5 Questions with Dr. John DiFiori, AMSSM President

amssm overuse

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Youth Sport and Burnout

January represents the new year here at CJSM, as it does of course for all of you in the blogosphere.  But what really excites us is not the opportunity to set new year’s resolutions:  it’s  the new issue of the CJSM, and that’s what I want to share with you today.

There is a lot on offer in this issue, including studies exploring treatments of articular cartilage pathology, a study of functional ankle instability, and a journal club exploring the relative of benefits of PRP and ESWT on chronic patellar tendinopathy.

The lead study is a systematic review and position statement on the issue of youth sports, with an evidence-based  focus on the phenomena of overuse injuries.  This blog reviewed the statement in an earlier post.  It’s an important study, and we want to make sure as many people as possible get a chance to read it.

And so, we feel fortunate to have had the chance over the holidays to chat with the lead author of the paper, Dr. John DiFiori, and ask him ’5 questions’ about his recent work.


1) CJSM: Dr. DiFiori, you are the lead author of the new American Medical Society for Sports Medicine (AMSSM) position statement on ’overuse injuries and burnout in youth sports.’  Can you tell us a bit about the genesis of this statement?  When was it first conceived?  How long did it take to go from initial conception to publication?  How did you gather together the group of experts who are authors on this statement?

JD: Given all of the issues currently surrounding youth sports, the AMSSM leadership felt that a position statement focusing on overuse injuries and burnout would be timely, and would help to address many of the concerns held by sports medicine professionals, as well parents, coaches, and the young athletes themselves. In late 2011, a nominating process was completed, and I was asked by AMSSM to lead this project. The six outstanding members of the writing group were identified through a similar process, based on their clinical expertise, and their record of educational and scholarly contributions in this area.

We began to develop the content areas and search strategy in early 2012. We endeavored to have the paper be as evidenced-based as possible. To this end, we utilized a systematic search process, followed by author review, to identify relevant literature. The writing process, multiple re-writes and editing to ensure accurate information, took about 1 year. Because of the length of the process, we performed another systematic literature search in mid 2013 to ensure the paper would be as up to date as possible. The draft then underwent critical review by several expert external reviewers, who provided some very valuable suggestions. Following this, the paper underwent another round of review by the AMSSM Board of Directors. And then it was off to CJSM. So, all in all it was a very thorough process. Hopefully the result is a document that will be a solid resource for the sports medicine community.

2) CJSM: The statement is a comprehensive review of some of the major phenomena in the world of youth sport:  overuse, early specialization, over scheduling, burnout. What do you think are some of the underlying forces driving these phenomena?  Are there different pressures being brought to bear on the modern youth athlete we didn’t see a generation ago?  And if so, what are they? Read more of this post

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