Overuse Injuries and Burnout in Youth Sports


10,000 hours of practice, and
he might make the Red Sox?*

We’re very pleased at CJSM to open the New Year with a shout:  a fantastic systematic review and position statement on the subject of youth sport, from the American Medical Society for Sports Medicine (AMSSM).

The focus of the paper–in the January 2014 issue, which has just published–is on overuse injuries, which are thought to represent roughly half of all the injuries youth athletes sustain.

All readers of the journal, and of this blog, will find this a worthwhile read.  I have a selfish interest in the subject, as I am currently practicing pediatric sports medicine, and in my professional life I live and breathe the issues discussed in the paper. Moreover, I know several of the authors of this paper, and I think highly of them all.

But this is not about ’eminence based’ medicine.  No, it’s evidence-based all the way.  The paper is both a systematic review and the AMSSM position statement on the subject of “Overuse Injuries and Burnout in Youth Sports”.  The authors conducted a thorough review of the literature, identifying 953 papers and citing 208 unique references in their comprehensive analysis of this broad subject.  They go on to review what is known, and then make recommendations, classified using the Strength of Recommendation Taxonomy (SORT) grading system.

The paper is broadly organized into the following subsections:  epidemiology; risk factors (intrinsic and extrinsic); discussion of high-risk overuse injuries;  discussion of several concepts mentioned frequently in the literature of youth sports (readiness for sport; sport specialization; burnout); and prevention.

The study is so very comprehensive, I cannot do better justice to it than encourage you to read it yourself.  I thought I might here mention some of what stood out for me. Read more of this post

Ringette: Who Knew?


Ringette Player in Action!

At CJSM we are already anticipating the start of 2014:  the January 2014 issue is still awaiting publication, but we are already releasing some of this coming year’s studies in our “Published ahead of print” collection.

One I wanted to talk about today, if only because the subject sport is an entirely new one to me: Ringette-related injuries in young female players.

Ringette.  As a middle-aged guy, I know I still have a lot to learn.  That said, I am delighted when I have a day where I acquire some new fact or concept I literally have never encountered in my over 18000 days on the planet.  Ringette.  I had never heard of this sport until I read this epidemiologic study.  Nearly everything I now know about the sport comes courtesy of the authors Glenn Keays, Isabelle Gagnon, and Debbie Friedman.  Thanks to you all!

A team sport played on ice rinks, ringette is similar to ice hockey with these notable exceptions:  1) 6 skaters comprise a team; 2) the skaters advance a doughnut shaped ring, rather than a puck, with a stick that has no blade; 3) the rules governing the sport encourage the development of team play; for instance, a player that might be lionized in hockey for being able to single-handedly advance the puck the length of the rink and score is, in ringette, penalized instead.  Like competitive women’s ice hockey, ringette is a non-collision sport, with all contact between players officially prohibited.  Players are equipped with safety devices such as helmets and visors.

The sport has been around for 50 years, originating in Canada.  It is expanding internationally, with associations in the USA, Finland, Sweden and beyond.  Read more of this post

Avery Faigenbaum y Cinco Preguntas con Revista Clinica de Medicina Deportiva

You read that right.

Like the NBA teams that don a Spanish jersey for an evening, at CJSM we are getting our Spanish on.

Faigenbaum_diRoda (1)

Drs. Avery Faigenbaum and
Provincial Senator Cristina diRado
in Mar del Plata, Argentina

Our good friend and contributor to these blog pages and to the journal, Dr. Avery Faigenbaum, has agreed to sit with us for “5 Questions with CJSM.” We have been trying to catch up with him since his trip to Argentina this summer where he was lecturing on Exercise Deficit Disorder (EDD) and working on his own Spanish skills.  I’m know he’s a lot better in that area than I am.

Dr. Faigenbaum is a professor in the Dept. of Health and Exercise Science at The College of New Jersey.  He has written about EDD in youth (“Thinking Outside the Sandbox”) and about the benefits and safety of resistance training in youth.  He has lectured widely:  I’ve heard him speak in various settings in the United States, and he’s set to speak to the American Academy of Pediatrics in 2014 on EDD. Catch him if you can, you’re sure to learn a lot and be entertained as well: his energy is infectious.

And here’s just a taste of what you’re in for if you do get to see him:


Avery Faigenbaum: Five Questions with CJSM

1) CJSM: With the recent award of the 2020 Olympic games to Tokyo, can you comment on any evidence out there that such events stimulate activity in young fans/viewers?  Is there a ‘trickle down’ effect for youth athletics/exercise from events like the Olympics?

AF: Last summer James Bond and the “Queen” opened the Olympic Games in London by jumping out of a helicopter. This was followed shortly thereafter by stellar performances from world class athletes including sprinter Usain Bolt, swimmer Michael Phelps, boxer Nicola Adams, and 23 year old Rosannagh MacLennan who started jumping on the trampoline at the age of seven. But in stark contrast to these remarkable feats of athleticism, physical inactivity among the world’s population is now recognized as a pandemic. Read more of this post

Once More Unto the Breach

henry v

Shakespeare and sports medicine:
A perfect mix

I’ll bookend this post with two heavyweights of Western Civilization: Shakespeare and Paul of Tarsus (a.k.a. St. Paul).   This must be an important issue!

Once more unto the breach dear friends!  Like Shakespeare’s Harry, I’ll head into the fray and pick up the thread of a conversation that dominated this blog a week ago, when we were discussing a position statement on Mandatory Bicycle Helmet Legislation (MHL).  Take a chance to look back at the entire blog, there have been several posts and over a hundred comments on the issue.

You’ll find two different polls in that series of posts.  I tallied up the votes on November 20 (the ‘polls are still open,’ and so the numbers will keep adding up) and wanted to share them with you.

On the question of whether there should be mandatory bicycle helmet legislation, the respondents voted so: 245 no, 31 yes, 2 undecided.

The next poll asked the question:  if you are opposed to MHL, what single issue most informs your opinion.  The choices (and votes for) are:

73 voters thought that MHL put the focus on the wrong group for an intervention; bike safety begins with road and car driver safety.

48 thought that MHL sent an inappropriate message:  that MHL indicated biking is risky behavior, when it is inherently safe.

29 were concerned that MHL negatively affected bicycle ridership (decreased rates of biking).

9 thought that MHL was an unjustified restriction of their civil liberties.

And 9 thought that MHL weren’t helpful in reducing what they are purported to do:  reduce bicyle-related head trauma.

I put these vote results, from a decidedly non-scientific poll, in graphical form below.  The vast majority of poll respondents oppose MHL, and a plurality are concerned that the focus on bike safety needs to be placed not on personal protective equipment for bicyclists, but on making roads safer and car drivers’ more cognizant of their responsibility to share the road.

MHL reformattedreason for opposition

Read more of this post

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