Youth Athlete Flashcards
Importance of Youth Sports -
Sport/Physical Activity is associated with:
Leadership skills
Self-esteem
Healthy lifestyle habits (active)
Reduced depression
Youth Athletes:
Includes both children and adolescents
Girls: Child (11 and under) adolescent (12-18)
Boys: Child (13 and under) adolescent (14-18)
Immature Skeletal Anatomy
growth plates (epiphyseal plates) are still open = more susceptible to growth-related injuries, such as apophysitis (inflammation of the growth plate)
Bones still developing = variations in density and strength compared to fully matured bones in adults
* increases the risk of fractures and stress injuries
joints and muscles may have greater flexibility, but lack the strength and stability seen in adults
*focus on balanced training to prevent injuries
Immature Emotional Development
Self-Regulation: Younger athletes may struggle with emotional regulation during competition, leading to impulsive decisions or difficulty managing stress and frustration.
Social Dynamics: The social aspect of sports is significant. Young athletes often navigate peer relationships and may experience pressure from teammates, coaches, and parents, impacting their enjoyment and mental health.
Identity Formation: Participation in sports plays a key role in developing self-identity. Young athletes may grapple with balancing their athletic identity with other aspects of their lives, such as academics and social interactions.
Development (Maturation)
Timing, rate, and magnitude vary
Not consistent between body systems
Some athletes may develop physically earlier or later than their peers, affecting their strength, speed, and skill acquisition
Coordination, balance, and cognitive skills develop at different rates, which can influence an athlete’s ability to learn new skills and adapt to the demands of their sport
Children are NOT small adults = Skeletal differences:
Bones less dense, more elastic (especially during growth spurt= transient mineral shortage)
*Greenstick Fx
Open Physis
*Weakest area, Salter-Harris fractures
Apophysis
*Insertional point for tendon/ligament
*Apophysitis and avulsion common
*Secondary growth center: opens ~ 9, closes ~ 22yo
Fastest growth rate (outside of infancy)
During a growth spurt, bones can grow faster than the soft tissues can adapt = increased injury risk
bones can grow quickly, often outpacing the growth of surrounding soft tissues (muscles, tendons, and ligaments)
Soft tissues may not stretch or strengthen at the same rate as bones, leading to imbalances and a greater likelihood of injury
Osgood-Schlatter Disease:
Inflammation of the growth plate below the knee, often seen in active adolescents.
Sever’s Disease:
Inflammation of the growth plate at the heel, common in young athletes involved in running and jumping sports.
Models of Youth Development: Sampling
Age: 6-12
Goal: Develop Fundamental Skills
Running, Jumping, Throwing, Catching
Physical Literacy Across Sports
Rotate Through Sports and Positions
Example: Learn to throw
Models of Youth Development: Specialization
Age: 13-15
Goal: Sport and Position-specific Skill Acquisition
Proficiency of Movement
Fine Tune Technique
Example: Learn to Pitch (how to throw a curveball)
Models of Youth Development: Investment
Age: 16-18
Goal: Skill Mastery
Proficiency of Movement
Increase Pitch Velocity
Improve Shooting Accuracy
Example: Throw a curveball with accuracy
What is Sport Specialization Original Definition (Hill 1987):
“Participation in a single sport to the exclusion of other sports”
What is Sport Specialization Expanded Definition (Hill 1987, Hill 1989, Jayanthi 2013):
Participation in a single sport >8 months per year
High intensity training and competition within that sport
Participation in multiple leagues throughout the year
Problem =
EARLY specialization (prior to age 12) is the problem
Early specialization linked with:
$2 Billion in Healthcare expenditures & growing
Increased Injury Risk
Burnout
Impaired physical/social development
Surgical sports injury cases <13 years old
2004-2009: 117 ± 32
2010-2014: 212 ± 70
noticeable increase in the average number of surgical sports injury cases among youth athletes under 13
rise of approximately 81%
Potential Factors Contributing to the Increase: Surgical sports injury cases <13 years old
Increased Participation: There may be more children participating in organized sports, leading to a higher incidence of injuries.
Specialization in Sports: Youth athletes may be specializing in specific sports at a younger age, which can increase the risk of overuse injuries and surgical interventions.
Increased Awareness and Reporting: Improved awareness of sports injuries and better reporting mechanisms could contribute to a rise in recorded surgical cases.
Changes in Training and Competition: More competitive environments and intensive training regimens may increase the risk of injuries among young athletes.
___% participate in some type of organized sport
70
Average age of specialization is ___
8 yo (<12 = early)
Encouraged to have a primary sport by ___
2nd grade
The average child today plays ___ sports
fewer than 2
Why is early specialization occurring?
Increased Competition
Parental Influence
Increased Access to Resources
Social Factors
Perceived Benefits
Cultural Trends
Increased Competition
Youth Sports Culture: There is a growing emphasis on competition and performance at younger ages. Families and coaches often prioritize winning, pushing children to specialize early to gain a competitive edge.
Scholarship Opportunities: The belief that early specialization can lead to college scholarships or professional opportunities drives many parents to encourage their children to focus on one sport.
Parental Influence
Expectations: Parents often have high expectations for their children, leading to pressure to excel in a single sport from an early age.
Role Models: Seeing elite athletes specialize in one sport can influence parents and children to adopt similar pathways, believing it is necessary for success.
Increased Access to Resources
Training Facilities: The availability of specialized training facilities and coaches for specific sports encourages children to focus on one sport rather than participate in multiple activities.
Year-Round Programs: Many sports now offer year-round training and competitive opportunities, making it easier for young athletes to commit to a single sport
Social Factors
Peer Influence: Children often want to fit in with peers who are also specializing, leading to a snowball effect where more children choose to focus on one sport.
Team Dynamics: As children progress, they may feel pressure to specialize to maintain their position on competitive teams, especially if their friends are also specializing.
Perceived Benefits
Skill Development: The belief that specializing early leads to greater skill development and mastery of a sport can encourage parents and athletes to commit early.
Reduced Time Commitment: Some families may find it easier to manage schedules with one sport rather than juggling multiple sports, believing it offers more focused training.
Cultural Trends
Media Influence: Coverage of elite athletes and success stories in specific sports can create a narrative that specializing is the most effective path to success.
Normalization of Specialization: As early specialization becomes more common, it reinforces the idea that it is the norm, encouraging more families to follow suit.
Why? Follow the Money
Youth sports is now a $15 Billion industry
youth sports industry has grown substantially
Year round availability of:
Sport specific lessons/training
Competitive travel teams
Competitive club teams
Showcase tournaments
Stakeholders: Understanding drivers of early sport specialization is complex
Parents: want their children to succeed, whether in sports or through scholarships, and may encourage specialization to enhance their chances
Coaches: encourage early specialization to build a competitive team
Peers/Society: look to their peers for cues on behavior and expectations
Early Sport Specialization = College & Pro Sport Success
Specializing in a single sport can lead to more targeted skill development
specialization allows for more hours of practice in one sport, which some believe leads to higher levels of competence and readiness for collegiate and professional competition
may provide young athletes with more competitive experience, as they often participate in higher-level competitions sooner than those who play multiple sports
concerned about getting injured:
most = a little concerned or somewhat concerned
least = extremely concerned
believe they will receive a college scholarship related to athletic performance:
most = somewhat likely
second most = neither likely nor unlikely
few = extremely unlikely or likely
parents awareness about sport specialization and injury:
partcipating all year-round increases chance of child getting injured = SOMEWHAT
Coaches and Early Specialization?
most: somewhat concerned or very concerned
least: not at all concerned
Parents Unaware of Recommendations
lack awareness of the potential risks associated with early specialization, including overuse injuries and burnout
support training regimens that increase their child’s risk of injury, resulting in long-term consequences for their health and athletic development
Coaches Unaware of Recommendations
Insufficient Training and Education
often rely on their own experiences and those of other coaches when making decisions about training and specialization
perpetuate the common belief that early specialization is essential for success, despite the lack of supporting evidence
prioritize winning over athlete development
What evidence do we have to refute early specialization?
higher incidence of overuse injuries, particularly in sports that require repetitive motions, such as baseball, gymnastics, and soccer
higher risk of developing conditions such as stress fractures and tendonitis
Burnout and Dropout Rates
Lack of Enjoyment
Research indicates that early specialization does not necessarily correlate with long-term success
Does Early Specialization Lead to Sport Success?
Unrealistic Expectations: 0.5% of HS athletes make it to the Pro level
vast majority of young athletes will not reach elite levels, regardless of their training intensity or focus on a single sport
NCAA probability of competing in professional athletics:
baseball:
M basketball:
W basketball:
football:
M ice hockey:
M soccer:
baseball: 9.5%
M basketball: 1.2%
W basketball: 0.9%
football: 1.6%
M ice hockey: 6.4%
M soccer: 1.4%
Does Early Specialization Lead to Injury Risk?
higher volumes of sport-specific training, which can result in overuse injuries
participate in training and competitions year-round without adequate rest and recovery periods
tendinitis, stress fractures, and growth plate injuries are more prevalent in young athletes who specialize early, particularly in sports that require repetitive motions, such as gymnastics, baseball, and soccer
effects of playing multiple high school sports:
multi-sport: less major injuries and reduces risk
Early Specialization Injury Risk Summary: Limited Evidence Suggests
High Sport Specialization is Associated with Higher Risk of Overuse Injury
81% more likely ~ Double the risk
No evidence to support early specialization in most sports
Multi-sport may even reduce risk
Injury Prevention Programs?
Education is the best we have right now
Less than 10% studies include under 18
*90% of athletes are under 18
Children are not small adults
Parent/Coach Education
30%>
general safety and injury prevention
effective motivational techniques
sports skills and tactics
CPR/basic first aid
concussion management
physical conditioning
AOSSM
Monitor closely if:
participate more hours per week than their age
> 16 hours per week of intense training
AOSSM
Recommendations:
Single sport athletes should have break periods involving diverse neuromuscular training
Promote multisport participation
Patient education
AMSSM
recommendations - training workload:
limit weekly and yearly participation time
limits on sport-specific repetitive movements
individualized base on age/growth rate/readiness/injury history
AMSSM
recommendations - strength and conditioning:
preseason conditioning programs
strength gains
injury prevention
injury rehab
improved sport performance
___ injuries are under-reported in the current literature because most of injury definitions have focused on ___
overuse
time loss from one sport
_____ is an established risk factor for overuse injuries and should be noted as part of each injury assessment
a history of prior injury
___may identify prior injury patterns and provide an opportunity to assess sport readiness
preparticipation exams
adolescent female athletes should be assessed for ____ as a potential predisposing factor to overuse injury
menstrual dysfunction
parents and coaches should be educated regarding the concept of s____ variations in cognitive development, as well as motor skills, should be considered when setting goals and expectations
port readiness
each sport specialization may not lead to long-term success in sports, and may increase risk for ____.
overuse injury and burnout
with the exception of of early entry sports such as _____ , sport diversification should be encouraged at younger ages
gymnastics
figure skating
swimming/diving
when an overuse injury is diagnosed, it is essential to address the ____ .the athlete, parents, and coaches should be involved in reviewing all risk factors and developing a strategy to attempt to avoid recurrent injury.
underlying causes
all overuse injuries are _____. clinicians should be familiar with specific high-risk injuries, including stress fractures of the femoral neck, tarsal navicular, anterior tibial cortex, and physis and effort thrombosis
not inherent benign
Common Youth Sports Injuries
Apophysitis
Avulsion Fractures
Apophysitis =
Traction injury to the apophysis in growing individuals
Cartilaginous that ossify during skeletal maturation (injury does not impact longitudinal bone growth)
Overuse
Repetitive explosive movements: running, jumping, throwing
Apophysitis
Common locations:
Tibial Tubercle: Osgood-Schlatter’s
Inferior Patellar Pole: Sinding-Larsen-Johansson
Calcaneus: Sever’s
Medial Epicondyle: Little league elbow
Little league Shoulder: traction injury to the proximal humeral growth plate
Apophysitis
Treatment:
Activity to tolerance (modify if needed)
*Unless growth plate involved
Muscle length
Muscle strength
Symptom management
*Chopat strap
It will go away with rest and as the apophysis matures
Avulsion Fractures =
Traction injury resulting in fracture
* Childrens ligaments/tendons are stronger than their pliable bones
- Ligament/tendon tears rare in children, more likely to avulse
*Same mechanism as acute tendon ruptures in adults
Sudden pop with pain, localized over bony insertion
+/- laxity
Avulsion Fractures
Common areas:
Medial epicondyle (instead of UCL injury)
Tibial spine (instead of ACL injury)
Iliac Crest/ASIS/AIIS/Ish
Tuberocity
Tibial tubercle
5th met
Calcaneus
Avulsion Fractures
Treatment:
Conservative management usually successful = Rest/immobilization similar to typical fx management
ORIF if:
*Conservative management fails (non union)
*Displaced too far to heal
If growth center is damaged: deformity
* Much more concerning in younger than older
Conclusions:
Prevention is key
Injuries to growth plates/growth centers can result in:
maldevelopment/malalignment with significant long-term consequences
Poorer results for knee and ankle
Significant deformity may require:
multiple surgeries and typically results in early joint degeneration = lots of downstream costs to healthcare system
