Over the past 15 years, there has been an increase in youth sports participation with a concomitant increase in early year-round training in a single sport. Many factors contribute to the desire of ...parents and coaches to encourage early single sport specialization, including the desire to give the young athlete an edge in competition, pursuit of scholarships, and potential professional status, and the ability to label a young athlete as elite at an early age. Despite these perceived advantages, some data suggest that early sport specialization does not lead to a competitive advantage over athletes who participate in multiple sports. Although the data are limited, there is some evidence that early sport specialization may put the young athlete at risk for overuse injuries. The focus of this review is to highlight the evidence regarding early sport specialization and risk for injury; discuss the risk factors for overuse injury in high-risk sports including ice hockey, swimming, gymnastics, and baseball; and discuss future potential research that would help define the risk of injury for young athletes who participate in early sport specialization.
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.
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.
Background:
Intensive sport participation in childhood and adolescence is an established cause of acute and overuse injury. Interventions and programs designed to prevent such injuries are important ...in reducing individual and societal costs associated with treatment and recovery. Likewise, they help to maintain the accrual of positive outcomes from participation, such as cardiovascular health and skill development. To date, several studies have individually tested the effectiveness of injury prevention programs (IPPs).
Purpose:
To determine the overall efficacy of structured multifaceted IPPs containing a combination of warm-up, neuromuscular strength, or proprioception training, targeting injury reduction rates according to risk exposure time in adolescent team sport contexts.
Study Design:
Systematic review and meta-analysis.
Methods:
With established inclusion criteria, studies were searched in the following databases: Cochrane Central Register of Controlled Trials, MEDLINE, SPORTDiscus, Web of Science, EMBASE, CINAHL, and AusSportMed. The keyword search terms (including derivations) included the following: adolescents, sports, athletic injuries, prevention/warm-up programs. Eligible studies were then pooled for meta-analysis with an invariance random-effects model, with injury rate ratio (IRR) as the primary outcome. Heterogeneity among studies and publication bias were tested, and subgroup analysis examined heterogeneity sources.
Results:
Across 10 studies, including 9 randomized controlled trials, a pooled overall point estimate yielded an IRR of 0.60 (95% CI = 0.48-0.75; a 40% reduction) while accounting for hours of risk exposure. Publication bias assessment suggested an 8% reduction in the estimate (IRR = 0.68, 95% CI = 0.54-0.84), and the prediction interval intimated that any study estimate could still fall between 0.33 and 1.48. Subgroup analyses identified no significant moderators, although possible influences may have been masked because of data constraints.
Conclusion:
Compared with normative practices or control, IPPs significantly reduced IRRs in adolescent team sport contexts. The underlying explanations for IPP efficacy remain to be accurately identified, although they potentially relate to IPP content and improvements in muscular strength, proprioceptive balance, and flexibility.
Clinical Relevance:
Clinical practitioners (eg, orthopaedics, physical therapists) and sports practitioners (eg, strength and conditioners, coaches) can respectively recommend and implement IPPs similar to those examined to help reduce injury rates in adolescent team sports contexts.
To describe age group patterns for injury incidence, severity and burden in elite male youth football.
Prospective cohort study capturing data on individual exposure and time-loss injuries from ...training and matches over four seasons (2016/2017 through 2019/2020) at a national football academy (U13-U18; age range: 11-18 years). Injury incidence was calculated as the number of injuries per 1000 hours, injury severity as the median number of days lost and injury burden as the number of days lost per 1000 hours.
We included 301 players (591 player-seasons) and recorded 1111 time-loss injuries. Overall incidence was 12.0 per 1000 hours (95% CI 11.3 to 12.7) and burden was 255 days lost per 1000 hours (252 to 259). The mean incidence for overall injuries was higher in the older age groups (7.8 to 18.6 injuries per 1000 hours), while the greatest burden was observed in the U16 age group (425 days; 415 to 435). In older age groups, incidence and burden were higher for muscle injuries and lower for physis injuries. Incidence of joint sprains and bone stress injuries was greatest for players in the U16, U17 and U18 age groups, with the largest burden observed for U16 players. No clear age group trend was observed for fractures.
Injury patterns differed with age; tailoring prevention programmes may be possible.
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.
To examine the perceptions of coaches in the high school versus club sport setting and compare their attitudes and behaviors toward sport specialization.
Cross-sectional survey.
A total of 769 coaches (497 high school coaches, 272 club sport coaches).
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.
High school coaches and club sport coaches differed in their perceptions of sport specialization (
= 1.41,
< .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 (
values > .05).
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.
Background
This review investigated the influence of scaling sports equipment and play area (e.g., field size) on children’s motor skill acquisition.
Methods
Peer-reviewed studies published prior to ...February 2015 were searched using SPORTDiscus and MEDLINE. Studies were included if the research (a) was empirical, (b) involved participants younger than 18 years, (c) assessed the efficacy of scaling in relation to one or more factors affecting skill learning (psychological factors, skill performance and skill acquisition factors, biomechanical factors, cognitive processing factors), and (d) had a sport or movement skills context. Risk of bias was assessed in relation to selection bias, detection bias, attrition bias, reporting bias and other bias.
Results
Twenty-five studies involving 989 children were reviewed. Studies revealed that children preferred using scaled equipment over adult equipment (
n
= 3), were more engaged in the task (
n
= 1) and had greater self-efficacy to execute skills (
n
= 2). Eighteen studies demonstrated that children performed skills better when the equipment and play area were scaled. Children also acquired skills faster in such conditions (
n
= 2); albeit the practice interventions were relatively short. Five studies showed that scaling led to children adopting more desirable movement patterns, and one study associated scaling with implicit motor learning.
Conclusion
Most of the studies reviewed provide evidence in support of equipment and play area scaling. However, the conclusions are limited by the small number of studies that examined learning (
n
= 5), poor ecological validity and skills tests of few trials.
To describe injuries and illnesses across traditional and new sports among the participating athletes of the Buenos Aires 2018 Youth Olympic Summer Games (BA YOG) (6-18 October 2018).
We recorded the ...daily number of athlete injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues manned by the BA YOG 2018 medical staff.
In total, 3.984 athletes from 206 NOCs were observed. NOCs and BA YOG 2018 medical staff reported 619 injuries and 334 illnesses, equalling 15.5 injuries and 8.4 illnesses per 100 athletes over the 13-day period. The eight new sports on the Youth Olympic programme (futsal, beach handball, karate, roller speed skating, kitesurfing, BMX freestyle, climbing and break dancing) fell in between the other sports with respect to injury and illness risk. Injury incidence was highest in rugby (43% of all rugby players), followed by boxing (33%) and badminton (24%), and lowest in swimming, archery, roller speed skating, equestrian, climbing and rowing (<5%). The highest incidences of illness were recorded in golf (20%), followed by triathlon (16%), beach volleyball and diving (both 14%). Of the illnesses, 50% affected the respiratory system and 15% the gastrointestinal system. Injury and illness incidences varied between continents with athletes representing Europe having significantly fewer injuries and illnesses compared with other continents, apart from a similar illness incidence to Asian athletes.
The overall injury incidence of 15.5 injuries per 100 athletes was higher, while the overall illness incidence of 8.4 illnesses per 100 athletes was similar to previous youth and Olympic Games. The new sports did not differ significantly compared with the other sports with respect to injury and illness risk.
Tennis is a sport that depends on neuromuscular performance during the game, regardless of the level of practice. This study aimed to describe the association between anthropometric and neuromuscular ...performance in pre-pubertal children tennis players (n=36) aged (10.15-12.77) years and compare them according to the level of practice. The participants were divided into two groups; the first was called "competitive," with a national ranking (n=18) aged (11.66 ± .72), and the second called "recreational" non-ranked in the national system (n=18) aged (11.52 ± .82). Basic anthropometry, including height, weight, and fat mass, was performed, as well as CMJ tests, 2kg medicine ball throws with three different techniques (forehand, backhand, and overhead), and 10m and 20m distance speeds. The comparison by groups t- student test found differences of (p≤0.01) in fat mass, CMJ, and the 20m test, and (p≤0.05) in the medicine ball throw and 10m. The height and CMJ variables were strongly associated with the other variables evaluated and competitive-level players had fitter anthropometric and neuromuscular attributes than their recreational-level contemporaries, perhaps due to adaptations in pre-pubertal ages to the time dedicated to the practice and the competitive demand.
El tenis es un deporte que depende del rendimiento neuromuscular para tener un mejor desempeño, independientemente del nivel de práctica. El objetivo de este estudio fue describir la asociación entre variables antropométricas y rendimiento neuromuscular niños tenistas (n=36) pre-púberes, en un rango de edad de (10.15-12.77) años, además de compararlos según el nivel de práctica. Los participantes fueron divididos en dos grupos, el primero fue denominado “competitivos”, con ranking nacional (n=18) edad (11.66 ± .72) y el segundo denominado “recreativos” sin ranking nacional (n=18) edad (11.52 ± .82). Se realizó una antropometría básica incluyendo estatura, peso y masa grasa, además se ejecutaron pruebas de CMJ, lanzamientos de balón medicinal de 2kg con tres técnicas diferentes (derecha, revés y por encima de la cabeza), y velocidades de 10m y 20m. En la comparación de grupos se encontraron diferencias (p≤0.01) en la masa grasa, CMJ y la prueba de 20m, y (p≤0.05) en los lanzamientos de balón medicinal y 10m. La estatura y el CMJ se asociaron a las otras variables evaluadas y los jugadores de nivel competitivo tuvieron mejores atributos antropométricos y neuromusculares que sus contemporáneos de nivel recreativo, tal vez por adaptaciones en edades pre-púberas al tiempo dedicado a la práctica, y a la exigencia competitiva.
In 2015, the Society of Health and Physical Educators of America (SHAPE America) launched 50 Million Strong
with goals of improving physical literacy, increasing physical activity levels, and ...encouraging lifelong physical activity among children by the year 2029. Not only are youth sports programs crucial to meeting 50 Million Strong
goals, but it also requires the purposeful efforts of sport coaches, program administrators, researchers, coach educators, and coach developers. While it is encouraging that research on sport coaching topics appears to be growing, there is still much to learn about how to prepare coaches to provide quality sport experiences for their athletes. Consequently, to further this call, it is crucial to understand the current state of sports coaching research and propose future research needs in the discipline. The purpose of this paper is to identify research needs in sports coaching and coach education/development that assists in achieving the 50 Million Strong
goals of SHAPE America. Throughout the paper, critical research questions are identified in two main areas: 1) coaches' roles in developing physically literate athletes, and 2) developing coaches in regards to coach learning, the efficacy of coach education, and coach health and well-being. Furthermore, commensurate with other papers in the series commissioned by the SHAPE America Research Consortium, we discuss these areas within a social ecological model to understand the impact of the bi-directional interactions between environmental factors and individual behaviors.
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