0131p hekiminin g\u00f6revi yaln\u0131zca hayat\u0131 tehdit eden durumlar\u0131 d\u0131\u015flamakla s\u0131n\u0131rl\u0131 kalmamal\u0131; altta yatan overuse sendromunun do\u011fru bi\u00e7imde tan\u0131mlanmas\u0131, gereksiz ileri tetkiklerin \u00f6n\u00fcne ge\u00e7ilmesi ve uygun ba\u015flang\u0131\u00e7 y\u00f6netimi ile takip plan\u0131n\u0131n kurgulanmas\u0131 da bu rol\u00fcn ayr\u0131lmaz par\u00e7as\u0131n\u0131 olu\u015fturmal\u0131d\u0131r. G\u00fcnl\u00fck pratikte dikkat edilmesi gereken alt\u0131 kritik nokta \u015f\u00f6yle \u00f6zetlenebilir:<\/p>\n\n\n\n

1. Normal r\u00f6ntgene aldanmay\u0131n. <\/strong>Erken evre stres k\u0131r\u0131klar\u0131nda ve apofizitlerde direkt grafiler s\u0131kl\u0131kla tamamen normaldir. R\u00f6ntgenin bu a\u015famadaki rol\u00fc t\u00fcm\u00f6r, enfeksiyon ve akut k\u0131r\u0131k gibi alternatifleri d\u0131\u015flamakt\u0131r; klinik tablo her zaman yol g\u00f6sterici olmal\u0131d\u0131r [7].<\/p>\n\n\n\n

2. Y\u00fcksek riskli stres k\u0131r\u0131klar\u0131n\u0131 tan\u0131y\u0131n. <\/strong>Her stres k\u0131r\u0131\u011f\u0131 e\u015fit riskli de\u011fildir. Femur boynu tansiyon taraf\u0131, anterior tibia korteksi, tarsal navik\u00fcler, 5. metatars diyafiz-metafiz bile\u015fkesi (Jones k\u0131r\u0131\u011f\u0131) ve sesamoidler; kaynamama ve erken dejeneratif eklem hastal\u0131\u011f\u0131 a\u00e7\u0131s\u0131ndan y\u00fcksek riskli lokalizasyonlard\u0131r. \u015e\u00fcphe varsa hasta y\u00fck verilmeksizin taburcu edilmeli ve acil ortopedi kontrol\u00fc planlanmal\u0131d\u0131r [7].<\/p>\n\n\n\n

3. \u201cB\u00fcy\u00fcme a\u011fr\u0131s\u0131\u201d tuza\u011f\u0131na d\u00fc\u015fmeyin. <\/strong>Antrenmanla artan, kemik \u00e7\u0131k\u0131nt\u0131lara (apofizlere) lokalize olan ve istirahatle hafifleyen her a\u011fr\u0131, aksi kan\u0131tlanana kadar overuse yaralanmas\u0131 ya da apofizit olarak de\u011ferlendirilmelidir. \u201cB\u00fcy\u00fcme a\u011fr\u0131s\u0131\u201d a\u00e7\u0131klamas\u0131 kolayd\u0131r, ancak altta yatan patolojiyi gizleyebilir.<\/p>\n\n\n\n

4. Gece a\u011fr\u0131s\u0131 asla masum de\u011fildir. <\/strong>Overuse yaralanmalar\u0131nda a\u011fr\u0131 aktiviteyle artar, istirahatle azal\u0131r. Bu \u00f6r\u00fcnt\u00fcden sapma uykudan uyand\u0131ran ya da istirahatte de ge\u00e7meyen \u015fiddetli a\u011fr\u0131 enfeksiyon ve malignitenin k\u0131rm\u0131z\u0131 bayra\u011f\u0131d\u0131r. Bu bulgu kar\u015f\u0131s\u0131nda MRG, sintigrafi ve laboratuvar ile ileri tetkik zorunludur; bekleme l\u00fcks\u00fc yoktur [7].<\/p>\n\n\n\n

5. Pediatrik kas-iskelet yap\u0131s\u0131n\u0131n \u00f6zelliklerini mutlaka ak\u0131lda tutulmal\u0131d\u0131r. <\/strong>\u00c7ocuklarda ba\u011flar ve tendonlar b\u00fcy\u00fcme k\u0131k\u0131rdaklar\u0131ndan 2-5 kat daha diren\u00e7lidir. Eri\u015fkinde ba\u011f kopmas\u0131na yol a\u00e7an ayn\u0131 mekanizma, \u00e7ocukta b\u00fcy\u00fcme k\u0131k\u0131rda\u011f\u0131 ayr\u0131lmas\u0131 veya av\u00fclsiyon k\u0131r\u0131\u011f\u0131yla sonu\u00e7lan\u0131r. Palpasyonunuzu ba\u011f yap\u0131lar\u0131ndan \u00f6nce fisis hatlar\u0131 ve apofizler \u00fczerine kurun; hassasiyet lokalizasyonu tan\u0131y\u0131 de\u011fi\u015ftirebilir [4].<\/p>\n\n\n\n

6. \u201cOynayabilirsin\u201d demeden \u00f6nce durun. <\/strong>Akut travmas\u0131 olmaks\u0131z\u0131n fonksiyonu k\u0131s\u0131tlanm\u0131\u015f bir \u00e7ocu\u011fa erken ye\u015fil \u0131\u015f\u0131k yakmak kronik hasar\u0131n kap\u0131s\u0131n\u0131 aralayabilir. Acil serviste konservatif kal\u0131n: aktiviteyi durdurun, kriyoterapi ve analjezi ba\u015flay\u0131n, ilgili uzmana y\u00f6nlendirin. Do\u011fru tan\u0131 konulmadan spora erken d\u00f6n\u00fc\u015f; b\u00fcy\u00fcme kusurlar\u0131na, kal\u0131c\u0131 eklem patolojilerine ve uzun vadede sportif performans\u0131n geri d\u00f6n\u00fc\u015fs\u00fcz kayb\u0131na zemin haz\u0131rlayabilir [7].<\/p>\n\n\n\n

G\u00f6r\u00fcnt\u00fclemede USG’nin Yeri<\/h2>\n\n\n\n

Pediatrik overuse yaralanmalar\u0131n\u0131n de\u011ferlendirilmesinde ultrasonografi (USG), giderek daha fazla \u00f6ne \u00e7\u0131kan bir “sorun \u00e7\u00f6z\u00fcc\u00fc” g\u00f6r\u00fcnt\u00fcleme arac\u0131 olmaktad\u0131r. \u00c7ocuk kas-iskelet sisteminde hen\u00fcz kemikle\u015fmemi\u015f k\u0131k\u0131rdak yap\u0131lar\u0131n ve y\u00fczeyel yumu\u015fak dokular\u0131n oran\u0131 y\u00fcksektir; y\u00fcksek frekansl\u0131 problar tendonlar\u0131, apofizleri, bursalar\u0131 ve b\u00fcy\u00fcme k\u0131k\u0131rda\u011f\u0131n\u0131 \u00fcst\u00fcn bir yumu\u015fak doku \u00e7\u00f6z\u00fcn\u00fcrl\u00fc\u011f\u00fcyle g\u00f6r\u00fcnt\u00fcleyebilir\u00a0[8]. USG’nin \u00e7ocuk hasta i\u00e7in en belirleyici \u00fcst\u00fcnl\u00fc\u011f\u00fc radyasyon i\u00e7ermemesi ve sedasyon gerektirmemesidir; bu sayede tekrarlayan takip g\u00f6r\u00fcnt\u00fclemelerine olanak tan\u0131maktad\u0131r. Ger\u00e7ek zamanl\u0131 ve dinamik de\u011ferlendirmeye izin vermesi (hareket s\u0131ras\u0131nda g\u00f6r\u00fcnt\u00fcleme), sa\u011flam tarafla anl\u0131k kar\u015f\u0131la\u015ft\u0131rma yap\u0131labilmesi ve renkli Doppler ile tendinopati ya da apofizitlerdeki neovask\u00fclarizasyon\/hipereminin g\u00f6sterilebilmesi di\u011fer \u00f6nemli avantajlar\u0131d\u0131r\u00a0[8]. Klinik pratikte USG, patellar ve A\u015fil tendinopatisi gibi tendon patolojilerinde tendon kal\u0131nla\u015fmas\u0131n\u0131 ve yap\u0131sal dejenerasyonu; Osgood-Schlatter, Sinding-Larsen-Johansson ve Sever gibi apofizitlerde ise yumu\u015fak doku \u00f6demini, apofiz fragmantasyonunu ve e\u015flik eden bursit\/ef\u00fczyonu ortaya koyabilmektedir\u00a0[4, 8]. Bununla birlikte USG’nin s\u0131n\u0131rlar\u0131 da net bi\u00e7imde tan\u0131nmal\u0131d\u0131r. Y\u00f6ntem belirgin \u00f6l\u00e7\u00fcde uygulay\u0131c\u0131ya ba\u011f\u0131ml\u0131d\u0131r ve erken evre stres k\u0131r\u0131klar\u0131, derin kemik patolojileri ile spondilolizis gibi tablolarda tan\u0131sal \u00fcst\u00fcnl\u00fck MRG ve BT’de \u00f6n plana \u00e7\u0131kmaktad\u0131r. USG bu durumlarda en fazla kortikal d\u00fczensizlik ya da periostal reaksiyon gibi dolayl\u0131 bulgular verebilmektedir\u00a0[6, 8]. Dolay\u0131s\u0131yla USG, direkt grafi ve MRG’nin yerini alan de\u011fil, do\u011fru endikasyonda onlar\u0131 tamamlayan; \u00f6zellikle y\u00fczeyel tendon ve apofiz patolojilerinde radyasyonsuz, h\u0131zl\u0131 ve dinamik bir ilk basamak g\u00f6r\u00fcnt\u00fcleme se\u00e7ene\u011fi olarak konumland\u0131r\u0131lmal\u0131d\u0131r\u00a0[8].<\/p>\n\n\n

\n
\"\"
A\u015f\u0131r\u0131 Kullan\u0131m Yaralanmalar\u0131nda USG’nin yeri<\/figcaption><\/figure>\n<\/div>\n\n\n

Sporcular Ne Zaman Doktora Ba\u015fvurmal\u0131?<\/h2>\n\n\n\n

Overuse yaralanmalar\u0131 sinsi ba\u015flad\u0131\u011f\u0131ndan, aileler ve sporcular \u00e7o\u011fu zaman a\u011fr\u0131y\u0131 “b\u00fcy\u00fcme a\u011fr\u0131s\u0131” san\u0131p ertelemektedir..\u00a0<\/p>\n\n\n\n

Alt\u0131n kural: <\/strong>Akut bir travma olmaks\u0131z\u0131n ortaya \u00e7\u0131kan, dinlenmeyle ge\u00e7meyen ve giderek k\u00f6t\u00fcle\u015fen her a\u011fr\u0131, aksi kan\u0131tlanana kadar overuse yaralanmas\u0131 olarak kabul edilmeli ve spora erken d\u00f6n\u00fc\u015f i\u00e7in “iyiyim” hissine g\u00fcvenilmemelidir [1, 9].<\/p>\n\n\n

\n
\"\"
A\u015f\u0131r\u0131 kullan\u0131m yaralanmalar\u0131nda k\u0131rm\u0131z\u0131 bayraklar<\/figcaption><\/figure>\n<\/div>\n\n\n

A\u015f\u0131r\u0131 Kullan\u0131m Yaralanmalar\u0131n \u00d6nlenmesi<\/h2>\n\n\n\n

Overuse yaralanmalar\u0131n\u0131n \u00f6nlenmesi, sahadaki uygulamalarla klinik fark\u0131ndal\u0131\u011f\u0131n birle\u015fti\u011fi \u00e7ok bile\u015fenli bir s\u00fcre\u00e7tir. Kan\u0131ta dayal\u0131 ba\u015fl\u0131ca \u00f6neriler \u015f\u00f6yle \u00f6zetlenebilir:<\/p>\n\n\n\n

    \n
  1. Antrenman y\u00fck\u00fc bireyselle\u015ftirilmelidir.<\/strong> Her \u00e7ocu\u011fun toparlanma kapasitesi farkl\u0131d\u0131r; y\u00fck kademeli artt\u0131r\u0131lmal\u0131, ani hacim s\u0131\u00e7ramalar\u0131ndan ka\u00e7\u0131n\u0131lmal\u0131d\u0131r. Y\u00fcksek haftal\u0131k y\u00fck, y\u00fck monotonlu\u011fu ve ani y\u00fck de\u011fi\u015fimleri yaralanma i\u00e7in ba\u011f\u0131ms\u0131z belirleyicilerdir .<\/li>\n\n\n\n
  2. \u0130stirahat<\/strong>. Haftal\u0131k en az bir tam dinlenme g\u00fcn\u00fc ve y\u0131l i\u00e7inde sezon d\u0131\u015f\u0131 ara verilmelidir. Sorunun \u00f6z\u00fcnde \u00e7o\u011fu zaman “\u00e7ok \u00e7al\u0131\u015fmak” de\u011fil “yeterince dinlenmemek” yatmaktad\u0131r.<\/li>\n\n\n\n
  3. Erken spesiyalizasyondan ka\u00e7\u0131n\u0131lmal\u0131d\u0131r.<\/strong> Tek bran\u015fta y\u0131l boyu (y\u0131lda 8 aydan fazla) yo\u011funla\u015fma geciktirilmelidir. \u00c7ok y\u00f6nl\u00fc\/farkl\u0131 spor kat\u0131l\u0131m\u0131n\u0131 te\u015fvik edilmelidir. Tek bran\u015fa y\u00f6nelen sporcularda diz ekstans\u00f6r mekanizma yaralanmalar\u0131 4 kata kadar artmaktad\u0131r [5].<\/li>\n\n\n\n
  4. Antrenman \u00f6ncesi yap\u0131land\u0131r\u0131lm\u0131\u015f n\u00f6romusk\u00fcler \u0131s\u0131nma <\/strong>uygulanmal\u0131d\u0131r<\/b>. FIFA 11+ Kids gibi programlar, haftada en az bir kez yakla\u015f\u0131k 20 dakika uyguland\u0131\u011f\u0131nda alt ekstremite yaralanmalar\u0131n\u0131 belirgin bi\u00e7imde azaltt\u0131\u011f\u0131n\u0131 g\u00f6stermektedir [10].<\/li>\n\n\n\n
  5. Denge ve bacak kas kuvveti hedeflenmelidir<\/strong>. Bu programlar statik\/dinamik dengeyi ve bacak kuvvetini anlaml\u0131 \u00f6l\u00e7\u00fcde art\u0131rarak \u00e7ocu\u011fu overuse’a yatk\u0131n k\u0131lan n\u00f6romusk\u00fcler kontrol a\u00e7\u0131\u011f\u0131n\u0131 do\u011frudan kapat\u0131r.<\/li>\n\n\n\n
  6. Antren\u00f6r ve aile e\u011fitilmelidir.<\/strong> Yorgunluk ve a\u015f\u0131r\u0131 y\u00fcklenme i\u015faretlerini erken tan\u0131ma, \u00e7ocuk sporcuyu koruman\u0131n ilk basama\u011f\u0131d\u0131r; bu ama\u00e7la geli\u015ftirilen tarama ara\u00e7lar\u0131 (\u00f6r. Youth Overuse Injury Questionnaire) erken risk tespitini kolayla\u015ft\u0131rmaktad\u0131r [5].<\/li>\n\n\n\n
  7. Erken belirtiler ciddiye al\u0131nmal\u0131d\u0131r.<\/strong> Yaln\u0131zca aktivite sonras\u0131 ortaya \u00e7\u0131kan Evre 1 a\u011fr\u0131s g\u00f6rmezden gelinmemelidir. Rehabilitasyon s\u00fcresi evre ilerledik\u00e7e uzad\u0131\u011f\u0131ndan en etkili m\u00fcdahale erken d\u00f6nemdedir.<\/li>\n<\/ol>\n\n\n\n

    Spora D\u00f6n\u00fc\u015f<\/h2>\n\n\n\n

    Overuse yaralanmalar\u0131nda spora d\u00f6n\u00fc\u015f, a\u011fr\u0131n\u0131n ge\u00e7mesiyle de\u011fil, dokunun y\u00fcklenmeye yeniden haz\u0131r h\u00e2le gelmesiyle belirlenen kademeli bir s\u00fcre\u00e7tir. Akut travmalardan farkl\u0131 olarak burada acele bir “ye\u015fil \u0131\u015f\u0131k”, altta yatan patolojiyi derinle\u015ftirerek b\u00fcy\u00fcme kusurlar\u0131na ve kal\u0131c\u0131 eklem hasar\u0131na zemin haz\u0131rlayabilir. Bu nedenle d\u00f6n\u00fc\u015f karar\u0131; semptomlar\u0131n seyrine, altta yatan risk fakt\u00f6rlerinin d\u00fczeltilmi\u015f olmas\u0131na ve fonksiyonel kapasitenin geri kazan\u0131lmas\u0131na dayanmal\u0131d\u0131r.<\/p>\n\n\n\n

    Kaynak\u00e7a<\/h2>\n\n\n\n

    1.Brenner, J.S. and A. Watson,\u00a0Overuse Injuries, Overtraining, and Burnout in Young Athletes.<\/em>\u00a0Pediatrics, 2024.\u00a0153<\/strong>(2).<\/p>\n\n\n\n

    2.DiFiori, J.P., et al.,\u00a0Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine.<\/em>\u00a0Br J Sports Med, 2014.\u00a048<\/strong>(4): p. 287\u20138.<\/p>\n\n\n\n

    3.\u00a0Valovich McLeod, T.C., et al.,\u00a0National Athletic Trainers’ Association position statement: prevention of pediatric overuse injuries.<\/em>\u00a0J Athl Train, 2011.\u00a046<\/strong>(2): p. 206\u201320.<\/p>\n\n\n\n

    4.Chang, G.H., et al.,\u00a0Lower extremity overuse injuries in pediatric athletes: clinical presentation, imaging findings, and treatment.<\/em>\u00a0Clin Imaging, 2013.\u00a037<\/strong>(5): p. 836\u201346.<\/p>\n\n\n\n

    5.Borkowski, R., et al.,\u00a0The Impact of Overtraining on Injury Rates in School-Age Athletes\u2014A Scoping Review.<\/em>Journal of Clinical Medicine, 2025.\u00a014<\/strong>.<\/p>\n\n\n\n

    6.Hoang, Q.B. and M. Mortazavi,\u00a0Pediatric overuse injuries in sports.<\/em>\u00a0Adv Pediatr, 2012.\u00a059<\/strong>(1): p. 359\u201383.<\/p>\n\n\n\n

    7.Paz, D.A., et al.,\u00a0Upper extremity overuse injuries in pediatric athletes: clinical presentation, imaging findings, and treatment.<\/em>\u00a0Clin Imaging, 2015.\u00a039<\/strong>(6): p. 954\u201364.<\/p>\n\n\n\n

    8.Chambers, G., J. Kraft, and K. Kingston,\u00a0The role of ultrasound as a problem-solving tool in the assessment of paediatric musculoskeletal injuries.<\/em>\u00a0Ultrasound, 2019.\u00a027<\/strong>(1): p. 6\u201319.<\/p>\n\n\n\n

    9.Christopher, N.C. and J. Congeni,\u00a0Overuse injuries in the pediatric athlete: Evaluation, initial management, and strategies for prevention.<\/em>\u00a0Clinical Pediatric Emergency Medicine, 2002.\u00a03<\/strong>(2): p. 118\u2013128.<\/p>\n\n\n\n

    10.Kambitta Valappil, I.N., et al.,\u00a0Effects of the FIFA 11\u2009+\u2009Program on Physical Fitness in Youth and Adult Soccer Players: A Systematic Review and Meta-analysis.<\/em>\u00a0Sports Med, 2026.\u00a056<\/strong>(2): p. 521\u2013541.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Yazar: Uzm. Dr. Muhammed Ali \u00dc\u00e7e\u015f Edit\u00f6r: Dr. \u00d6\u011fr. \u00dcyesi \u00d6mer Yusuf Erdurmu\u015f Giri\u015f En basit tan\u0131m\u0131yla overuse yaralanmas\u0131; kas ve iskelet sistemini etkileyen tekrarlayan, k\u00fc\u00e7\u00fck y\u00fcklenmelerin birikerek kronik bir…<\/p>\n","protected":false},"author":177,"featured_media":433,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","_tatd_show_on_main_site":"","footnotes":""},"categories":[1,10014,10015],"tags":[10018,10033,10032,10021,10035,10034,10036],"class_list":["post-432","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-genel","category-akademik-blog-yazisi","category-sosyal-blog-yazisi","tag-acil-tip","tag-asiri-kullanim","tag-overuse","tag-spor-acilleri","tag-spor-travma","tag-spor-yaralanmasi","tag-sports-medicine"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/posts\/432","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/users\/177"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/comments?post=432"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/posts\/432\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/media\/433"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/media?parent=432"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/categories?post=432"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/tags?post=432"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}