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Abstract
Youth sport participation patterns have drastically changed over the past two decades. Increasingly, young individuals are specializing in single sport while skeletally immature. Sport specialization in the growing athlete has profound effects on performance, short- and long-term injury risks, and joint health. Evidence continues to mount as the detrimental effects of this trend on the immature athlete. The knee, shoulder, and elbow of these young athletes are particularly affected by this emphasis on skill-based sporting activity as opposed to generalized fitness and participation. An understanding of the epidemiology of sport participation, particularly financial impacts, and the effects on elite sport performance are critical so that the clinician can effectively educate athletes, parents, and coaches.
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Sport specialization is associated with upper-extremity overuse injury in high school baseball players. J Shoulder Elbow Surg 2020; 29:1775-1782. [PMID: 32381476 DOI: 10.1016/j.jse.2020.01.092] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/13/2020] [Accepted: 01/21/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND HYPOTHESIS Sport specialization is increasingly common in youth sports and is a risk factor for lower-extremity overuse injuries. However, limited data exist on whether specialization is associated with upper-extremity (UE) overuse injuries, specifically in youth baseball players. We hypothesized that specialization in baseball and being a pitcher would be associated with poorer arm health and UE overuse injury history in the previous year. METHODS During the 2019 spring baseball season, 551 high school baseball athletes (aged 15.9 ± 1.3 years) from 3 states (Alabama, n = 200; California, n = 188; and Michigan, n = 163) completed an anonymous questionnaire. Athletes were recruited from 5 high schools in each state, with schools matched based on factors that influence specialization rates. The questionnaire consisted of (1) demographic characteristics, (2) baseball participation information (including sport specialization status), and (3) throwing-arm health and UE injury history in the previous 12 months. Throwing-arm health was assessed using the Youth Throwing Score (YTS), a validated and reliable outcome measure for youth baseball players. Multivariate regression analyses were used to examine the association between variables of interest and the YTS or UE overuse injury history, adjusting for covariates. RESULTS After adjustment for covariates, highly specialized athletes were more likely to report a UE overuse injury in the previous year compared with low-specialization athletes (odds ratio [OR], 3.77; 95% confidence interval [CI], 1.39-10.2, P = .009). Both athletes who reported playing baseball for more than 8 months per year (OR, 2.03; 95% CI, 1.12-3.65; P = .019) and athletes who reported being a pitcher (OR, 2.11; 95% CI, 1.20-3.72; P = .010) were more likely to report a history of UE overuse injury. Highly specialized players reported lower (worse) YTS values compared with low-specialization players (least-squares mean estimate ± standard error, 56.5 ± 1.1 vs. 53.3 ± 0.7; P = .034). Players who reported pitching as one of their positions scored worse on the YTS than non-pitchers (least-squares mean estimate ± standard error, 51.6 ± 0.8 vs. 57.2 ± 0.6; P < .001). CONCLUSION Although baseball recommendations that discourage sport specialization are widely available for parents, athletes, and coaches, high rates of sport specialization were reported in our sample. We found that being highly specialized in baseball was associated with UE overuse injury history and worse throwing-arm health in high school baseball athletes. Continued education for baseball parents, athletes, and coaches is necessary to raise awareness of the risks associated with high specialization.
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Biese KM, McGuine TA, Kliethermes SA, Bell DR, Post EG, Watson AM, Brooks MA, Lang PJ. Sport specialization and sport participation opportunities and their association with injury history in female high school volleyball athletes. Phys Ther Sport 2020; 45:86-92. [PMID: 32717700 DOI: 10.1016/j.ptsp.2020.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Determine the association of sport specialization in female volleyball athletes with previous injury history and determine the association of sport specialization with volleyball participation opportunities. DESIGN Cross-sectional. SETTING Recruitment occurred from 83 Wisconsin high schools during the 2018 volleyball season. PARTICIPANTS Female volleyball athletes (N = 1,588, grades 9-12, age = 15.6 ± 1.1 years). MAIN OUTCOMES Participants completed a pre-season questionnaire soliciting information regarding 1) demographics, 2) sport specialization, 3) sport participation, and 4) sport-related injuries in the previous 12 months. Univariable logistic regression models were used to identify associations with previous injury. Chi-square analyses were used to investigate associations between sport specialization classification and other sport participation opportunities. RESULTS Both moderately and highly specialized athletes were more likely to report a previous injury compared to low specialized athletes (moderate OR: 1.84 [1.29-2.62]; p < 0.001 and high OR: 2.30 [1.64-3.24]; p < 0.001). Highly specialized athletes were more likely to report participating in club volleyball, summer tournaments, and training camps in the past 12 months. Participants who reported participating in club volleyball, summer competitions, and training camps last year were more likely to report an injury. CONCLUSIONS Specialization was associated with injury history and year-round volleyball opportunities among female adolescent volleyball athletes.
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Affiliation(s)
- Kevin M Biese
- Department of Kinesiology, University of Wisconsin - Madison, Madison, WI, United States.
| | - Timothy A McGuine
- Department of Orthopedics and Rehabilitation, University of Wisconsin - Madison, Madison, WI, United States
| | - Stephanie A Kliethermes
- Department of Orthopedics and Rehabilitation, University of Wisconsin - Madison, Madison, WI, United States
| | - David R Bell
- Department of Kinesiology, University of Wisconsin - Madison, Madison, WI, United States; Department of Orthopedics and Rehabilitation, University of Wisconsin - Madison, Madison, WI, United States
| | - Eric G Post
- Department of Applied Medicine and Rehabilitation at Indiana State University, Terre Haute, IN, United States
| | - Andrew M Watson
- Department of Orthopedics and Rehabilitation, University of Wisconsin - Madison, Madison, WI, United States
| | - M Alison Brooks
- Department of Orthopedics and Rehabilitation, University of Wisconsin - Madison, Madison, WI, United States
| | - Pamela J Lang
- Department of Orthopedics and Rehabilitation, University of Wisconsin - Madison, Madison, WI, United States
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Is the incidence of paediatric stress fractures on the rise? Trends in New York State from 2000 to 2015. J Pediatr Orthop B 2020; 29:499-504. [PMID: 31305361 DOI: 10.1097/bpb.0000000000000650] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
The purpose of this study is to analyze trends in the epidemiology of paediatric stress fractures. The New York Statewide Planning and Research Cooperative System database was queried for stress fractures in children between the ages of 6 and 18 years. After checking for monotonicity of the data, Spearman's correlation coefficient was calculated. Multivariate regressions were used to test for associations between demographic variables and risk of stress fracture. Analysis of 11 475 386 outpatient visits between 2000 and 2015 showed that the annual incidence of paediatric stress fractures increased from 1.37 cases per 100 000 outpatient visits in 2006 to 5.32 per 100 000 visits in 2015 (ρ = 0.876, P < 0.01). The mean age at the time of injury was 14.4 ± 2.8 years. Children younger than 14 years accounted for 33.6% of the cohort. Age, male sex, white ethnicity, and private insurance were statistically significant predictors of stress fractures in a multivariate model. This study is the first to document an increase in the annual incidence of paediatric stress fractures.
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Evaluation of adolescent sport specialization and injury mechanism by sex: A secondary analysis. J Sci Med Sport 2020; 23:721-725. [DOI: 10.1016/j.jsams.2020.01.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 01/10/2020] [Accepted: 01/29/2020] [Indexed: 11/17/2022]
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Garcia S, Pandya NK. Anterior Cruciate Ligament Re-tear and Revision Reconstruction in the Skeletally Immature Athlete. Curr Rev Musculoskelet Med 2020; 13:369-378. [PMID: 32388725 PMCID: PMC7251003 DOI: 10.1007/s12178-020-09627-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE OF REVIEW With an increase in high-demand sporting activity, the rate of pediatric and adolescent anterior cruciate ligament (ACL) reconstruction is increasing. Yet, the failure rates after reconstruction are much higher than the adult population. The purpose of this paper is to understand failure rates, reasons for graft failure, and strategies for successful revision surgery. RECENT FINDINGS A complete understanding of the failure etiology is essential for the clinician treating this population prior to revision. This begins with an assessment of post-operative patient compliance and sporting activity. Surgical technique must then be scrutinized for non-anatomic tunnel placement and poor graft size/type. Concurrent bony deformity must also be addressed including lower extremity valgus alignment and tibial slope abnormalities. Meniscus and chondral injury must be aggressively treated. Furthermore, imaging must be examined to look for missed posterolateral corner injury. Lateral extra-articular tenodesis (in the setting of ligamentous laxity or rotational instability) may be also indicated as well. The surgeon can then choose a graft type and surgical technique that optimizes outcome and respects skeletal growth. Prior to surgical intervention, the clinician must also counsel patients in regard to the guarded prognosis and outcomes in this setting. Prolonged rehabilitation protocols/return-to-play timing as well as sporting activity modification in the post-operative period after revision are critical. There is limited literature on revision ACL reconstruction in the skeletally immature athlete. An understanding of all the risk factors for failure is essential in order to achieve treatment success.
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Affiliation(s)
- Steven Garcia
- Department of Orthopedic Surgery, University of California San Francisco, 1500 Owens Street, San Francisco, CA 94158 USA
| | - Nirav K. Pandya
- Department of Orthopedic Surgery, Benioff Children’s Hospital, University of California San Francisco, 747 52nd Street, Oakland, CA 94609 USA
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57
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Jayanthi N, Kleithermes S, Dugas L, Pasulka J, Iqbal S, LaBella C. Risk of Injuries Associated With Sport Specialization and Intense Training Patterns in Young Athletes: A Longitudinal Clinical Case-Control Study. Orthop J Sports Med 2020; 8:2325967120922764. [PMID: 32637428 PMCID: PMC7318830 DOI: 10.1177/2325967120922764] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 02/12/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND There are no clinical longitudinal studies exploring the associations between sport specialization and intense training patterns and injuries in young athletes. PURPOSE To prospectively determine the relationship between young athletes' degree of sport specialization and their risk of injuries and reinjuries. STUDY DESIGN Case-control study; Level of evidence, 2. METHODS Young athletes aged between 7 and 18 years presenting for sports-related injuries or sports physical examinations were recruited from either sports medicine clinics or pediatric/family medicine offices. Each participant completed a baseline survey at enrollment and an identical follow-up survey every 6 months for 3 years. Surveys assessed training patterns and injuries. Injury type (acute, overuse, or serious overuse) and clinical diagnosis were also recorded from electronic medical records. RESULTS Of the 1208 participants who provided consent, 579 (48%) completed the baseline survey and first follow-up survey at 6 months (mean age, 14.1 ± 2.3 years; 53% female). Of this sample, 27% (158/579) of participants were uninjured, and 73% (421/579) were injured, with 29% (121/421) of injuries classified as reinjuries. Consistent with previous studies, over the 3-year study period, the degree of sport specialization had an effect such that more specialized athletes were significantly more likely to be injured (P = .03) or have an overuse injury (P = .02) compared with less specialized athletes after adjusting for potential confounders. Additionally, female athletes were more at risk for all injuries (P = .01) and overuse injuries (P = .02) after adjusting for covariates. Finally, young athletes who trained in weekly hours in excess of their age or who trained twice as many hours as their free play were significantly more likely to be injured on univariate analysis (both P < .001). CONCLUSION Our study confirms that over time, young athletes, and in particular young female athletes, were more likely to be injured and sustain an overuse injury if they had a higher degree of sport specialization. Similarly, those athletes whose training hours exceeded thair age or whose sports hours exceeded their free play by a factor of greater than 2 were also more likely to develop injuries and overuse injuries.
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Affiliation(s)
- Neeru Jayanthi
- Departments of Orthopaedics and Family and Preventive Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
- Emory Sports Medicine Center, Johns Creek, Georgia, USA
| | - Stephanie Kleithermes
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Lara Dugas
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Chicago, Illinois, USA
| | | | - Sara Iqbal
- Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois, USA
| | - Cynthia LaBella
- Institute for Sports Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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58
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Hernandez MI, Biese KM, Schaefer DA, Post EG, Bell DR, Brooks MA. Different Perceptions of Parents and Children on Factors Influencing Sport Specialization. J Sport Rehabil 2020; 30:190-197. [PMID: 32335526 DOI: 10.1123/jsr.2019-0357] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/06/2020] [Accepted: 02/16/2020] [Indexed: 09/07/2024]
Abstract
CONTEXT Sport specialization among youth athletes has been associated with increased risk of overuse injuries. Previous research demonstrates that children perceive specialization to be beneficial in making their high school team and receiving athletic college scholarships. Previous research demonstrates that parents play a significant role in their child's sport experience. However, it is unknown if parents and children answer questions related to specialization factors in a similar manner. OBJECTIVE To evaluate the beliefs of youth athletes and parents on factors related to sport specialization and evaluate the level of agreement between dyads on sports specialization. DESIGN Cross-sectional. SETTING Online and paper surveys. PATIENTS OR OTHER PARTICIPANTS Aim 1: 1998 participants (993 children and 1005 parents). Aim 2: 77 paired parent-child dyads. INTERVENTIONS Self-administered survey. MAIN OUTCOME MEASURES The responses were summarized via frequency and proportions (%). Chi-squares were calculated between parent and child responses. Kappa coefficients were calculated for dyads to determine level of agreement. Sport specialization was classified using a common 3-point scale. RESULTS The parents were more concerned about risk of injury in sports compared with children (P < .001, χ2 = 231.4; parent: extremely: 7.1%; child: extremely: 3.7%). However, children were more likely to believe that specialization was associated with their chances of obtaining an athletic college scholarship compared with parents (P < .001, χ2 = 201.6; parent: very/extremely likely: 13.7%; child: very/extremely likely: 15.8%). Dyad subanalysis indicated a moderate level of agreement for "quitting other sports to focus on one sport" (κ = .50) and a low level of agreement for "identifying a primary sport" (κ = .30) and "training >8 months per year in primary sport" (κ = .32). CONCLUSIONS Parents and youth athletes had differing beliefs on the factors related to sport specialization. Dyad analysis shows that parents and children answer sport specialization classification questions differently. Health care providers should be aware of these differences, and messaging should be individualized to the audience.
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Ahlquist S, Cash BM, Hame SL. Associations of Early Sport Specialization and High Training Volume With Injury Rates in National Collegiate Athletic Association Division I Athletes. Orthop J Sports Med 2020; 8:2325967120906825. [PMID: 32201707 PMCID: PMC7068747 DOI: 10.1177/2325967120906825] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 11/19/2019] [Indexed: 11/16/2022] Open
Abstract
Background: There are 60 million US youth who participate in organized athletics, with
large increases in both sport participation and specialization during the
past 2 decades. There is some evidence that increased sport specialization
and training volumes may be associated with increased injuries in adolescent
populations. This study examines these variables in a population of elite
college athletes. Hypothesis: Early sport specialization (ESS) and a high training volume are risk factors
for injury and/or surgery in National Collegiate Athletic Association (NCAA)
Division I athletes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: All Division I athletes at a single institution were surveyed regarding
demographics, scholarship status, reason for specialization, age at
specialization, training volume, and injury history. Chi-square and
Mann-Whitney U tests were performed to identify significant
differences. Results: Athletes who specialized in their eventual varsity sport before age 14 years
were more likely to report a history of injuries (86.9% vs 71.4%), multiple
injuries (64.6% vs 48.8%), multiple college injuries (17.2% vs 6.0%), a
greater number of total injuries (2.0 vs 1.0), and require more time out for
an injury (15.2 vs 6.5 weeks) than those who did not. They were also more
likely to be recruited (92.9% vs 82.1%) and receive a scholarship (82.8% vs
67.9%). Athletes who trained for greater than 28 hours per week in their
eventual varsity sport before high school were more likely to report
multiple injuries (90.0% vs 56.3%), multiple college injuries (40.0% vs
12.5%), a surgical injury (60.0% vs 22.9%), multiple surgical injuries
(30.0% vs 4.7%), a greater number of total injuries (2.5 vs 2.0), and more
time out for an injury (36.5 vs 11.0 weeks) than those who did not (all
P < .05). However, these athletes were not more
likely to be recruited (90.0% vs 89.8%) or receive a scholarship (80.0% vs
74.5%). Conclusion: NCAA Division I athletes with ESS and/or a high training volume sustained
more injuries and missed more time because of an injury, but those with ESS
were more likely to be recruited and receive a college scholarship. This
knowledge can help inform discussions and decision making among athletes,
parents, coaches, trainers, and physicians.
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Affiliation(s)
- Seth Ahlquist
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA
| | - Brian M Cash
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA
| | - Sharon L Hame
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA
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60
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Post EG, Trigsted SM, Schaefer DA, Cadmus-Bertram LA, Watson AM, McGuine TA, Brooks MA, Bell DR. The Association of Sport Specialization, Overuse Injury, and Travel With Daytime Sleepiness in Youth Athletes. ACTA ACUST UNITED AC 2020. [DOI: 10.3928/19425864-20190219-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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61
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McGowan J, Whatman C, Walters S. The associations of early specialisation and sport volume with musculoskeletal injury in New Zealand children. J Sci Med Sport 2020; 23:139-144. [DOI: 10.1016/j.jsams.2019.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 08/05/2019] [Accepted: 09/04/2019] [Indexed: 10/26/2022]
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62
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Tenforde AS, Roberts WO, Krabak BJ, Davis IS, Fredericson M, Luke AC, Ackerman KE. Recommendations to Optimize Health in Youth Runners. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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63
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Post EG, Schaefer DA, Biese KM, Cadmus-Bertram LA, Watson AM, McGuine TA, Brooks MA, Bell DR. A Comparison of Emergency Preparedness Between High School Coaches and Club Sport Coaches. J Athl Train 2020; 54:1074-1082. [PMID: 31633408 DOI: 10.4085/1062-6050-207-18] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONTEXT Recent studies suggested that a large population of high school-aged athletes participate on club sport teams. Despite attempts to document emergency preparedness in high school athletics, the adherence to emergency and medical coverage standards among club sport teams is unknown. OBJECTIVE To determine if differences in emergency preparedness and training existed between coaches of high school teams and coaches of high school-aged club teams. DESIGN Cross-sectional survey. SETTING Online questionnaire. PATIENTS OR OTHER PARTICIPANTS A total of 769 coaches (females = 266, 34.6%) completed an anonymous online questionnaire regarding their emergency preparedness and training. MAIN OUTCOME MEASURE(S) The questionnaire consisted of (1) demographics and team information, (2) emergency preparedness factors (automated external defibrillator [AED] availability, emergency action plan [EAP] awareness, medical coverage), and (3) emergency training requirements (cardiopulmonary resuscitation/AED, first aid). RESULTS High school coaches were more likely than club sport coaches to be aware of the EAP for their practice venue (83.9% versus 54.4%, P < .001), but most coaches in both categories had not practiced their EAP in the past 12 months (70.0% versus 68.9%, P = .54). High school coaches were more likely to be made aware of the EAP during competitions (47.5% versus 37.1%, P = .02), but the majority of coaches in both categories indicated that they were never made aware of EAPs. High school coaches were more likely than club coaches to (1) have an AED available at practice (87.9% versus 58.8%, P < .001), (2) report that athletic trainers were responsible for medical care at practices (31.2% versus 8.8%, P < .001) and competitions (57.9% versus 31.2%, P < .001), and (3) be required to have cardiopulmonary resuscitation, AED, or first-aid training (P < .001). CONCLUSIONS High school coaches displayed much greater levels of emergency preparedness and training than coaches of high school-aged club teams. Significant attention and effort may be needed to address the lack of emergency preparedness and training observed in club coaches.
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Affiliation(s)
- Eric G Post
- School of Exercise and Nutritional Sciences, San Diego State University, CA
| | | | - Kevin M Biese
- Department of Kinesiology, University of Wisconsin-Madison
| | | | | | - Timothy A McGuine
- Department of Orthopaedics and Rehabilitation, University of Wisconsin-Madison
| | - M Alison Brooks
- Department of Orthopaedics and Rehabilitation, University of Wisconsin-Madison
| | - David R Bell
- Department of Kinesiology, University of Wisconsin-Madison.,Department of Orthopaedics and Rehabilitation, University of Wisconsin-Madison
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64
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Dahab K, Potter MN, Provance A, Albright J, Howell DR. Sport Specialization, Club Sport Participation, Quality of Life, and Injury History Among High School Athletes. J Athl Train 2020; 54:1061-1066. [PMID: 31633407 DOI: 10.4085/1062-6050-361-18] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
CONTEXT Many factors can affect the injury risk and quality of life among high school athletes. Early sport specialization and club sport participation may be components to consider when assessing the injury risk and quality of life. OBJECTIVE To investigate patient-reported quality-of-life and injury-history measures among adolescent athletes at different sport-specialization levels and to compare these measures between those who did and those who did not report participating in club sports. DESIGN Cross-sectional study. SETTING High school athletic facility. PATIENTS OR OTHER PARTICIPANTS High school student athletes 13 to 18 years of age were recruited and tested during their annual preseason athletic physical examinations. MAIN OUTCOME MEASURE(S) Our primary grouping variables were sport-specialization level (classified as low, moderate, or high) and club sport participation (organized sport outside of traditional school athletics). Our outcome variables were the Patient-Reported Outcome Measurement Information System Pediatric Profile-37 rating, Severity Measure for Depression-Child score, and injury history. RESULTS A total of 97 individuals participated (mean age = 15.2 ± 1.1 years; 38% female). Relatively similar proportions of individuals reported participating at each level of sport specialization (low = 34%, moderate = 40%, high = 26%). Forty-six (48%) participants stated they participated in club sports. No differences were evident in quality of life (P values = .15-.92 across domains), depression (P = .60), or injury history (P > .70) among the specialization groups. Those who described participating in club sports had a higher proportion of time-loss musculoskeletal injuries (63% versus 29%; P = .002) and of injuries requiring imaging, injection, a cast, a brace, or crutches (72% versus 46%; P = .013) than those who did not. CONCLUSIONS Although no injury-history differences were found among the sport-specialization groups, a higher proportion of club sport athletes than nonclub sport athletes reported a history of injury. Club sports are generally seen as more competitive, and the higher number of injuries seen in this setting could be related to a higher level of play among club sport athletes.
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Affiliation(s)
- Katherine Dahab
- Sports Medicine Center, Children's Hospital Colorado, Aurora.,Department of Orthopaedics, University of Colorado School of Medicine, Aurora
| | - Morgan N Potter
- Department of Orthopaedics, University of Colorado School of Medicine, Aurora
| | - Aaron Provance
- Sports Medicine Center, Children's Hospital Colorado, Aurora.,Department of Orthopaedics, University of Colorado School of Medicine, Aurora
| | - Jay Albright
- Sports Medicine Center, Children's Hospital Colorado, Aurora.,Department of Orthopaedics, University of Colorado School of Medicine, Aurora
| | - David R Howell
- Sports Medicine Center, Children's Hospital Colorado, Aurora.,Department of Orthopaedics, University of Colorado School of Medicine, Aurora
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65
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Bell DR, DiStefano L, Pandya NK, McGuine TA. The Public Health Consequences of Sport Specialization. J Athl Train 2020; 54:1013-1020. [PMID: 31633411 DOI: 10.4085/1062-6050-521-18] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Sport specialization was thought to affect a relatively small number of elite athletes, but it is now a common practice in youth sport culture. Recent research in the field of sport specialization has led to a better understanding of the influence this issue is having on youth (ie, younger than 19 years of age) today. This review focuses on sport specialization from a public health perspective to elucidate the effect that this practice is having within the United States. The specific goals of this review are to describe (1) the prevalence of sport specialization and the factors that may affect the decision to specialize, (2) the costs of youth sport-related injuries in the context of sport specialization, (3) the financial costs that sport specialization has for families, and (4) how sport specialization may be affecting physical literacy.
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Affiliation(s)
- David R Bell
- Department of Kinesiology and Wisconsin Injury in Sport Laboratory, University of Wisconsin-Madison
| | - Lindsay DiStefano
- Department of Kinesiology, University of Connecticut, Storrs.,Department of Orthopaedic Surgery, University of Connecticut School of Medicine, Farmington
| | - Nirav K Pandya
- Department of Orthopedic Surgery, University of California, San Francisco
| | - Timothy A McGuine
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison
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66
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Jayanthi NA, Post EG, Laury TC, Fabricant PD. Health Consequences of Youth Sport Specialization. J Athl Train 2020; 54:1040-1049. [PMID: 31633420 DOI: 10.4085/1062-6050-380-18] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Sport specialization is a training method now commonly used by young athletes who hope to achieve elite-level success. This may be defined as (1) choosing a main sport, (2) quitting all other sports to focus on 1 sport, and (3) year-round training (greater than 8 months per year). A number of sports medicine organizations have published recommendations based on the limited evidence available on this topic. The objective of this article was to perform a narrative review of the currently available evidence and sports medicine organizational recommendations regarding sport specialization and its effects on health to guide athletic trainers and sports medicine providers. To accomplish this goal, we conducted a narrative review of articles and position statements on sport specialization published from 1990 through 2018. Injury, overuse injury, serious overuse injury, and lower extremity injury were likely associated with higher degrees of sport specialization in various populations. Sports medicine organizations in general recommended against sport specialization in young athletes and instead promoted multisport participation for physical and psychological benefits. Few long-term data suggest that sport specialization has negative health-related quality-of-life consequences. Higher degrees of sport specialization likely pose risks of overuse injury; however, the age of specialization at which this risk occurs is not known. Because different populations and sports activities may put children at risk for certain injuries, future researchers should monitor large populations with sport-specific prospective active surveillance.
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Affiliation(s)
- Neeru A Jayanthi
- Emory Sports Medicine Center.,Department of Orthopedics, Department of Family Medicine, Emory University School of Medicine, Atlanta, GA
| | - Eric G Post
- School of Exercise and Nutritional Sciences, San Diego State University, CA
| | | | - Peter D Fabricant
- Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, and Department of Orthopaedic Surgery, Weill Cornell Medical College, New York, NY
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Post EG, Rosenthal MD, Rauh MJ. Attitudes and Beliefs towards Sport Specialization, College Scholarships, and Financial Investment among High School Baseball Parents. Sports (Basel) 2019; 7:sports7120247. [PMID: 31835455 PMCID: PMC6955882 DOI: 10.3390/sports7120247] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/25/2019] [Accepted: 11/29/2019] [Indexed: 12/05/2022] Open
Abstract
Adolescent athletes are increasingly encouraged to specialize in a single sport year-round in an effort to receive a college scholarship. For collegiate baseball, only 11.7 scholarships are available for a 35-player team. The beliefs of the parents of baseball athletes towards sport specialization are unknown, along with whether they have an accurate understanding of college baseball scholarship availability. The parents of high school baseball athletes were recruited to complete an anonymous questionnaire that consisted of (1) parent and child demographics, (2) child baseball participation information, and (3) parent attitudes and beliefs regarding sport specialization and college baseball scholarships. One hundred and fifty-five parents participated in the questionnaire (female: 52.9%, age: 49.4 ± 5.5 years old). The parents spent a median of 3000 USD [Interquartile Range (IQR): 1500–6000] on their child’s baseball participation. Most parents believed that specialization increased their child’s chances of getting better at baseball (N = 121, 79.6%). The parents underestimated the number of college baseball scholarships available per team (median [IQR]: 5 [0–5]), but 55 parents (35.9%) believed it was likely that their child would receive a college baseball scholarship. Despite having a realistic understanding of the limited college scholarships available, the parents were optimistic that their child would receive a baseball scholarship.
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68
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Ryder SC, Gnirke M, Laker SR, Hoffmire C, Comstock RD. Relationship of Overuse Injuries and Extrascholastic Sport Participation in High School Athletes 2009-2010 through 2015-2016. PM R 2019; 12:882-890. [PMID: 31769926 DOI: 10.1002/pmrj.12297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 11/19/2019] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Overuse injuries (injuries due to repetitive loads with inadequate rest) can negatively affect high school athletes, but limited data exist on the effect of sports participation outside of the school-sanctioned season on the development of overuse injuries. OBJECTIVE Compare overuse injury patterns among high school athletes who participate in extrascholastic athletics to those participating only in scholastic sports. DESIGN Descriptive cross-sectional, secondary analysis of injury data collected on high school athletes across 22 sports over the 2009-2010 through 2015-2016 academic years. SETTING Deidentified data collected as part of the High School Reporting Information Online study (HS RIO). PARTICIPANTS High school athletes from a large convenience sample of U.S. high schools. MAIN OUTCOME MEASUREMENTS Injury proportion ratios (IPRs) were computed overall and for individual sports to compare the proportion of overuse injuries in athletes competing in extrascholastic sports to athletes participating only in scholastic athletics. RESULTS Overall, extrascholastic athletes experienced a higher proportion of overuse injuries compared to scholastic-only athletes (IPR = 1.21, 95% confidence interval [CI] 1.13-1.30), but this association varied by sport. Among extrascholastic athletes, a higher proportion of overuse injuries occurred in those simultaneously playing the same sport outside the school setting (IPR = 1.32, 95% CI 1.11-1.57) as well as having experienced an injury within the past year (IPR = 1.63, 95% CI 1.36-1.95) compared to those sustaining non-overuse injuries. CONCLUSIONS Overuse injuries were associated with extrascholastic athletics and occurred in higher proportion in extrascholastic athletes who were playing the same sport in more than one league.
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Affiliation(s)
- Stephanie Cowherd Ryder
- Department of Physical Medicine and Rehabilitation, University of Colorado, School of Medicine, Aurora, CO
| | - Matthew Gnirke
- Department of Physical Medicine and Rehabilitation, University of Colorado, School of Medicine, Aurora, CO
| | - Scott R Laker
- Department of Physical Medicine and Rehabilitation, University of Colorado, School of Medicine, Aurora, CO
| | - Claire Hoffmire
- Department of Veterans Affairs, VISN 19 Rocky Mountain Mental Illness Research, Education and Clinical Care Center (MIRECC), Denver, CO
| | - R Dawn Comstock
- Department of Epidemiology and Pediatric Injury Prevention, Education and Research (PIPER) Program, Colorado School of Public Health, Aurora, CO
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Post EG, Biese KM, Schaefer DA, Watson AM, McGuine TA, Brooks MA, Bell DR. Sport-Specific Associations of Specialization and Sex With Overuse Injury in Youth Athletes. Sports Health 2019; 12:36-42. [PMID: 31724908 DOI: 10.1177/1941738119886855] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Significant evidence has emerged that sport specialization is associated with an increased risk of overuse injury in youth athletes. Several recommendations exist to reduce the risk of overuse injury in youth sports, but the risk of overuse injuries may be dependent on specific movements required by a given sport. HYPOTHESES Associations between specialized sport participation and overuse injury will exist in volleyball athletes but not soccer or basketball athletes. Female athletes will be more likely to report an overuse injury in the previous year, regardless of sport. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS Youth athletes between the ages of 12 and 18 years were recruited in-person at club team tournaments, competitions, and events around the state of Wisconsin during the 2016-2017 school year. Participants were asked to complete an anonymous questionnaire that consisted of (1) participant demographics, (2) sport specialization status, (3) monthly and weekly sport volume, and (4) sport-related injury history in the previous year. RESULTS A total of 716 youth athletes completed the questionnaire (70.8% female; mean age, 14.21 ± 1.50 years; 43.2% basketball, 19.4% soccer, 37.4% volleyball; 41.8% highly specialized; 32.3% reported overuse injury in the previous year). Sex was associated with overuse injury among basketball athletes, with female basketball athletes nearly 4 times more likely to report an overuse injury compared with male basketball athletes (odds ratio, [OR], 3.7; 95% CI, 2.1-6.6; P < 0.001). High specialization (OR, 2.3; 95% CI, 1.1-4.9; P = 0.02) and participating in a single sport for more than 8 months per year (OR, 2.0; 95% CI, 1.1-3.5; P < 0.05) were associated with overuse injury only among volleyball athletes. CONCLUSION Specialization and exceeding 8 months per year in a single sport was associated with overuse injury in volleyball, which is one of the most popular youth sports for female athletes. Specialization was not associated with overuse injury in basketball or soccer athletes. Female basketball athletes were nearly 4 times more likely to report a history of overuse injury compared with male basketball athletes. The sex of a youth athlete and the sport that he or she plays may influence the risk of overuse injury associated with sport specialization. CLINICAL RELEVANCE Youth athletes, parents, and clinicians should be aware that the potential risks of specialization might vary based on the athlete's sport and sex.
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Affiliation(s)
- Eric G Post
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California
| | - Kevin M Biese
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Daniel A Schaefer
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Andrew M Watson
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
| | - Timothy A McGuine
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
| | - M Alison Brooks
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
| | - David R Bell
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
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Abstract
Participation in youth soccer in the United States continues to increase steadily, with a greater percentage of preadolescent participants than perhaps any other youth sport. Despite the wide-ranging health benefits of participation in organized sports, injuries occur and represent a threat to the health and performance of young athletes. Youth soccer has a greater reported injury rate than many other contact sports, and recent studies suggest that injury rates are increasing. Large increases in the incidence of concussions in youth soccer have been reported, and anterior cruciate ligament injuries remain a significant problem in this sport, particularly among female athletes. Considerable new research has identified a number of modifiable risk factors for lower-extremity injuries and concussion, and several prevention programs have been identified to reduce the risk of injury. Rule enforcement and fair play also serve an important role in reducing the risk of injury among youth soccer participants. This report provides an updated review of the relevant literature as well as recommendations to promote the safe participation of children and adolescents in soccer.
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Affiliation(s)
- Andrew Watson
- Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; and
| | - Jeffrey M Mjaanes
- Department of Orthopedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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71
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DiSanti JS, Post EG, Bell DR, Schaefer DA, Brooks MA, McGuine TA, Erickson K. Exploring Coaches' Perceptions of Youth Sport Specialization: A Comparison of High School and Club Sport Contexts. J Athl Train 2019; 54:1055-1060. [PMID: 31633416 PMCID: PMC6805062 DOI: 10.4085/1062-6050-409-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
CONTEXT Previous researchers have identified sport specialization as being associated with various negative outcomes (eg, overuse injuries and adverse psychosocial outcomes). However, little is known regarding how the underlying attitudes, beliefs, and values of sport stakeholders may be shaping this trend. OBJECTIVE To examine the perceptions of coaches in the high school versus club sport setting and compare their attitudes and behaviors toward sport specialization. DESIGN Cross-sectional survey. PATIENTS OR OTHER PARTICIPANTS A total of 769 coaches (497 high school coaches, 272 club sport coaches). MAIN OUTCOME MEASURE(S) Participants completed a novel measure that surveyed their perceptions regarding various aspects of youth sport specialization. Additionally, each coach completed a questionnaire detailing his or her relevant demographic and sport background information. RESULTS High school coaches and club sport coaches differed in their perceptions of sport specialization (t767 = 1.41, P < .001); club coaches (2.43 ± 0.25) were more likely than high school coaches (2.31 ± 0.21) to rate specialization as a positive, adaptive practice. The multiple linear regression equations for both the high school and club coaches indicated that no educational, experiential, or demographic factors predicted coaches' perceptions of specialization (P values > .05). CONCLUSIONS Club sport coaches were more likely to possess attitudes in favor of sport specialization. Additionally, coaches' background characteristics did not predict their perceptions of specialization, suggesting that the competitive context itself (high school versus club) may be the most salient influencer of these perceptions. Athletes and sports medicine practitioners should be aware of the heightened expectation of specialized participation and resulting increased injury risk in these contexts. Pediatric sport researchers and practitioners should continue to explore how these different group perceptions manifest in participation behaviors and may link to overall athlete health, wellbeing, and development.
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Affiliation(s)
- Justin S. DiSanti
- Department of Kinesiology, College of Education, Michigan State University, East Lansing
| | - Eric G. Post
- School of Exercise and Nutritional Sciences, San Diego State University, CA
| | - David R. Bell
- Departments of Kinesiology, University of Wisconsin–Madison
- Orthopedics and Rehabilitation, University of Wisconsin–Madison
| | | | | | | | - Karl Erickson
- Department of Kinesiology, College of Education, Michigan State University, East Lansing
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72
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Brenner JS, LaBotz M, Sugimoto D, Stracciolini A. The Psychosocial Implications of Sport Specialization in Pediatric Athletes. J Athl Train 2019; 54:1021-1029. [PMID: 31532693 PMCID: PMC6805069 DOI: 10.4085/1062-6050-394-18] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Data on the psychosocial implications of sport specialization in pediatric athletes are lacking. Sport specialization often requires increased training hours and may predispose young athletes to social isolation, poor academic performance, increased anxiety, greater stress, inadequate sleep, decreased family time, and burnout. Sport specialization frequently introduces multiple stressors that could be expected to adversely affect mental health and function in young athletes and may increase the risk for burnout. This may be confounded by altered sleep duration and quality, increased drive for elite status, and perfectionistic personality types. The signs and symptoms of burnout in young athletes can be difficult to detect. It is important to be aware of the possible diagnosis of burnout in young athletes who display vague symptoms and a decrease in academic performance. The purpose of this review was to survey the available literature on sport specialization in young athletes and its association with mental health, sleep, the drive for success in sport, and burnout.
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Affiliation(s)
- Joel S. Brenner
- Sports Medicine Program, Children's Hospital of The King's Daughters, Norfolk, VA
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk
- Division of Sports Medicine, Children's Specialty Group, PLLC, Norfolk, VA
| | - Michele LaBotz
- InterMed P.A., Portland, ME
- Tufts University School of Medicine, Boston, MA
| | - Dai Sugimoto
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, MA
- The Micheli Center for Sports Injury Prevention, Waltham, MA
- Harvard Medical School, Boston, MA
| | - Andrea Stracciolini
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, MA
- The Micheli Center for Sports Injury Prevention, Waltham, MA
- Harvard Medical School, Boston, MA
- Department of Medicine, Division of Emergency Medicine, Boston Children's Hospital, MA
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73
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Relationships Between Sport Specialization, Sleep, and Subjective Well-Being in Female Adolescent Athletes. Clin J Sport Med 2019; 29:384-390. [PMID: 31460952 DOI: 10.1097/jsm.0000000000000631] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the relationship between sport specialization, sleep, and subjective well-being in female youth soccer players. DESIGN Prospective cohort study. SETTING Community soccer organization. METHODS During a 4-month season, 52 female youth soccer players (aged 13-18 years) reported daily training load (TL) and every morning recorded sleep duration and stress, mood, fatigue, soreness, and sleep quality from -3 (worst) to +3 (best). As all the athletes participate in soccer as their primary sport for over 8 months of the year, players were considered specialized if they participated in soccer exclusively and had previously quit another sport to focus on soccer. Least-square mean values from linear mixed effects models were used to compare TL, subjective well-being, and sleep while adjusting for individual repeated measures. RESULTS Daily TL during the season did not differ between specialized and nonspecialized athletes (412 ± 24 vs 415 ± 19 arbitrary units, P = 0.96, respectively). Despite similar nightly sleep duration (8.10 ± 0.14 vs 8.25 ± 0.11 hours, P = 0.42), specialized athletes were found to have lower (worse) fatigue (1.02 ± 0.14 vs 1.50 ± 0.11, P = 0.010), soreness (0.66 ± 0.18 vs 1.23 ± 0.14, P = 0.013), mood (1.32 ± 0.12 vs 1.72 ± 0.10, P = 0.013), and sleep quality (1.07 ± 0.13 vs 1.42 ± 0.10, P = 0.035) than the nonspecialized group. Although stress was lower (worse) among the specialized athletes, the difference was not statistically significant (0.97 ± 0.16 vs 1.32 ± 0.13, P = 0.092). CONCLUSIONS Among female youth soccer players, sport specialization was associated with impairments in subjective well-being and sleep quality. Additional research is necessary to determine whether this relationship is causal or if factors that influence sport specialization also influence sleep and subjective well-being.
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74
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Sugimoto D, Borg DR, Brilliant AN, Meehan WP, Micheli LJ, Geminiani ET. Effect of Sports and Growth on Hamstrings and Quadriceps Development in Young Female Athletes: Cross-Sectional Study. Sports (Basel) 2019; 7:sports7070158. [PMID: 31261679 PMCID: PMC6680738 DOI: 10.3390/sports7070158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/23/2019] [Accepted: 06/25/2019] [Indexed: 11/17/2022] Open
Abstract
Context: Lower extremity muscular strength may vary by different sport participation during growth process. Objective: To investigate effect of sport participation and growth by comparing strength of the hamstrings, quadriceps, and hamstrings to quadriceps strength ratio (H:Q ratio) between young female figure skaters and soccer players. Design: Cross-sectional. Settings: Laboratory affiliated with regional sports medicine center. Participants: pediatric and adolescent female athletes. Procedures: Isometric hamstrings and quadriceps strength were measured. Main Outcome Measures: Strength of the hamstrings, quadriceps, and hamstrings to quadriceps strength ratio (H:Q ratio). Statistical Analysis: Effect of sport participation and growth was analyzed through a two-way (two sports: figure skaters and soccer players; three age groups: <12 years, 13–16 years, and >17 years) analysis of covariance. Results: Hamstrings strength was significantly greater in figure skaters than soccer players. Also, hamstring strength of 13–16 years and >17 years was higher compared to <12 years. Additionally, significantly higher H:Q ratio in figure skaters compared to soccer players. Conclusions: There is effect of growth on hamstrings strength among 13–16 years and >17 years compared to <12 years. Figure skaters showed greater hamstrings strength and H:Q ratio than female soccer players.
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Affiliation(s)
- Dai Sugimoto
- The Micheli Center-for Sports Injury Prevention, Waltham, MA 02453, USA.
- Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA 02453, USA.
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA 02453, USA.
| | - Dennis R Borg
- The Micheli Center-for Sports Injury Prevention, Waltham, MA 02453, USA
- Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA 02453, USA
| | - Anna N Brilliant
- The Micheli Center-for Sports Injury Prevention, Waltham, MA 02453, USA
- Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA 02453, USA
| | - William P Meehan
- The Micheli Center-for Sports Injury Prevention, Waltham, MA 02453, USA
- Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA 02453, USA
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA 02453, USA
| | - Lyle J Micheli
- The Micheli Center-for Sports Injury Prevention, Waltham, MA 02453, USA
- Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA 02453, USA
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA 02453, USA
| | - Ellen T Geminiani
- The Micheli Center-for Sports Injury Prevention, Waltham, MA 02453, USA
- Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, MA 02453, USA
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA 02453, USA
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DiSanti JS, Erickson K. Youth sport specialization: a multidisciplinary scoping systematic review. J Sports Sci 2019; 37:2094-2105. [PMID: 31135271 DOI: 10.1080/02640414.2019.1621476] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Despite continued interest in youth sport participation, the consensus among researchers is that a thorough understanding of the phenomenon of youth sport specialization is still lacking. The popular and scholarly narratives regarding sport specialization challenge the adaptive nature of this practice. However, the lack of synthesis of youth sport specialization research makes existing practical recommendations potentially tenuous. This scoping review utilized a multidisciplinary lens to survey and integrate the full spectrum of youth sport specialization research by summarizing empirical findings and examining the characteristics of empirical research (e.g., field of publication, participant role, study design). Multiple databases were utilized to span the various disciplines in which sport specialization has been studied. The systematic review protocol yielded 906 publications for screening. After analysis of these records through inclusion/exclusion criteria, 40 empirical research publications examining youth sport specialization were included in this review. Analysis of these empirical findings indicated two higher-order emerging themes of this research: 1) Sport specialization participation behaviours; 2) Sport specialization outcomes. Descriptive results of the research characteristics are also explored. This review examined key findings that underlie recommendations for structuring youth sport participation, and highlighted future research avenues vital towards a more holistic understanding of this phenomenon.
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Affiliation(s)
- Justin S DiSanti
- a Department of Kinesiology, College of Education , Michigan State University , East Lansing , MI , USA
| | - Karl Erickson
- a Department of Kinesiology, College of Education , Michigan State University , East Lansing , MI , USA
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Patel NM, Mundluru SN, Beck NA, Ganley TJ. Which Factors Increase the Risk of Reoperation After Meniscal Surgery in Children? Orthop J Sports Med 2019; 7:2325967119842885. [PMID: 31080841 PMCID: PMC6498778 DOI: 10.1177/2325967119842885] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Meniscal injuries in children can pose treatment challenges, as the meniscus must maintain its biomechanical function over a long lifetime while withstanding a high activity level. While the adult literature contains a plethora of studies regarding risk factors for failure of meniscal surgery, such reports are scarcer in children. Purpose: To determine the rate at which children undergoing meniscal surgery require subsequent reoperation as well as to define risk factors for reoperation in this population. Study Design: Case-control study; Level of evidence, 3. Methods: A retrospective institutional database of 907 first-time meniscal surgical procedures performed between 2000 and 2015 was reviewed. All patients were <18 years old. Demographic and intraoperative information was recorded, as were concurrent injuries or operations and subsequent procedures. Univariate analysis consisted of chi-square and independent-samples t tests. Multivariate logistic regression with purposeful selection was then performed to adjust for confounding factors. Results: The mean ± SD patient age was 13.2 ± 2.1 years, and 567 (63%) were male. The mean postoperative follow-up duration was 20.1 ± 10.1 months. Overall, 83 patients (9%) required repeat surgery at a mean of 23.2 months after the index operation. After adjustment for confounders in a multivariate model, meniscal repair resulted in 3.1-times higher odds of reoperation when compared with meniscectomy (95% CI, 1.2-8.3; P = .02), while white-white zone tears had 2.8-times lower odds of reoperation (95% CI, 1.01-7.7; P = .04) versus red-red and red-white zone tears. Conclusion: Approximately 9% of children undergoing meniscal surgery will require reoperation at a mean 23.2 months after the index operation. Repair carried approximately 3-times higher odds of reoperation than meniscectomy, while white-white zone tears had nearly 3-times lower odds of requiring repeat surgery when compared with tears in other zones.
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Affiliation(s)
- Neeraj M. Patel
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USA
| | - Surya N. Mundluru
- University of Texas Health Science Center at Houston, Houston, Texas, USA
| | | | - Theodore J. Ganley
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Theodore J. Ganley, MD, Division of Orthopaedic Surgery, Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA ()
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77
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Sugimoto D, Jackson SS, Howell DR, Meehan WP, Stracciolini A. Association between training volume and lower extremity overuse injuries in young female athletes: implications for early sports specialization. PHYSICIAN SPORTSMED 2019; 47:199-204. [PMID: 30403911 DOI: 10.1080/00913847.2018.1546107] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Recent studies indicated greater risk of overuse injuries among young female athletes than their male counterparts. However, few studies have focused on female athletes and the effect of single-sport participation on lower extremity overuse injuries. OBJECTIVE The objective of this study is to identify an independent risk variable for lower extremity overuse injuries based on status of sport participations (single- and multisports) in young female athletes. METHODS In this cross-sectional study, 12-18-year-old female athletes were asked to complete electronic questionnaires describing their current sport participation and previous injury history. Range of motion (ROM), muscular strength, and performance parameters were measured at the time of completion of electronic questionnaires. Potential risk variables were compared between single- and multisport athletes and entered into a logistic regression model. Adjusted odds ratio (aOR), 95% confidence intervals (95% CIs), and p values were recorded to find an association with increased likelihood of lower extremity overuse injuries. RESULTS The study cohort comprised 236 female young athletes (single-sport athletes: N = 60, multisport athletes: N = 176). A few variables including age, BMI, weekly hours of training for a sport, knee ROM, ankle ROM, and knee extensor strength were identified as potential risk variables. A logistic regression analysis showed an independent association between increased weekly hours of training for a sport and greater likelihood of histories of lower extremity overuse injuries (aOR = 1.091, 95% CIs: 1.007-1.183, p = .034). CONCLUSION Although status of single- or multisports participation was not a significant risk variable, increased training volume was found to be an independent contributing factor for greater likelihood of lower extremity overuse injury histories in 12-18 years female athletes. The current study identified that single-sport athletes trained nearly twice as many hours per week when compared to multisport athletes, which may explain an underlying mechanism of sports specialization.
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Affiliation(s)
- Dai Sugimoto
- a The Micheli Center for Sports Injury Prevention , Waltham , MA , USA.,b Division of Sports Medicine, Department of Orthopaedics , Boston Children's Hospital , Boston , MA , USA.,c Department of Orthopaedic Surgery , Harvard Medical School , Boston , MA , USA
| | - Sarah S Jackson
- a The Micheli Center for Sports Injury Prevention , Waltham , MA , USA.,b Division of Sports Medicine, Department of Orthopaedics , Boston Children's Hospital , Boston , MA , USA.,c Department of Orthopaedic Surgery , Harvard Medical School , Boston , MA , USA
| | - David R Howell
- a The Micheli Center for Sports Injury Prevention , Waltham , MA , USA.,d Department of Orthopaedics, School of Medicine , University of Colorado , Aurora , CO , USA.,e Sports Medicine Center , Children's Hospital Colorado , Aurora , CO , USA
| | - William P Meehan
- a The Micheli Center for Sports Injury Prevention , Waltham , MA , USA.,b Division of Sports Medicine, Department of Orthopaedics , Boston Children's Hospital , Boston , MA , USA.,c Department of Orthopaedic Surgery , Harvard Medical School , Boston , MA , USA
| | - Andrea Stracciolini
- a The Micheli Center for Sports Injury Prevention , Waltham , MA , USA.,b Division of Sports Medicine, Department of Orthopaedics , Boston Children's Hospital , Boston , MA , USA.,c Department of Orthopaedic Surgery , Harvard Medical School , Boston , MA , USA
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78
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Post EG, Schaefer DA, Biese KM, Watson AM, McGuine TA, Brooks MA, Bell DR. A Comparison of Team Sport Volume Surveyed Between High School and Club Sport Coaches. Orthop J Sports Med 2019; 7:2325967119836484. [PMID: 31001566 PMCID: PMC6454658 DOI: 10.1177/2325967119836484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Club sport participation is increasingly common among high school athletes. Sport participation characteristics may vary widely between the high school and club sport settings. However, there have been no large-scale comparisons of sport participation volume between high school and club teams from similar sports. PURPOSE/HYPOTHESIS The purpose of this study was to compare the sport participation characteristics of high school and high school-aged club teams. We hypothesized that club team athletes would participate in more months per year and hours per week and would take more overnight trips than high school athletes and that club team coaches would be less likely to track their athletes' sport volume than high school coaches. STUDY DESIGN Cross-sectional study. METHODS A total of 769 coaches (266 female; 34.6%) from 3 sports (basketball, volleyball, soccer) completed an anonymous online questionnaire regarding their team's sport volume and their knowledge, attitudes, and beliefs regarding sport specialization. Coaches were eligible to participate if they had served as the head or assistant coach of a high school sport team or high school-aged club sport team in the past 12 months. RESULTS Overall, 64.6% (n = 497) were coaches of a high school team, and 35.4% (n = 272) were coaches of a club team with high school-aged athletes. Club coaches' teams played more months out of the year and took more overnight trips for competitions than high school coaches' teams but participated in fewer hours per week of practices or competitions during their season. There were no differences between club and high school coaches in tracking their athletes' sport volume, with most coaches in both settings reporting that they do not track the amount of time that their athletes participate in other sports. CONCLUSION Significant differences in sport participation volume exist between the teams of high school and club coaches.
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Affiliation(s)
- Eric G. Post
- School of Exercise and Nutritional Sciences, San Diego State
University, San Diego, California, USA
| | - Daniel A. Schaefer
- Department of Kinesiology, University of Wisconsin–Madison, Madison,
Wisconsin, USA
| | - Kevin M. Biese
- Department of Kinesiology, University of Wisconsin–Madison, Madison,
Wisconsin, USA
| | - Andrew M. Watson
- Department of Orthopedics and Rehabilitation, University of
Wisconsin–Madison, Madison, Wisconsin, USA
| | - Timothy A. McGuine
- Department of Orthopedics and Rehabilitation, University of
Wisconsin–Madison, Madison, Wisconsin, USA
| | - M. Alison Brooks
- Department of Orthopedics and Rehabilitation, University of
Wisconsin–Madison, Madison, Wisconsin, USA
| | - David R. Bell
- Department of Kinesiology, University of Wisconsin–Madison, Madison,
Wisconsin, USA
- Department of Orthopedics and Rehabilitation, University of
Wisconsin–Madison, Madison, Wisconsin, USA
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McLeod TV, Israel M, Christino MA, Chung JS, McKay SD, Lang PJ, Bell DR, Chan CM, Crepeau A, Davis E, Fletcher AL, Laniak J, McCaffrey K, Pacicca D, Riederer M, Rizzone K, Rush JK, Zaslow T. Sport Participation and Specialization Characteristics Among Pediatric Soccer Athletes. Orthop J Sports Med 2019; 7:2325967119832399. [PMID: 30944839 PMCID: PMC6437330 DOI: 10.1177/2325967119832399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Soccer is an increasingly popular sport for children and adolescents in the United States. Little is known about participation patterns related to sport specialization. Purpose: To investigate soccer participation levels and sport specialization characteristics among youth soccer athletes. Study Design: Cross-sectional study. Methods: Adolescent athletes aged between 12 and 18 years completed an online survey addressing participant demographics, sports and soccer participation history, and level of specialization. Descriptive analyses characterized participation, while chi-square and Kruskal-Wallis tests assessed the influence of specialization, sex, and grade on survey variables. Results: Overall, 83.7% of 746 respondents participated in an organized soccer league outside of school, and 37% played in multiple leagues concurrently. Nearly three-quarters of respondents trained in soccer more than 8 months of the year, with those who participated in club soccer being more likely to train more than 8 months of the year. More respondents were classified as high specialization (37.5%), followed by moderate (35.6%) and low (28.6%) specialization. No differences between sexes were noted for level of specialization or quitting other sports to specialize in soccer, but male athletes were more likely to train more than 8 months per year compared with female athletes. Respondents in older grades (9th-10th and 11th-12th grades) were more likely to be highly specialized and quit other sports to focus on soccer. No differences between grade levels were found among respondents training more than 8 months per year. Conclusion: The study findings suggest that many youth soccer athletes participated in multiple teams or leagues at the same time and trained more than 8 months of the year. Characteristics including participation on a club team, level of specialization, and male sex were associated with a greater likelihood of exceeding the 8-month training recommendation.
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Affiliation(s)
| | - Michael Israel
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Melissa A Christino
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jane S Chung
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Scott D McKay
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Pamela J Lang
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - David R Bell
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Charles M Chan
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Allison Crepeau
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Elizabeth Davis
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Amanda L Fletcher
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jessica Laniak
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kelsie McCaffrey
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Donna Pacicca
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Mark Riederer
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Katherine Rizzone
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jeremy K Rush
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Tracy Zaslow
- Investigation performed at the University of Wisconsin-Madison, Madison, Wisconsin, USA
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80
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Bult HJ, Barendrecht M, Tak IJR. Injury Risk and Injury Burden Are Related to Age Group and Peak Height Velocity Among Talented Male Youth Soccer Players. Orthop J Sports Med 2018; 6:2325967118811042. [PMID: 30560140 PMCID: PMC6293374 DOI: 10.1177/2325967118811042] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The relationship between injury risk (IR) in age groups and periods around
peak height velocity (PHV) remains unclear. PHV is defined as the moment of
the largest increase in body height. Purpose: To investigate injury risk and injury burden as functions of growth velocity
(periods around PHV) and chronological age groupings (under 12 years [U12]
to U19) in talented youth male soccer players. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 170 players from the youth academy of a Dutch soccer club (highest
professional league: Eredivisie) were observed for 1 to 3 seasons. Injuries,
exposure, PHV age, and chronological age were registered. The injury
incidence density (IID) and injury burden per 1000 hours of soccer
participation, with 95% CIs, were calculated for 5 PHV periods and 7 age
groups. These were compared with the overall cohort results using incidence
ratios (IRs) and burden ratios (BRs) with 95% CIs. Results: The mean age at PHV was 14.4 ± 0.65 years (range, 12.8-16.5 years). The mean
IID for the total cohort was 8.34 injuries per 1000 hours (95% CI,
7.71-9.02). Compared with the overall mean, a significantly higher IID was
found for PHV period 4+5 (IR, 1.31 [95% CI, 1.00-1.71]; P =
.049) and for the U15 group (IR, 1.49 [95% CI, 1.24-1.79];
P < .001). The overall injury burden was 58.37
injury days per 1000 hours (95% CI, 56.66-60.13). In PHV period 4+5, the
injury burden was significantly higher (BR, 1.53 [95% CI, 1.39-1.68];
P < .001) when compared with the overall mean. Also,
compared with the overall mean, the injury burden was higher in the U16 (BR,
1.48 [95% CI, 1.39-1.58]; P < .001), U15 (BR, 1.28 [95%
CI, 1.19-1.38]; P < .001), and U17 groups (BR, 1.21 [95%
CI, 1.13-1.31]; P < .001). Conclusion: Talented young soccer players were more prone to injuries during the 6 months
after PHV (31% above overall mean) as well as in the U15 group (49% above
overall mean). Based on the higher injury burden in the U16 (48%), U15
(28%), and U17 (21%) groups, we suggest that research on injury risk factors
and preventive measures should primarily target these age groups. Additional
interventions based on PHV may be of limited value from a screening
perspective. Further research is needed on the interaction between age
groups and PHV periods.
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Affiliation(s)
- Hans Jan Bult
- Dutch Institute of Allied Health Care, Amersfoort, the
Netherlands
- Hans Jan Bult, MSc, Dutch Institute of Allied Health Care,
Berkenweg 7, PO Box 1161, 3800 BD Amersfoort, the Netherlands (
) (Twitter: @hans_bult)
| | | | - Igor Joeri Ramon Tak
- Physiotherapy Utrecht Oost, Utrecht, the Netherlands
- Academic Center for Evidence-Based Sports Medicine, Amsterdam, the
Netherlands
- Amsterdam Collaboration on Health & Safety in Sports, Amsterdam,
the Netherlands
- AMC/VUmc IOC Research Center, Amsterdam, the Netherlands
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81
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Bell DR, Lang PJ, Valovich McLeod TC, McCaffrey KA, Zaslow TL, McKay SD. Sport Specialization Is Associated With Injury History in Youth Soccer Athletes. ACTA ACUST UNITED AC 2018. [DOI: 10.3928/19425864-20180813-01] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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82
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Bell DR, Post EG, Biese K, Bay C, Valovich McLeod T. Sport Specialization and Risk of Overuse Injuries: A Systematic Review With Meta-analysis. Pediatrics 2018; 142:peds.2018-0657. [PMID: 30135085 DOI: 10.1542/peds.2018-0657] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2018] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Sport specialization is theorized to increase the risk of sustaining overuse musculoskeletal injuries. OBJECTIVE To complete a systematic review and meta-analysis of the literature to determine if sport specialization is associated with overuse musculoskeletal injuries. DATA SOURCES An electronic search was conducted using the search terms "specialization," "year-round," "overuse," "repetitive stress," "injury," "young," "pediatric," and "sports." STUDY SELECTION Studies were included if their population was ≤18 years of age, if they compared athletes with high or single-sport specialization with athletes with low or multisport specialization, and focused on overuse injuries. DATA EXTRACTION Of the 12 articles that were identified for full-text review, 5 studies met all the inclusion criteria. Four studies provided adequate data for the meta-analysis. Quality scores on the modified Downs and Black scale ranged from 69% to 81%. RESULTS Athletes with high specialization were at an increased risk of sustaining an overuse injury compared with athletes with low (pooled relative risk [RR] ratio: 1.81; 95% confidence interval [CI]: 1.26-2.60) and moderate (pooled RR: 1.18; 95% CI: 1.05-1.33) specialization. Athletes with moderate specialization were at a higher risk of injury compared with athletes with low specialization (RR: 1.39 [95% CI: 1.04-1.87]). LIMITATIONS Four of the 5 studies included in this systematic review were included in the meta-analysis because of the lack of access to the original data set for 1 article. CONCLUSIONS Sport specialization is associated with an increased risk of overuse musculoskeletal injuries (Strength of Recommendation Taxonomy grade: B).
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Affiliation(s)
- David R Bell
- Wisconsin Injury in Sport Laboratory and .,Departments of Kinesiology and.,Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin; and
| | - Eric G Post
- Wisconsin Injury in Sport Laboratory and.,Departments of Kinesiology and
| | - Kevin Biese
- Wisconsin Injury in Sport Laboratory and.,Departments of Kinesiology and
| | - Curtis Bay
- Athletic Training Department, A.T. Still University, Mesa, Arizona
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83
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Goodman AD, DeFroda SF, Gil JA, Kleiner JE, Li NY, Owens BD. Season-Ending Shoulder Injuries in the National Collegiate Athletic Association: Data From the NCAA Injury Surveillance Program, 2009-2010 Through 2013-2014. Am J Sports Med 2018; 46:1936-1942. [PMID: 29791182 DOI: 10.1177/0363546518773062] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Examination of the incidence of shoulder season-ending injury (SEI) in the collegiate athlete population is limited. PURPOSE To determine the incidence of shoulder SEI in the National Collegiate Athletic Association (NCAA) and to investigate the risk factors for a shoulder injury ending an athlete's season. STUDY DESIGN Descriptive epidemiology study. METHODS All shoulder injuries from the NCAA Injury Surveillance Program database for the years 2009-2010 to 2013-2014 were extracted, and SEI status was noted. The incidences of SEI and non-SEI were calculated for athlete, activity, and injury characteristics and compared via univariable analysis and risk ratios to determine risk factors for an injury being season ending. RESULTS Shoulder injuries were season ending in 4.3% of cases. The overall incidence of shoulder SEI was 0.31 per 10,000 athlete exposures (AEs), as opposed to 7.25 per 10,000 AEs for all shoulder injuries. Shoulder instability constituted 49.1% of SEI, with an incidence of 0.15 per 10,000 AEs, while fractures had the highest rate of being season ending (41.9%). Men's wrestling had the highest incidence of shoulder SEI (1.65 per 10,000 AEs), while men's soccer had the highest proportion of shoulder injuries that ended a season (14.6%). Overall, men had a 6.3-fold higher incidence of SEI than women and a 2.4-fold increased likelihood that an injury would be season ending. CONCLUSION Injury to the shoulder of an NCAA athlete, while somewhat infrequent, can have significant implications on time lost from play. Incidence of these injuries varies widely by sport and injury, with a number of associated risk factors. Athletes sustaining potentially season-ending shoulder injuries, with their coaches and medical providers, may benefit from these data to best manage expectations and outcomes.
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Affiliation(s)
- Avi D Goodman
- Department of Orthopaedics, Warren Alpert Medical School of Brown University / Rhode Island Hospital, Providence, Rhode Island, USA
| | - Steven F DeFroda
- Department of Orthopaedics, Warren Alpert Medical School of Brown University / Rhode Island Hospital, Providence, Rhode Island, USA
| | - Joseph A Gil
- Department of Orthopaedics, Warren Alpert Medical School of Brown University / Rhode Island Hospital, Providence, Rhode Island, USA
| | - Justin E Kleiner
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Neill Y Li
- Department of Orthopaedics, Warren Alpert Medical School of Brown University / Rhode Island Hospital, Providence, Rhode Island, USA
| | - Brett D Owens
- Department of Orthopaedics, Warren Alpert Medical School of Brown University / Rhode Island Hospital, Providence, Rhode Island, USA
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84
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Brooks MA, Post EG, Trigsted SM, Schaefer DA, Wichman DM, Watson AM, McGuine TA, Bell DR. Knowledge, Attitudes, and Beliefs of Youth Club Athletes Toward Sport Specialization and Sport Participation. Orthop J Sports Med 2018; 6:2325967118769836. [PMID: 29770341 PMCID: PMC5946645 DOI: 10.1177/2325967118769836] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: There are a variety of proposed motivations for sport specialization, such as improving sport skills to an elite level, making all-star or travel teams, or receiving a scholarship or professional contract. However, there has not been a quantitative examination of the attitudes and beliefs that may be contributing to the trend of sport specialization and year-round sport participation. Purpose: The primary aim was to describe the attitudes and beliefs of youth club sport athletes regarding sport specialization and sport participation. A secondary objective was to investigate whether an association exists between the level of sport specialization and the belief in receiving a college scholarship. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 974 youth athletes (578 female; mean age, 14.2 ± 1.6 years) completed an anonymous questionnaire that focused on attitudes and beliefs toward sport specialization and sport participation. Questions were developed utilizing the feedback of a panel of content area experts and the University of Wisconsin Survey Center. Data were summarized using frequencies, proportions (%), and means ± SDs. Results: Fewer than half of all athletes (45.8%) believed that specialization increased their chances of getting injured either “quite a bit” or “a great deal.” However, 91% of athletes believed that specialization increased their chances of getting better at their sport either “quite a bit” or “a great deal.” Similarly, the majority of athletes believed that specialization increased their chances of making their high school team (80.9%) or a college team (66.9%) either “quite a bit” or “a great deal.” Overall, 15.7% of athletes believed that they were either “very” or “extremely” likely to receive a college scholarship based on athletic performance. Highly specialized athletes were nearly twice as likely to have a high belief in receiving a college scholarship compared with low-specialization athletes (20.2% vs 10.2%, respectively; χ2 = 18.8; P = .001). Conclusion: Most youth athletes in this study believe that specialization increases their sport performance and ability to make not only a college team but also their high school team. Highly specialized athletes were more likely to believe that they will receive a college scholarship.
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Affiliation(s)
- M. Alison Brooks
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA
- M. Alison Brooks, MD, MPH, University of Wisconsin–Madison, 1685 Highland Avenue, Madison, WI 53705, USA () (Twitter: DrABrooksUWisc)
| | - Eric G. Post
- Department of Kinesiology, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Wisconsin Injury in Sport Laboratory, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Stephanie M. Trigsted
- Department of Athletic Training, High Point University, High Point, North Carolina, USA
| | - Daniel A. Schaefer
- Department of Kinesiology, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Wisconsin Injury in Sport Laboratory, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Daniel M. Wichman
- Wisconsin Injury in Sport Laboratory, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Andrew M. Watson
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Timothy A. McGuine
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - David R. Bell
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Department of Kinesiology, University of Wisconsin–Madison, Madison, Wisconsin, USA
- Wisconsin Injury in Sport Laboratory, University of Wisconsin–Madison, Madison, Wisconsin, USA
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DePhillipo NN, Cinque ME, Kennedy NI, Chahla J, Moatshe G, LaPrade RF. PATELLOFEMORAL CHONDRAL DEFECT IN A PREADOLESCENT SKIER: A CASE REPORT IN EARLY SPORT SPECIALIZATION. Int J Sports Phys Ther 2018; 13:131-136. [PMID: 29484250 PMCID: PMC5808009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND AND PURPOSE Early sport specialization (ESS) refers to intense training year round in a specific sport starting at a young age with no or limited participation in other sports. This approach to training is highly controversial; recent literature suggests that this type of specialized training could be a contributing source to overuse injuries in youth athletes. The purpose of this case report was to describe a patellofemoral articular cartilage defect of the knee in a preadolescent skier due to overuse and repetitive microtrauma as a result of ESS. STUDY DESIGN Case Report. CASE DESCRIPTION A healthy 11-year-old male competitive alpine skier presented with recurrent swelling of his right knee and persistent anterior knee pain while skiing without evidence of any specific history of injury or traumatic event. The patient failed a conservative treatment regimen including rest and formal physical therapy focused on generalized knee strengthening. Magnetic resonance imaging was ordered and revealed an articular cartilage defect of the medial patellar facet. The patient was treated with an arthroscopic debridement of his articular cartilage defect. OUTCOME At 12 weeks postoperatively, the patient presented with a normalized gait pattern, no evidence of knee effusion, full knee range of motion and patellar mobility symmetric to his contralateral limb, and no patellar crepitation or painful palpation on physical exam. The patient was released to begin return to sport progression at 12 weeks, and was cleared for full activities/returned to competitive skiing at 15 weeks postoperatively. At 16 weeks postoperatively, he won an international alpine ski race in Europe for his age group. DISCUSSION Cartilage injuries and osteochondral defects are very common in adolescent athletes and often go undiagnosed. Allied healthcare professionals must be educated on the known causes of recurrent knee effusions and how early sport specialization may result in overuse injuries to knee joint cartilage. LEVEL OF EVIDENCE 4.
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