Ankle Sprains in the National Basketball Association, 2013-2014 Through 2016-2017

Background: Ankle sprains are one of the most common injuries in basketball. Despite this, the incidence and setting of ankle sprains among elite basketball players are not well described. Purpose: To describe the epidemiology of ankle sprains among National Basketball Association (NBA) players. Study Design: Cohort study; Level of evidence, 3. Methods: All players on an NBA roster for ≥1 NBA game (preseason, regular season, or playoffs) during the 2013-14 through 2016-17 seasons were included. Data were collected with the NBA electronic medical record system. All NBA teams used the electronic medical record continuously throughout the study period to record comprehensive injury data, including onset, mechanism, setting, type, and time lost. Game incidence rates were calculated per 1000 player-games and per 10,000 player-minutes of participation, stratified by demographic and playing characteristics. Results: There were 796 ankle sprains among 389 players and 2341 unique NBA player-seasons reported in the league from 2013-14 through 2016-17. The overall single-season risk of ankle sprain was 25.8% (95% CI, 23.9%-28.0%). The majority of ankle sprains occurred in games (n = 565, 71.0%) and involved a contact mechanism of injury (n = 567, 71.2%). Most ankle sprains were lateral (n = 638, 80.2%). The incidence of ankle sprain among players with a history of prior ankle sprain in the past year was 1.41 times (95% CI, 1.13-1.74) the incidence of those without a history of ankle sprain in the past year (P =.002). Fifty-six percent of ankle sprains did not result in any NBA games missed (n = 443); among those that did, players missed a median of 2 games (interquartile range, 1-4) resulting in a cumulative total of 1467 missed player-games over the 4-season study period. Conclusion: Ankle sprains affect approximately 26% of NBA players on average each season and account for a large number of missed NBA games in aggregate. Younger players and players with a history of ankle sprain have elevated rates of incident ankle sprains in games, highlighting the potential benefit for integrating injury prevention programs into the management of initial sprains. Research on basketball- and ankle-specific injury prevention strategies could provide benefits

Defining a research agenda for youth sport specialisation in the USA: The AMSSM Youth Early Sport Specialization Summit

Sport specialisation is becoming increasingly common among youth and adolescent athletes in the USA and many have raised concern about this trend. Although research on sport specialisation has grown significantly, numerous pressing questions remain pertaining to short-term and long-term effects of specialisation on the health and well-being of youth, including the increased risk of overuse injury and burnout. Many current elite athletes did not specialise at an early age. Methodological and study design limitations impact the quality of current literature, and researchers need to prioritise pressing research questions to promote safe and healthy youth sport participation. The American Medical Society for Sports Medicine hosted a Youth Early Sport Specialization Summit in April 2019 with the goal of synthesising and reviewing current scientific knowledge and developing a research agenda to guide future research in the field based on the identified gaps in knowledge. This statement provides a broad summary of the existing literature, gaps and limitations in current evidence and identifies key research priorities to help guide researchers conducting research on youth sport specialisation. Our goals are to help improve the quality and relevance of research on youth sport specialisation and to ultimately assure that opportunities for healthy and safe sport participation continue for all youth

Defining a Research Agenda for Youth Sport Specialization in the United States: The AMSSM Youth Early Sport Specialization Summit

Sport specialization is becoming increasingly common among youth and adolescent athletes in the United States and many have raised concern about this trend. Although research on sport specialization has grown significantly, numerous pressing questions remain pertaining to short- and long-term effects of specialization on the health and well-being of youth, including the increased risk of overuse injury and burnout. Many current elite athletes did not specialize at an early age. Methodological and study design limitations impact the quality of current literature, and researchers need to prioritize pressing research questions to promote safe and healthy youth sport participation. The American Medical Society for Sports Medicine hosted a Youth Early Sport Specialization Summit in April 2019 with the goal of synthesizing and reviewing current scientific knowledge and developing a research agenda to guide future research in the field based on the identified gaps in knowledge. This statement provides a broad summary of the existing literature, gaps and limitations in current evidence, and identifies key research priorities to help guide researchers conducting research on youth sport specialization. Our goals are to help improve the quality and relevance of research on youth sport specialization and to ultimately assure that opportunities for healthy and safe sport participation continue for all youth

Systematic Review of Health Organization Guidelines Following the AMSSM 2019 Youth Early Sport Specialization Summit

Context: Youth sport specialization may place young athletes at increased risk for negative impacts to their physical and/or psychological health. In response to these health concerns, several health organizations have created guidelines and position statements to guide parents and practitioners toward best practices for management of the young athlete. Objective: To systematically review and synthesize current organizations’ recommendations and guidelines regarding youth sport specialization. Data Sources: English-language articles from January 1, 2000, to December 31, 2018, in the NCBI Pubmed, Embase, Cochrane, CINAHL, and SPORTDiscus databases. Study Selection: Articles that reported on recommendations or interventions by health organizations or health representatives of sports organizations. A total of 56 articles were assessed, with 11 meeting inclusion eligibility criteria. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Two investigators independently identified all recommendations within the results that fit within a 15-item framework encompassing 4 domains: Psychological Development/Approach, Physical Development/Load, Facilities and Resources, and Timing and Monitoring of Specialization. Results: Recommendations across organizations were primarily clustered in the Physical Development/Load (43%), Facilities and Resources (48%), and Sport Specialization (55%) domains. In contrast, the Psychological Development/Approach domain had fewer recommendations (20%). The most common recommendations endorsed concepts: “Monitor athlete well-being,” “Youth athletes need access to well-trained, quality coaches,” “Multi-sport participation,” “Limit early organized participation and/or training,” and “Parents require awareness of training, coaching, and best practices.” The level of evidence provided to support a given recommendation varied significantly. The level of detail and the consistency of terms used throughout the results were typically low. Recommendations were frequently made without reference to potential outcome measures or specific strategies that could be used for practical implementation in the community. Conclusion: There was broad representation of different aspects of specialization but limited consistency between health organization guidelines. Adopting a framework for recommendations as used in this review could assist organizations in structuring future recommendations that are specific, measurable, and framed in a manner that will promote action in the youth sport community