Lower Extremity Biomechanics Are Altered Across Maturation in Sport-Specialized Female Adolescent Athletes

Sport specialization is a growing trend in youth athletes and may contribute to increased injury risk. The neuromuscular deficits that often manifest during maturation in young, female athletes may be exacerbated in athletes who specialize in a single sport. The purpose of this study was to investigate if sport specialization is associated with increased lower extremity biomechanical deficits pre- to post-puberty in adolescent female athletes. Seventy-nine sport-specialized female adolescent (Mean ± SD age = 13.4 ± 1.8 years) basketball, soccer, and volleyball athletes were identified and matched with seventy-nine multi-sport (soccer, basketball, and volleyball) female athletes from a database of 1,116 female adolescent basketball, soccer, and volleyball athletes who were enrolled in one of two large prospective, longitudinal studies. The athletes were assessed over two visits (Mean ± SD time = 724.5 ± 388.7 days) in which they were classified as pre-pubertal and post-pubertal, respectively. Separate 2 × 2 analyses of covariance were used to compare sport-specialized and multi-sport groups and dominant/non-dominant limbs with respect to pubertal changes in peak knee sagittal, frontal, and transverse plane joint angular measures and moments of force recorded while performing a drop vertical jump task. The sport-specialized group were found to exhibit significantly larger post-pubertal increases in peak knee abduction angle (p = 0.005) and knee abduction moment (p = 0.006), as well as a smaller increase in peak knee extensor moment (p = 0.032) during landing when compared to the multi-sport group. These biomechanical changes are indicative of potentially compromised neuromuscular control that may increase injury risk pre- to post-puberty in sport-specialized female athletes. Consideration of maturation status may be an important factor in assessing the injury risk profiles of adolescent athletes who specialize in sport

Bony Morphology of Femoroacetabular Impingement in Young Female Dancers and Single-Sport Athletes

Background: Femoroacetabular impingement (FAI) is a painful and limiting condition of the hip that is often seen in young athletes. Previous studies have reported a higher prevalence of this disorder in male athletes, but data on the structural morphology of adolescent and young adult female athletes, specifically those involved in dance, are lacking. Purpose: (1) To investigate the radiographic morphology of FAI deformities in adolescent and young adult female single-sport dance and nondance athletes and (2) to examine the differences in the radiographic findings between these 2 groups. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A retrospective chart review of 56 female single-sport athletes 10 to 21 years of age with a diagnosis of FAI within a single-sports medicine division of a pediatric academic medical center was performed. Acetabular index (AI), lateral center-edge angle (LCEA), crossover sign, and ischial spine sign were measured bilaterally on anteroposterior radiographs; alpha angle (AA) was measured on lateral films, and anterior center-edge angle (ACEA) was measured on false-profile films. Independent t tests and Mann-Whitney U tests were used to compare mean angle measurements between dance and nondance athletes. Dichotomized categorical variables and crossover and ischial spine signs were analyzed between dance and nondance athletes by applying a chi-square test. Statistical significance was set as P < .05 a priori. Results: Significant differences in angle measurements were noted. AA was significantly lower in the dancers compared with the nondance athlete group (49.5° ± 6.0° vs 53.9° ± 7.3°, P = .001). The LCEA and ACEA of dance athletes were significantly greater compared with nondance athletes (33.8° ± 6.7° vs 30.9° ± 5.8° [P = .016] and 36.0° ± 8.1° vs 32.3° ± 7.0° [P = .035], respectively). No significant difference in AI was seen between the 2 cohorts (5.0° ± 4.0° for dancers vs 5.9° ± 3.4° for nondancers, P = .195). Conclusion: Significant differences existed in the radiographic bony morphology of young female single-sport dance athletes compared with nondance athletes with FAI. In dance athletes, symptoms were seen in the setting of normal bony morphology

Common causes, concers, and coordinating for a cure

El aumento de la participación de los niños y jóvenes en las competiciones deportivas ha llevado a un incremento paralelo de la incidencia de lesiones por sobre uso en este grupo poblacional. Las observaciones empíricas de que los niños y adolescentes de hoy en día realizan menor nivel de actividad física respecto de sus padres y abuelos contrasta con el incremento progresivo del estrés específico causado por las actividades deportivas actuales. Los niños de hoy han mostrado tener menor capacidad de recuperación y un sistema musculo esquelético más débil y por lo tanto con mayor riesgo de dañarse cuando se les somete a la realización repetida de actividades especificas intensas. Existen diferencias físicas y fisiológicas entre niños y indolentes que hace que los primeros sean más susceptibles de lesionarse. Muchas factores contribuyen a la existencia de estas diferencias, incluido el proceso de crecimiento en sí mismo, la vulnerabilidad del cartílago de crecimiento, las deficiencias de fuerza y insuficiente la capacidad para realizar habilidades motoras complejas. Durante los periodos de rápido crecimiento, los desequilibrios en la fuerza muscular y la flexibilidad predisponen a los deportistas jóvenes a sufrir lesiones de gran importancia que puedan determinar un déficit motor que permanezca durante toda la vida. El objetivo de este artículo es revisar las lesiones más habituales que el médico clínico observa en niños y jóvenes deportistas. Un equipo multidisciplinario es necesario para atender las necesidades de esta población específica. El futuro de la medicina deportiva pediátrica es la prevención de lesiones siendo la educación para realizar una intervención temprana la clave para alcanzar el éxito.The dramatic rise in organized sports participation by the young athlete has been met with an increase in significant acute and overuse injuries. The empiric observation that children and adolescents in our modern society are confronted with fewer physical stresses than their parents or grandparents is contrasted with the increasing specificity of stresses that are placed on them during current sports and athletic training activities. Children today may have less resilient and weaker muscle-tendon units and therefore face double jeopardy when confronted with specific, intense physical challenges that apply repetitive stress to unprepared tissues. There are physical and physiological differences between children and adults that may cause children to be more vulnerable to injury. Many factors contribute to these differences, including the growth process itself, vulnerability of growth cartilage to stresses, and strength and complex motor skill deficits. During times of rapid growth muscle strength and flexibility imbalances predispose the young athlete to injuries that are significant and possibly contribute to lifelong deficits. It is the objective of this lecture to review common pediatric sports injuries presenting to the clinician. A multidisciplinary team is required to address the unique needs of this expanding population. The future of pediatric sports medicine is injury prevention. Education with regard to early intervention is the key to success.Sin financiaciónNo data 201

Self-regulatory skills: Are they helpful in the prevention of overuse injuries in talented tennis players?

Talented athletes use metacognitive skills to improve their performance. Also, it is known that these skills are important for managing one's health. The goal of this study was to identify the relationship between metacognitive skills and overuse injuries in talented tennis players. Metacognitive skills were measured in 73 talented tennis players (45 boys and 28 girls, age 11-14) at the start of the season, using the Self-Regulation of Learning Self-Report Scale. Overuse injuries were monitored for one season using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Ordinal regression indicated that moderate or low selfmonitoring skills (compared to high selfmonitoring) (OR 4.555, CI 1.096-18.927, P = 0.037) and exposure time (OR 1.380, CI 1.106-1.721, P = 0.004) were associated with more time loss overuse injuries. A second analysis showed that this was the case in girls (OR 10.757, CI 1.845-62.714, P = 0.008), but not in boys. Linear regression revealed that higher reflection scores and exposure time predicted overuse severity (F(5,58) = 2.921, P = 0.020, R-2 = 0.201). Possibly, selfmonitoring can help players to prevent themselves from time loss overuse injuries. Coaches should be aware that players can differ in selfmonitoring ability and thus in the ability to prevent overuse injuries. The role of reflection needs more research