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Sport injuries in adolescents

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In spite of the wide range of injuries in adolescents during sports activities, there are only a few studies investigating the type and frequency of sport injuries in puberty. However, this information may help to prevent, diagnose and treat sports injuries among teens. 4468 injuries in adolescent patients were treated over a ten year period of time: 66,97% were boys and 32.88% girls. The most frequent sports injuries were football (31.13%) followed by handball (8.89%) and sports during school (8.77%). The lower extremity was involved in 68.71% of the cases. Knee problems were seen in 29.79% of the patients; 2.57% spine and 1.99% head injuries. Injuries consisted primarily of distortions (35.34%) and ligament tears (18.76%); 9,00% of all injuries were fractures. We found more skin wounds (6:1) and fractures (7:2) in male patients compared to females. The risk of ligament tears was highest during skiing. Three of four ski injuries led to knee problems. Spine injuries were observed most often during horse riding (1:6). Head injuries were seen in bicycle accidents (1:3). Head injuries were seen in male patients much more often then in female patients (21:1). Fractures were noted during football (1:9), skiing (1:9), inline (2:3), and during school sports (1:11). Many adolescents participate in various sports. Notwithstanding the methodological problems with epidemiological data, there is no doubt about the large number of athletes sustain musculoskeletal injuries, sometimes serious. In most instances, the accident does not happened during professional sports and training. Therefore, school teachers and low league trainer play an important role preventing further accidence based on knowledge of individual risk patterns of different sports. It is imperative to provide preventive medical check-ups, to monitor the sport-specific needs for each individual sports, to observe the training skills as well as physical fitness needed and to evaluation coaches education.
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[page 82] [Orthopedic Reviews 2011; 3:e18]
Sport injuries in adolescents
Susanne Habelt,1Carol Claudius Hasler,2
Klaus Steinbrück,3Martin Majewski1
1Department of Orthopaedic Surgery,
University Hospital of Basel, Basel;
2Department of Orthopaedic Surgery,
University Children’s Hospital of Basel,
Switzerland; 3Clinic of Orthopaedic
Surgery, Stuttgart-Botnang, Germany
Abstract
In spite of the wide range of injuries in ado-
lescents during sports activities, there are only
a few studies investigating the type and fre-
quency of sport injuries in puberty. However,
this information may help to prevent, diagnose
and treat sports injuries among teens. 4468
injuries in adolescent patients were treated
over a ten year period of time: 66,97% were
boys and 32.88% girls. The most frequent
sports injuries were football (31.13%) followed
by handball (8.89%) and sports during school
(8.77%). The lower extremity was involved in
68.71% of the cases. Knee problems were seen
in 29.79% of the patients; 2.57% spine and
1.99% head injuries. Injuries consisted prima-
rily of distortions (35.34%) and ligament tears
(18.76%); 9,00% of all injuries were fractures.
We found more skin wounds (6:1) and frac-
tures (7:2) in male patients compared to
females. The risk of ligament tears was high-
est during skiing. Three of four ski injuries led
to knee problems. Spine injuries were
observed most often during horse riding (1:6).
Head injuries were seen in bicycle accidents
(1:3). Head injuries were seen in male
patients much more often then in female
patients (21:1). Fractures were noted during
football (1:9), skiing (1:9), inline (2:3), and
during school sports (1:11). Many adolescents
participate in various sports. Notwithstanding
the methodological problems with epidemio-
logical data, there is no doubt about the large
number of athletes sustain musculoskeletal
injuries, sometimes serious. In most
instances, the accident does not happened dur-
ing professional sports and training.
Therefore, school teachers and low league
trainer play an important role preventing fur-
ther accidence based on knowledge of individ-
ual risk patterns of different sports.
It is imperative to provide preventive med-
ical check-ups, to monitor the sport-specific
needs for each individual sports, to observe the
training skills as well as physical fitness need-
ed and to evaluation coaches education.
Introduction
When we think of sports, we usually think
about professional sports. We think about foot-
ball, skiing or athletic competitions being per-
formed by adults. Most sports are performed,
however, by children and adolescents.1In the
United States over 25-30 million children and
adolescents take part in school sports activities
and 20 million are members of sport clubs.2,3
The number of young athletes is continually
increasing.1,4 Parallel to this increase of partic-
ipants, the number of acute and over use
injuries is raising.5,6
Children and adolescents are at a special
risk for injuries because most sports are not
adapted to the motor skills of their specific age
group.6,7 Thus, adolescents play according to
the rules of adults and the apparatuses are not
adjusted to their sizes.6,7 For example, the bas-
ketball baskets are just available in one height
and almost all sports have only one ball size,
the one used for adults.6However, particularly
adolescents may sustain injuries, which can
impair their growth with potential lifelong
effect.8
The aim of the following study was to pro-
vide epidemiologic data, which can aid to pre-
vent, diagnose and treat sports injuries among
adolescents.
Materials and Methods
Over a ten year period of time, all patients
with sports injuries treated in the sports clinic
were documented in a specially designed com-
puter program. Since the implementation of
the computerized case history, 17,397 patients
with 19,530 injuries have been analyzed: 4468
injuries (25.68%) were related to patients
between 10 and 19 years of age; 66,97% of the
patients were male, 32.88% were female and
the remaining 0.16% were of ambiguous gen-
der (Table 1).
Patient’s sex, kind of injury, localisation of
injury and type of sports, as well as the treat-
ment were documented. All patient examina-
tions during outpatient clinic were performed
either by, or under the supervision of, a senior
consultant.
All patients were examined clinically regard-
ing pain, swelling, range of motion, and stabil-
ity. The clinical examination was followed by a
radiographic evaluation (anterior-posterior
and lateral view) depending on the type of
injury. If the clinical and radio logic findings
remained doubtful or required further investi-
gation, the patients were transferred for ultra-
sound or MRI examination.
Sports injuries occurring during warm-up
were not included in the study.
Results
Sports
Most injuries occurred while engaging one
popular European sports, soccer. Soccer was
involved in 31.13% of all injuries followed by
handball (8.89%), sports during school
(8.77%), skiing (5.95%), and biking (5.71%)
(Table 2).
Location
The upper extremities were involved in
25.27% of the injuries, the lower extremities in
68.71%, the spine in 2.57% and the head in
1.99% of the cases. Injuries of the upper extrem-
ity were seen on all locations with an especially
high number of injuries at fingers (8.12%),
metacarpus (3.13%) and wrist (3.54%). The
knee (29.79%) and ankle joint (24.02%) were
most often involved during injuries of the lower
leg. Compared to knee and ankle joint, the
shoulder (5.42%) and elbow (2.84%) were not
often injured (Table 3).
Type of injury
Over all, injuries consisted primarily of dis-
tortions (35.34%) as well as ligament tears
(18.76%); 9,00% of all injuries were fractures.
(Table 3)
Gender
More than half of the male patients played
ball games such as soccer (1311 patients),
handball (222 patients) and basketball (168
patients). Girls skied (156 patients), danced
(79 patients), and did gymnastic (123
patients). However, 175 girls played handball
or had their accident during school sports (167
patients).
Orthopedic Reviews 2011; volume 3:e18
Correspondence: Martin Majewski, Department
of Orthopaedic Surgery and Traumatology,
University of Basel, Spitalstrasse 21, 4031 Basel,
Switzerland.
Tel: +41.61.265.25.25 - Fax: +41.61.328.78.03.
E-mail: majewski01@yahoo.de
Key words: epidemiology, sport injury, adolescent.
Received for publication: 13 September 2011.
Accepted for publication: 16 October 2011.
This work is licensed under a Creative Commons
Attribution NonCommercial 3.0 License (CC BY-
NC 3.0).
©Copyright S. Habelt et al., 2011
Licensee PAGEPress, Italy
Orthopedic Reviews 2011; 3:e18
doi:10.4081/or.2011.e18
[Orthopedic Reviews 2011; 3:e18] [page 83]
Type of injury
Looking at the over all distribution of boys
and girls (2:1) we found more skin wounds
(6:1) and fractures (7:2) in male patients. Girls
showed more ligament tears (3:2).
Sex and location
Compared to the overall distribution of male
and female patients (2:1) head injuries were
seen more often in male patients than in female
patients (21:1). Shoulder, hand and lower leg
injuries showed a boy-girl distribution of 4:1.
We found a boy-girl distribution of 5:4 of spine,
elbow and knee problems (Table 1).
Sports and location
In contrast to the overall relative number of
head injuries (1:50), head injuries during bicy-
cle accidents were seen much more often
(1:10); 1:3 head injuries have been bicycling
injuries. Spine injuries were observed in gen-
eral with a distribution of 1:40. During horse
riding 1 of 3 injuries affected the spine and 1:6
of all spine injuries were related to horse rid-
ing. Shoulder injuries were seen in 1:17 cases,
shoulder injuries during skiing were seen with
a distribution of 1:10. The overall hand and
elbow injury rate was 1:30 and 1:35 respective-
ly. During biking the hand (1:9) and elbow
(1:8) were injured much more often. In gener-
al, finger injuries were seen in 1:12 patients.
School sports primarily led to ankle sprains,
nevertheless, every 5th accident during sports
in school was located at the fingers. One third
of all injuries were been related to the knee,
3:4 ski injuries led to knee problems (Table 4).
Sports and type of injury
The highest number ligament tears (279
patients) and joint sprains (500 patients) were
the results of accidents during soccer. The per-
centage of ligament tears compared to the
overall number of accidents (1:5) was highest
during skiing; 1:3 skiing injuries were liga-
mentous injuries. Approximately the same dis-
tribution was seen while playing handball
(1:3). Fractures were noted among football
(1:9), skiing (1:9), inline skating (2:3), and
during school sports (1:11). The overall frac-
ture rate was 1:11. Wrestling (1:5) and snow-
boarding (1:6) had a high number of disloca-
tions compared to all dislocations that were
seen (1:20). Wounds were seen most often
after bike falls (1:5) (Table 2).
Location and type of injury
The injuries of the lower extremities con-
sisted primarily of ligament tears: 1:5 injuries
at the lower extremity were ligament tears and
approximately all ligament tears occurred in
the legs. Fractures were mostly seen at the
upper extremity (Table 3).
Discussion
Little is known about sports-related injuries
to the locomotor system in children and adoles-
cents. However, these groups are the ones who
are most likely to sustain injuries because they
are constantly in motion. This is surely a suffi-
cient motivation to gather epidemiological
data to discuss the basics of their injuries.
Article
Table 2. Sports specific diagnosis, sorted by number of injuries.
Skin Contusion Distortion Muscle Ligament Tendon Dislocation Fracture Cartilage Total
wound injury injury injury Total lesion
Football 26 271 500 31 279 4 66 154 60 1391
Handball 16 53 168 2 83 14 15 22 24 397
Scholl Sport 0 88 188 12 52 1 11 36 4 392
Ski 6 16 96 0 86 1 22 30 9 266
Biking 75 85 28 0 24 07 18 18 255
Basketball 2 17 112 2 70 0 10 13 9 235
Gymnastics 1 34 49 4 25 16 17 29 166
Volleyball 0 16 75 3 40 0 12 36155
Trek and Field 6 24 45 12 23 03 6 31 150
Tennis 99 38 3 20 05 6 38 128
Ice skating 3 24 27 5 11 17 10 9 97
Dance 0 14 38 7 12 07 4 8 90
Judo 2 23 21 68 0 9 5 5 79
Swimming 2 16 8 10 108311 59
Jogging 02 27 6 13 11 2 3 55
Horse riding 0 29 504 0 1 8 2 49
Badminton 05 11 0 25 02 1 1 45
Wrestling 0 10 11 16 0 9 7 1 45
Inline skating 28 10 10 0 1 15 0 37
Skateboard 03 16 05 1 3 8 0 36
Table 1. Gender specific location within
4468 sports injuries.
No specificationMale Female Total
Head 0 85 4 89
Chest 0 16 3 19
Pelvis 0 38 8 46
Spine 0 65 50 115
Shoulder 2 199 53 254
Upper arm 0 14 5 19
Elbow 0 72 55 127
Forearm 0 51 17 68
Wrist 1 114 43 158
Hand 0 110 30 140
Finger 0 224 139 363
Hip 0 16 2 18
Thigh 0 130 58 188
Knee 1 773 557 1331
Lower leg 1 149 35 185
Ankle 1 756 316 1073
Foot 1 123 72 196
Toes 0 57 22 79
Total 7 2992 1469 4468
[page 84] [Orthopedic Reviews 2011; 3:e18]
Adolescent are subjected to many stresses,
strains and injuries. An increase in the num-
ber of injuries has been seen.1,4 In the United
States alone, sports related injuries in children
and adolescents cost more than 1.8 billion dol-
lars per year.2
The actual incidence of injuries in children
and adolescents is difficult to determine.
Between 3-11% of schoolchildren are injured
each year.8-10 Children and adolescents may be
particularly at risk for sports-related injuries
as a result of improper technique, muscle
weakness and poor proprioception.7,11,12
Boys sustain twice as many injuries as girls.
In accordance with the literature two third of
our patients were male.8-11,13 Males participat-
ing in sport may be at greater risk of injury as
they tend to be more aggressive, have larger
body mass, and experience greater contact
compared with girls in the same sports and
they more involved in contact sports and foot-
Article
Table 3. Location specific diagnosis within 4468 sports injuries.
Skin Contusion Distortion Muscle Ligament Tendon Dislocation Fracture Cartilage Total
wound injury injury injury Total lesion
Head 50 26 000 0 0 13 0 89
Chest 0 18 000 0 0 0 1 19
Pelvis 5 25 300 0 0 1 12 46
Spine 1 37 35 10 000131 115
Shoulder 5 41 46 12 1 100 40 18 254
Upper arm 54 420 0 0 3 1 19
Elbow 15 52 20 07 0 11 8 14 127
Forearm 2 17 200 0 1 42 4 68
Wrist 2 38 87 10 0 1 23 6 158
Hand 7 39 29 02 0 1 56 6 140
Finger 6 89 156 0 22 15 11 64 0 363
Hip 67 100 2 0 0 2 18
Thigh 3 46 58 67 010310 188
Knee 20 153 441 0 460 1 103 20 133 1331
Lower leg 19 53 0 39 14055 14 185
Ankle 3 56 611 1 342 11 36 22 1073
Foot 12 80 58 02 0 0 23 21 196
Toes 1 32 28 00 0 1 14 3 79
Total 162 813 1579 121 838 25 230 402 298 4468
Table 4. Sports specific location, sorted by number of injuries.
Head Chest Pelvis Spine Shoulder Upper Elbow Fore Wrist Hand Finger Hip Tight Knee Lower Ankle Foot Toes Total
arm arm leg
Football 30 2 14 15 41 1823 66 40 80 9 82 473 48 353 71 35 1391
Handball 11 010 23 670328 57 04117 1 126 11 2 397
Scholl Sport 65 3 6 17 1918477 1 10 78 18 134 13 1 392
Ski 00 0 0 29 1012116 08196 10 200266
Biking 27 461 16 0 33 8 28 23 65347 25 6 17 0 255
Basketball 22 0 3 7 0 200 6 42 0348 2 116 20235
Gymnastics 11 1 18 10 1 12 8 15 390934 9 25 91166
Volleyball 10 0 3 9 0 403 3 28 0121 1 76 50155
Trek and Field 00 8 13 3010270119 34 19 37 33150
Tennis 00 2 9 9 2 1190 30034 9 35 86128
Ice skating 21 6 2 6 0 2137 16 0334 373197
Dance 00 0 0 2 0 1001 1210 21 2 29 19 2 90
Judo 20 0 1 9 0 12 010 30721 0211 10 79
Swimming 10 0 3 9 2 11 200 002812 12659
Jogging 00 0 0 1 0 000 0 10113 7 25 2555
Horse riding 00 0 19 10000000613 144149
Badminton 00 1 2 0 0 010 0 00035 060045
Wrestling 02 1 1 16 1 10 11 1 3003 3 20045
Inline skating 10 1 0 2 0 2555 301 5 1 60037
Skateboard 00 0 5 3 0 0041 5003 1 14 0036
Total 10 1 0 2 0 255 5 301 5 1 60037
[Orthopedic Reviews 2011; 3:e18] [page 85]
ball.11,13 All of these factors may lead to
increased forces in running, jumping, pivot-
ing, and contact, which may increase suscepti-
bility to injury.11 Underlining this, we found
more skin wounds and fractures as well as
head and shoulder injuries in males.
Therefore, paediatric orthopaedic patients
fall into two groups: obese patients or young
athletes.14 On one hand, due to our technolog-
ical environment, adolescents tend not be as
active anymore and through this do not have
the level of coordination that one would sus-
pect.6,14 On the other hand, youths tend to have
reduced perception of risk and boundless ener-
gy.15 In addition, the sports apparatuses are
rarely tailored to the needs of the adoles-
cent.7,16 Skiing is one of the only sports where
the height and weight of each individual is
taken into consideration when giving out
equipment. Adolescents play according to the
rules of adults and the apparatuses are not
adjusted to their sizes.7
However, most sports are not adapted to the
motor skills and size of adolescents.6,7
Adolescents play according to the rules of
adults.6,7 Almost all sports have only one ball
size, the one used for adults.6However, partic-
ularly adolescents may benefit from sports
equipment adapted to there needs.8
Teachers deal with all kind of problems,
because the school population is not specially
selected or trained. Therefore they have to
simultaneously handle obese patients, young
athletes, low level of coordination, and reduced
perception of risk, as well as adult sports
equipment.17 Playing with adult-sized balls,
sports injuries account for a significant mor-
bidity with frequent finger injuries among ado-
lescents during sports in school. 8.77% of all
injuries we have seen were caused during
school sports. School sports primarily led to
ankle sprains and every 5th accident was locat-
ed at the fingers; 9% of those injuries were
fractures.
The province of Quebec does not allow ado-
lescents to body check until the age of 14,
whereas in Ontario they are already allowed to
at the age of 10 to 12 years. Analysis of hockey
injuries in the two provinces showed a higher
incidence of injury when checks were allowed,
with a higher proportion of head injuries and
fractures. A simple change in regulation could
prevent many injuries among adolescents play-
ing hockey.18
The Toronto District School Board abruptly
removed playground equipment from 136
schools because it was dangerously non-com-
pliant with standards. After the equipment was
removed and replaced with safe equipment,
the injury rates dropped down by 50%. The
same number of children did the same playing,
but in a safe environment. Therefore the
injury risk was substantially reduced.19
The examples of playground and ice hockey
are not exhaustive for formal and organized
sports and leisure activities. We found a high
number of head injuries during bicycle acci-
dents and spine injuries were observed during
horse riding. These injuries might be reduced
by wearing a helmet or and spinal protection
even during leisure bike rides or horse riding.
Elevated speed and falls from greater
heights are the cause of severe injuries.10 The
most dangerous sports are today's most popu-
lar sports such as snowboarding, carving and
inline skating.20-22 In his study Diamond found
that skiing poses an especially high risk for
head injuries in children.23 Accidents are due
to balance problems and collisions.20
Beginners have more injuries of the forearm
(46%) and the most advanced tend to suffer
from head and neck injuries (30%).22 A situa-
tion possible to changed by better protection of
the head. Out of our personal experience
coaches appear to have a specific perception
concerning the causes of sports accidents.
They somehow believe that factors like meth-
ods or organization of the game do not have an
effect on accidents.7In addition, adolescents
are under intense pressure, with a higher level
of training, to meet the expectation from the
coach and their parents.3
On the other hand there are exogenous fac-
tors such as apparatuses, which are not adapt-
ed to the adolescents’ size, as well as endoge-
nous factors such as the individual level of per-
formance that are important for the cause of
injuries. Potential factors adapted from Emery
were listed in Table 5.11
Beside the above mentioned, the type of
sport is a deciding factor and determines the
rate of injury as well as the localisation and the
resulting diagnosis.13,22,24 In our study ball
games like soccer, handball and basketball in
boys and school sports, handball and skiing in
girls accounted for the highest number of
injuries. An American study showed that injury
occurred most often during basketball, soccer,
baseball, football and roller blading.13 62% of
sports injuries take place in athletic clubs, 21%
in school sports, and 17% during leisure sports.
Abernethy reported an even higher percent of
schools sports injuries with 51%.25,26
It is quite noticeable that adolescents have
the same types of injuries that adults have.13, 27
Patel stated in his work on sport injuries in
adolescents, that most common types of
injuries are soft tissue injuries as sprains,
strains, and contusions.28 However, in our
study 9% of all injuries had been fractures.
Our unique description of epidemiological
data of adolescents sport injuries, showed the
highest number ligament tears and joint
sprains as a result of accidents during soccer.
Never less, the risk of ligament injury was
highest during skiing and handball. Fractures
were noted among soccer, skiing, inline-skat-
ing, and during school sports and dislocations
were seen during wrestling. Injuries of the
lower extremities consisted primarily of liga-
ment tears and fractures were mostly seen at
the upper extremity.
In conclusion school teachers and coaches
play an important role preventing further acci-
dents based on knowledge of individual risk
patterns of individual sports. Risk factors may
be extrinsic (sport, position, level, weather) or
intrinsic (previous injury, sex) to the individ-
ual participating in sports. Modifiable risk fac-
tors refer to those with the potential to be
altered by injury prevention strategies such as
education or behavioural intervention (rules,
playing time), environmental interventions
(playing surface, equipment), and legislative
interventions.11
However, a reduction of the incidence of
injuries should not only be confined to a modi-
fication of rules and apparatuses. It is impera-
tive to provide preventive medical check-ups,
to monitor the sport-specific needs for each
individual sports, to observe the training skills
as well as physical fitness needed and to eval-
uation coaches education. This is an important
duty for each paediatrician or family physician
who is interested in sports medicine.
Article
Table 5. Potential risk factors for injury in adolescent sport.
Extrinsic risk factors Intrinsic risk factors
Non-modifiable Kind of sport Age
Level of sport Previous injury
Position Sex
Time of season
Weather
Potential modifiable Equipment Coordination
Playing surface Fitness level
Playing time Flexibility
Rules Participation in sport-specific training
Time of day Proprioception
Psychological factors
Strength
[page 86] [Orthopedic Reviews 2011; 3:e18]
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Article
... These injuries may be acute, occurring suddenly, or due to repeated actions, known as overuse injuries (Dhillon et al., 2017). Case history data of all adolescents presenting to sports clinics in Europe due to sports injuries, spanning over ten years, was systematically recorded on a purpose-built software program (Habelt et al., 2011). A total of 17,397 individuals sought treatment, from 19,530 injuries. ...
... 68%, 4,468) were in those aged between 10-19 years. Over one third were males (66.97%), and 32.88% were females, while the remaining 0.16% were classified as other gender categories (Habelt et al., 2011). Soccer was the most common cause of injury (31.13%), reflecting general popularity throughout Europe. ...
... Soccer was the most common cause of injury (31.13%), reflecting general popularity throughout Europe. Handball, school sport-related activities, skiing, and biking accounted for 8.89%, 8.77%, 5.95%, and 5.71% of other injuries, respectively (Habelt et al., 2011). Most injuries occurred in the lower limbs (68.71%), followed by the upper limbs (25.27%), with the spine and head being injured in 2.57% and 1.99% of the cases, respectively. ...
Article
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Purpose. Physiotherapists are trained to prevent, assess, and rehabilitate all kinds of injuries including sports injury. The goal of the physical therapist should be making sure that the athlete is in optimal shape to perform, with a minimal risk for developing an injury. This study aims to assess the physiotherapists’ awareness, implementation, and views of sports injury prevention programs (IPPs) from an international perspective. Materials and methods. A self-administered questionnaire was developed and distributed to physiotherapists worldwide through World Physiotherapy member organizations. The study targeted physiotherapists at an international level. The study included 484 participants, of whom 44.4% were male and 55.6% were female physiotherapists. Results. A total of 287 (59.3%) of the participants were aware of the current sports IPPs, 177 (36.6%) were implementing sports IPPs in their current practice. Participants who implemented the sports IPPs reported a positive opinion about the program efficacy, with a score of 7.3 ± 2.11 out of 10. Conclusions. Globally, physiotherapists have average awareness and low implementation levels of IPPs. Physiotherapists showed a positive score regarding the effectiveness of IPPS, especially the KIPP and the iSPRINT.
... Therefore, since adolescence is divided into three phases (early: 10-13 years; middle: 14-17; late: [18][19][20][21] [10], the highest drop-out rate occurs in middle adolescence. Moreover, according to the current evidence, one of the main reasons for sport drop-out is the occurrence of injuries [11]. Therefore, an in-depth review of the youth sports programs to make sports practice safer. ...
... These results are similar to those obtained in the present study, in which 68.33% of the injuries occurred in the lower body, 20.45% in the upper limb, and 11.22% in the trunk. Habelt et al. [11] also observed a similar incidence (lower extremities 68.71%, upper extremities 25.27%, spine 2.57%, and head 1.99%). ...
... Additionally, the study participants whose sports techniques one sports coach supervised execution had a significantly lower ID, ISS, and IR than those who did not. These results are also consistent with numerous studies indicating that correct technical execution is a crucial factor in sports injury prevention [11]. ...
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Citation: Prieto-González, P.; Martínez-Castillo, J.L.; Fernández-Galván, L.M.; Casado, A.; Soporki, S.; Sánchez-Infante, J. Abstract: The present study aimed to determine the epidemiology of sport-related injuries in amateur and professional adolescent athletes and the incidence of different risk factors on those injuries. Four hundred ninety-eight athletes aged 14 to 21 voluntarily participated in this prospective injury surveillance, conducted from 1 January 2019 to 31 December 2019. The information collected included: personal data, sports aspects, characteristics of the injuries, and lifestyle. Forty point four percent of the participants suffered an injury in 2019 (39% of them in a previously injured area). The average injury rate was 2.64 per 1000 h. Soccer presented the highest rate (7.21). The most common injuries were: lumbar muscle strains (12.24%), ankle sprains (11.98%), and bone fractures (9.31%). Ankles (36.12%), knees (19.32%), and shoulders (6.47%) concentrated the highest number of injuries. Fifty-nine point twenty-eight percent of the injuries occurred during practices, and 40.72% during competition or peri-competition. Higher injury rates were associated (in this order) with the following factors: (a) Greater number of hours of practice per week. (b) Not performing warm-ups. (c) Using inadequate sports facilities. (d) Being aged 14-17. (e) Not performing physical preparation. (f) Inappropriate training load. (g) Not performing injury-preventive activities. (h) Performing sports technique without the supervision of one sports coach. (i) Inadequate sports equipment. In conclusion, since most injury risk factors are modifiable, it is imperative to implement strategies to reduce amateur and professional adolescent athletes' injury rates.
... Uraz de fi niu je się ja ko za dzia ła nie czyn ni ka ze wnętrz ne go, wy wo łu ją ce go w or ga ni zmie czło wieka zmia ny ana to micz ne i czyn no ścio we [1]. Wy stąpie nie ura zu u osób mło dych mo że ne ga tyw nie wpłynąć na dal szy roz wój i ka rie rę spor to wą [2,3] Fo ot ball ame ry kań ski, pił ka noż na, pił ka ręcz na i piłka siat ko wa to spor to we gry ze spo ło we bar dzo zróżni co wa ne pod wzglę dem re guł, ro dza ju tre nin gu i rywa li za cji. Fo ot ball ame ry kań ski jest uwa ża ny za jedną z bru tal niej szych gier ze spo ło wych. ...
... Injury is defined as the activity of an external factor, responsible for anatomical and functional changes in the human body [1]. In young persons, injuries may adversely affect their further development and sport careers [2,3]. ...
Article
Streszczenie Wstęp. Celem badań było określenie częstości urazów czterech dyscyplin spor to wych-gier zespołowych oraz określenia powiązań między poszczególnymi dys cy plinami, a ro dza-jem i miejscem występowania najczęstszych urazów, a także ich po dobieństw pod tym, w ujęciu wielowymiarowym. Materiał i metody. Badania przeprowadzono w 2017 roku, w klubach sportowych funk-cjonujących na terenie województwa dolnośląskiego. Grupę badawczą stanowiło 125 za-wodników płci męskiej w wieku między 15 a 18 rokiem życia (kadet-junior) ze średnią 16,27 lat. Reprezentowali oni 4 dyscypliny sportowe. 22 zawodników uprawiających football ame-rykański, 30 zawodników uprawiających piłkę nożną, 49 zawodników piłkę ręczną oraz 24 zawodników uprawiających piłkę siatkową. Do analizy wykorzystano dane ankietowe dotyczące urazów związanych z uprawianą dyscypliną sportu. Wyniki. Zdecydowana większość badanych (81,60%) odniosła uraz w wyniku upra-wia nia wybranej dyscypliny sportu. Najczęściej urazy odnosili piłkarze nożni, (96,66%), najrzadziej siatkarze (54,55%). Najczęściej urazom ulegają kończyny, szczególnie koń-czyna dolna-70,40% wszystkich stwierdzonych urazów. Najczęstszym rodzajem urazu jest stłuczenie (54,40%). Ogółem, niewiele mniej urazów dotyczy uszkodzenia mięśni-(52%). Wnioski. Uprawianie przedstawionych sportowych gier zespołowych wiąże się z ryzy-kiem wystąpienia urazu. Najbardziej na uraz narażeni są piłkarze nożni, a najmniej siat-karze. Urazy najczęściej dotyczą kończyn dolnych, z czego większość to stłuczenia i ura-zy mięśniowe. Postuluje się poszukiwanie rozwiązań prewencyjnych chroniących zawod-ni ków przed urazami. Summary Introduction. The purpose of the study was to determine the incidence of injuries in four team games, to determine the relationship between the discipline and the type and incidence of the most common injuries, as well as the similarities between the disciplines in terms of injury incidence using a multidimensional approach. Material and methods. The research was conducted in 2017, in sports clubs in Lower Silesia region. The research group included 125 male athletes aged between 15 and 18 years (Cadet-junior), The mean age in this group was 16.27 years. They represented 4 sports. The sample included 22 American football players, 30 football players, 49 handball players and 24 volleyball players. The analysis used the survey data on the history of injuries related to the discipline, circumstances, parts of the body involved and the type of injury. Results. The vast majority of the surveyed athletes (81.60%) sustained sport-related injuries. The most common injuries were sustained by footballers, (96.66%) while the least common injuries were sustained by volleyball players (54.55%). The most common injuries included limb injuries, especially low limb injuries (70.40% of all identified injuries). The most common type of injuries were fractures (54.40%). Overall, muscle lesions were slightly fewer injuries (fractures, sprain) (52%). Conclusions. Involvement in the presented team games entails the risk of injury. Most of the injuries were sustained by footballers, and the fewest injuries were sustained by volleyball players. Lower limb injuries were most frequent and included bruises and muscle injuries. Preventive solutions should be sought to protect players against injuries.
... Numerous young athletes resign from a sport at the age of 15 (in the range of 14-17 years) [1,3]. The occurrence of an injury is considered one of the main reasons for this fact [9]. Moreover, the rate of injuries increases linearly (in the range from age 9 to 15) with a peak at age of 13 among young male football players [10,11]. ...
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Biological maturation has an increasingly important role in youth sports. The aim of the study was to evaluate the relationship between dynamic balance and lower limb power and biological maturation in young football players. Seventy-two healthy, young male elite football players (age: 10 ± 2) participated in the study. Dynamic balance was assessed using a modified Star Excursion Balance Test (mSEBT). Power of the lower limbs was examined by a Countermovement Jump test (CMJ) and Single Leg Hop for Distance (SLHD). Furthermore, anthropometry and biological maturation (age, peak height velocity, and maturity offset) were assessed. There was a strong positive correlation between vertical jump (r = 0.75), distance long jump (r = 0.84), and biological maturation. A moderate positive correlation was found between dynamic balance (mSEBT COM, PL, and PM) and maturity offset. There was a significant association between mSEBT, CMJ, and SLHD (p < 0.05). Moreover, maturity offset explained 75% of vertical jump and 74% of distance long jump performance, respectively, and 12% of dynamic balance. Biological maturation should be considered when assessing athletic performance, establishing rehabilitation, and sports training in youth football players.
... The practice of many sports can expose the ankle joint to a high risk of acute and other long-term negative consequences (Armenis et al, 2011;Frisch et al, 2009;Golanó et al, 2014;Habelt et al, 2011) but only some sports such as soccer seem to induce evident changes in the ankle range of motion (ROM) (Moreno-Pérez et al, 2020;Rein et al, 2011;Travers&Evans, 1976). This condition is dreaded because it has been reported that it can increase the risk of injuries in soccer players (SP) and have negative effects on the integrity of the ankle, as well as on balance, posture and the biomechanics of movement (Brockett&Chapman, 2016;Fong et al, 2011;Kaufman et al, 1999;Moreno-Pérez et al, 2020;Paterno et al, 2013). ...
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Soccer practice can induce a limitation of ankle joint mobility (AJM) that is a dreaded risk factor for injury and other negative consequences over time. Objective: The aim of this study was to investigate the role of muscle strength (MS) in the definition of AJM of young soccer players (YSP). Methods: In 160 YSP, mean age 12.0±2.5 yrs, body mass index (BMI) 18.8±2,9 Kg/m 2 , and in 61 subjects who practiced basketball, volleyball and martial arts matched for age, BMI and sex, the AJM in both plantar flexion and dorsiflexion and the handgrip strength (HGS) were evaluated by inclinometer and Jamar hydraulic hand dynamometer respectively. Time series analysis was applied to assess the association between muscle strength and AJM in the soccer group versus the non-soccer group, depending on the age of the members of the two groups. Results: The AJM value observed in YSP was significantly lower compared to that of the controls (p<0.001). The HGS values found in YSP were similar to those of non-soccer players. Multivariate analysis showed that AJM resulted significantly associated with sport practiced (p<0.001). In the soccer group correlation analysis showed an inverse correlation between HGS and ankle dorsiflexion (p=0.005). Decomposition of time series analysis showed that in YSP after 13.3 years of age AJM decreases maintaining an inverse relationship with HGS (p<0.001). Conclusions: In YSP the ankle joint mobility is inversely correlated to muscle strength. The trend of this inverse relationship provides an indication of the important role of muscle activity in the development of ankle stiffness as well as indications for the monitoring and prevention of the same limited AJM
... The main reasons for knee joint injuries are change of direction or cutting action combined with deceleration, jumping to the ground when close to full extension, and pivoting and standing firm when the knee is close to full extension [2]. Badminton is the sport with the highest rate of acute injury among the sports, accounting for 1-5 percent of total sports injuries [12]. The technical characteristics of the unilateral handhold also affect the imbalanced development of the arms and torso, which is mainly manifested as an imbalance of muscle strength and an asymmetry in the quality of the completion of actions. ...
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Objectives: Investigate the effects of integrated neuromuscular training (INT) on injury prevention and the performance of professional female badminton athletes by comparing their preintervention and postintervention tests. The study hypothesized that integrated neuromuscular training can improve the asymmetry and improve the sport performance of female badminton players. Methods: According to pretest value based on functional movement screening, 38 participants were divided into a high-risk group (HG) and a low-risk group (LG) with 22 and 16 people in each group. Two groups of athletes took part in an 8-week INT program consisting of four 90-min sessions each week. The asymmetries in movement, physical fitness, and special abilities were tested before and after the intervention. Independent sample t-test was used for the statistical analysis. Results: This research found indicated that 8 weeks of INT influenced FMS scores in both groups (HG and LG). The change of inline lunge (ES H = 0.42, ES L = 0.21) and trunk stability push-up (ES H = -0.58, ES L = -0.20) showed significant differences (P < 0.05), and the change of the FMS scores (ES H = 0.81, ES L = 0.65), deep squat (ES H = 0.6, ES L = 0.3), and rotation stability (ES H = -0.65, ES L = -0.72) showed very significant differences (P < 0.01). Compared to the pretest, most of the physical fitness parameters improved significantly in the HG and LG groups except strength index, and special abilities of the HG and LG group women badminton athletes showed a substantial increase. Conclusion: Integrated neuromuscular training can effectively improve the asymmetry of female badminton athletes' limbs, prevent sports injury, and improve the athlete's performance ability. However, athletes in different risk groups have certain differences in the degree of improvement in their motor skills.
... Despite the health benefits, taking part in sports exposes the athlete to high injury risks. The occurrence of injuries on recreational and competitive athletes is affected by multiple parameters, such as the age, gender, sport type (contact or non-contact), training workload, moving patterns that each sport includes and other important factors that are analyzed further through this study [6], [7], [8], [9], [10], [11], [12], [13], [14] and [15]. Basketball is widespread all over the world, from recreational to professional gaming levels. ...
Article
The sports industry utilizes science to improve short to long-term team and player management regarding budget, health, tactics, training, and most importantly performance. Data Science (DS) and Sports Analytics play key roles in supporting teams, players and experts to improve performance. This paper reviews the literature to identify important attributes correlated with injuries and attempts to quantify their impact on player and team performance, using analytics in the National Basketball Association (NBA) from 2010 up to 2020. It also provides an overview of Machine Learning (ML) and DS techniques and algorithms used to study injuries. Additionally, it provides information for coaches, sports and health scientists, managers and decision makers to recognize the most common injuries and investigate possible injury patterns during competitions. We identify teams and players who suffered the most, and the type of injuries requiring more attention. We found a high impact from injuries and pathologies on performance; musculoskeletal impairments are the most common ones that lead to decreased performance. Finally, we conclude that there is a weak positive relationship between performance and injuries based on a holistic multivariate model that describes player and team performance.
Article
Purpose To compare osteochondral allograft (OCA) transplantation outcomes between adolescent patients ≤ 16 years of age and patients >16 years old. A secondary aim was to analyze the association between physeal closure status and outcomes. Methods Consecutive patients aged 18 years or younger who underwent OCA transplantation with a minimum 2-year follow-up were identified from a prospectively collected database. Patients were divided into two groups, ≤ 16 years old (group 1) and 17-18 years old (group 2). Outcomes included patient-reported outcomes (PROs), complications, reoperations, and cartilage revision surgery. Outcomes were compared between groups and physeal status was analyzed as a prognostic indicator. Results Thirty-six patients met the inclusion criteria; 18 patients in group 1 and 18 patients in group 2. There were no significant differences between the groups in terms of demographics, prior surgical history, and surgical details, including concomitant procedures, or other surgical details. Mean overall follow-up was 4.6±2.5 years (range 2-10.3 years) with no significant difference between the groups (p<0.21). There were 10 reoperations (28.8%), 4 in group 1 and 6 in group 2 (p=0.47). Overall time to reoperation was 2.8 years and did not significantly differ between groups (p=0.75). Failure rate was 5.6%, with one patient in each group undergoing either graft debridement or revision OCA transplantation. All PROs were significantly improved postoperatively (P<0.05), except for the WOMAC stiffness score (p=0.28) and the SF-12 mental score (p=0.19). There were no significant between-group differences in terms of PROs. Patients with a closed physis had a significantly greater increase in most PROs compared to patients with an open physis (p<0.05). Conclusion OCA transplantation in adolescents results in significant PRO scores improvement and low failure rate, albeit reoperations are not uncommon. Patients with closed physes demonstrated greater PRO scores improvement compared to those with open physes.
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Increasing numbers of children are becoming involved in competitive sport. International trends in pre-adolescent sports participation are mirrored in New Zealand, where promising young athletes are being exposed to high-intensity training from an earlier age. As a consequence, overuse injuries which were traditionally described in more mature athletes are now becoming recognized in pre-adolescents. The immature musculoskeletal system is less able to cope with repetitive biomechanical stress. Sites of overuse injury reflect the sites of rapid musculoskeletal development. It therefore behoves all medical practitioners, but particularly those in primary care, to be aware of the young athlete at risk. Inherent in the presentation of such musculoskeletal insult there often lurks an over-enthusiastic parent. We are all well reminded of the covert pressures adults may bring to bear upon children. Psychological, as well as physical injury often results.
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A total of 2617 sports injuries in children were analysed from a 2-year-period. The age-dependent rate of sports injuries in this material was 30% to 40% of all injuries in childhood. Although male children predominated over females with 2:1 depending from the type of sport, the sexual preponderance was very different. Horse riding injuries showed a female preponderance of 4:1. Most common occurrences were low-grade injuries such as contusions, distorsions or wounds. One-third of the injuries were fractures. 5% of the children had a brain injury such as commotio or contusio cerebri. Sequelae of accidents differed largely between different forms of sport. To quantify the extent of the injuries, a score was calculated from the rate of head injuries, times the rate of brain damage, times the rate of fractures of the long bones. By means of this score it can be shown that the most severe injuries occur during horse riding, skating, tobogganing and bicycle riding. A detailed analysis of different injury patterns allows recommendations for preventive measures. Language: de
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To describe the demographics and types of sports-related injuries (SRIs) in children. The authors performed a retrospective chart review of children 5-18 years of age diagnosed as having an SRI in a pediatric emergency department (ED) during a two-year period. Patients were identified by ICD-9 codes. Data collected were age, sex, sport, ED interventions, consultations, mechanism, location, and injury type. Pairwise comparisons were reported as odds ratios with 95% confidence intervals. Six hundred seventy-seven SRIs fit the inclusion criteria; 480 of the patients were male (71%). The mean ages of the males and females were 13.0 years (SD +/- 3.0 yr) and 12.4 years (SD +/- 2.9 yr), respectively. The six most common sports implicated were basketball (19.5%), football (17.1%), baseball/softball (14.9%), soccer (14.2%), in-line skating (Rollerblading)/skating (5.7%), and hockey (4.6%). Sprains/strains (32.0%), fractures (29.4%), contusions/abrasions (19. 3%), and lacerations (9.7%) accounted for 90% of injury types. Pairwise comparison of the four injury types in the six sports listed showed significant associations for contusions/abrasions in baseball, sprains/strains in basketball, fractures in Rollerblading/skating, and lacerations in hockey. Age variance, including all sports, of the younger group (5-11 yr) in fractures and the older group (12-18 yr) in sprains was significant. The most common injury location was wrist/hand (28%), followed by head/face (22%) and ankle/foot (18%). Each had significant sport-specific predilections. Contact with person or object was the mechanism for >50% of the SRIs. Sport-specific mechanisms followed lines drawn from the sport-specific injury types and locations. The pediatric age group incurs a variety of injuries in numerous sports with diverse sex, age, mechanism, location, injury type, and sport-specific differences.
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A total of 2617 sports injuries in children were analysed from a 2-year-period. The age-dependent rate of sports injuries in this material was 30% to 40% of all injuries in childhood. Although male children predominated over females with 2:1 depending from the type of sport, the sexual preponderance was very different. Horse riding injuries showed a female preponderance of 4:1. Most common occurrences were low-grade injuries such as contusions, distorsions or wounds. One-third of the injuries were fractures. 5% of the children had a brain injury such as commotio or contusio cerebri. Sequelae of accidents differed largely between different forms of sport. To quantify the extent of the injuries, a score was calculated from the rate of head injuries, times the rate of brain damage, times the rate of fractures of the long bones. By means of this score it can be shown that the most severe injuries occur during horse riding, skating, tobogganing and bicycle riding. A detailed analysis of different injury patterns allows recommendations for preventive measures.
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Within a 3-year period, from 1980 to 1982, 1124 sports injuries of children aged 6-15 years were treated in the Turku University Central Hospital casualty department. Two-thirds (69%) of the injuries were sustained by boys. Sports injuries represented 21% of the diagnoses related to accidents in this age group. Half of the sports accidents occurred during the 4 winter months. Boys were injured most commonly in ice hockey (36%) and football (20%) and girls in skating (18%) and riding (18%). One quarter (26%) of the injuries were located in the head and neck, 36% in the upper extremities, 33% in the lower limbs, and 4% in the trunk. The most common types of injuries were fractures (26%), sprains and strains (24%), contusions (22%) and wounds (17%). The proportional occurrence of fractures increased with age in boys (P less than 0.001) and decreased in girls (P less than 0.001), luxations (P less than 0.05) and sprains (P less than 0.001) increased with age in girls; skull injuries (P less than 0.01) and contusions and wounds (P less than 0.001) decreased in boys. Girls had more sprains (P less than 0.001) but fewer contusions and wounds (P less than 0.001). Most of the injuries were mild; 9% of the cases were hospitalized. Minor surgery was performed in 16% and reconstructive surgery in 2% of all injuries. About 70% of the injuries occurred in nonorganized sports.
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The increasing frequency of injury in young athletes over the last 2 decades reflects the increases in sports participation of children of a young age. Physical injury is an inherent risk in sports participation at any age. In general, the factors causing sports injuries can be grouped in 2 separate broad categories: extrinsic and intrinsic factors. However, the great majority of injuries which are sustained are minor and self-limiting, suggesting that children and youth sports are safe. However, a increasing number of children undergo treatment because of the effects that injuries may have on their developing bodies. A child’s skeletal system shows pronounced adaptive changes to intensive sports training. Sports injuries affect both growing bone and soft tissues, and could result in damage of the growth mechanisms with subsequent life-lasting damage. Adolescents are particularly vulnerable to injuries, at least partially due to an imbalance in strength and flexibility. During growth there are significant changes in the biomechanical properties of bone. In young athletes, as bone stiffness increases and resistance to impact diminishes, sudden overload may cause bones to bow or buckle. Epiphyseal injuries occur at the epiphyseal growth plates. They are usually due to shearing and avulsion forces, although compression also plays a significant role. Given the remarkable healing potential of bone in youngsters, fractures that initially united with some deformity can completely remodel and appear totally normal in later life. As the risk of injuries sustained by young athletes can be significant, it is essential that training programmes take into account their physical and psychological immaturity, so that the growing athlete can adjust to their own body changes.
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Scholastic-age sports are generally safe, and major musculoskeletal injuries are uncommon. Injuries are proportional to the athlete's age, size, and type of sport. Significant knee injuries do occur, especially during adolescence, and they require prompt, accurate diagnosis and specific treatment. The team physician plays a major role in injury prevention and management.
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A current injury profile was constructed on the data of the accident reports (n = 6366) in school sport coming in with the municipality accident insurance association for Schleswig-Holstein. The largest injury frequency occurred at the period from 9 o'clock until 10 o'clock. In this way, the "2nd hour" showed the highest injury risk referring to the lessons. In this case, a significant connection appeared between motivation and injury risk. The upper extremities were affected with a part of about 48% of all injuries most frequently. Within the injury kinds the distortion in 45% of the cases dominated. Cause of the injuries was the ball in 28% of the cases. The most injuries within the ball games resulted at the basketball (17%). By far most injuries of upper extremities occurred during a game phase. In about 80% the cases the injuries were on the fingers identified caused by the ball. The present results can help to analyze causes of accident and discuss measures for the prevention of sport injuries during the school sport.
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To establish the demographic profile and injury characteristics of children presenting with rollerblading or skateboarding associated injuries. This study also examines the circumstances leading to these injuries with a view to suggesting preventive measures. A prospective study using a proforma to collect data from each child presenting with rollerblading or skateboarding related injuries. Injury details were obtained from clinical and radiological records. The injury severity score (ISS) was calculated for each child and statistical analysis was done using chi2. Eighty one children presented with rollerblading associated injuries accounting for 7% of childhood injuries seen during the eight month study period. The mean age was 10.3 years and sex distribution was equal. Soft tissue injuries accounted for 51% and fractures for 49% of the injuries. Wrist fractures alone accounted for 86% of all fractures seen. Seventy per cent of soft tissue injuries involved the upper limb. The overall mean ISS was 3.0 with a range from 1 to 9. Injury was attributed to fall secondary to loss of control or collision with an obstacle while rollerblading in the majority of children. Injury occurred while rollerblading in residential or public places in 99% of the children. In contrast skateboarding related injuries were much rarer and caused soft tissue injuries only. This study has revealed a higher incidence of rollerblading injuries than previously suspected. Effective management strategies should include not only the treatment of these injuries but also attention to their causes and prevention.
Article
Most injuries in children's sports are minor and self-limiting, suggesting that children and youth sports are safe. A child's skeletal system shows pronounced adaptive changes to intensive sports training. Sports injuries affect both growing bone and soft tissues and could result in damage of the growth mechanisms with subsequent life-lasting damage. During growth there are significant changes in the biomechanical properties of bone. In young athletes, as bone stiffness increases and resistance to impact diminishes, sudden overload may cause bones to bow or buckle. Epiphyseal injuries are usually due to shearing and avulsion forces, although compression also plays a significant role. Given the remarkable healing potential of bone in youngsters, fractures that initially united with some deformity can completely remodel and appear totally normal in later life. Conclusion As the risk of injuries sustained by young athletes can be significant, it is essential that training programmes take into account their physical and psychological immaturity, so that growing athletes can adjust to their own body changes.