Overuse injuries in youth sports: biomechanical considerations.

Many children today participate in highly organized sports programs that involve regimented year-round repetitive training. This type of training has led to an increased incidence of overuse musculoskeletal injuries. Sports physicians have dealt with sports injuries in children for many years and, on the basis of their clinical experience, have developed guidelines to treat and to try and prevent these injuries. The purpose of this article is to provide a biomechanical perspective of sports injuries in young athletes and blend ideas from this perspective with more traditional clinical perspectives that dominate the literature relative to this topic. Basic tissue and gross movement mechanics principles are used to identify growth, morphological, and movement factors that may predispose a child to an overuse injury. Several biomechanical analyses of simple movement tasks are presented to quantify the forces developed in various tissues and to illustrate the effects that growth can have on these forces. Guidelines are given for developing injury prediction models that may be used in the future to establish safe and effective training guidelines for children.

[1]  C B Frank,et al.  Tensile properties of the medial collateral ligament as a function of age , 1986, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[2]  Richard G. Snyder,et al.  ANTHROPOMETRY OF INFOANTS, CHILDREN, AND YOUTHS TO AGE 18 FOR PRODUCT SAFETY DESIGN , 1977 .

[3]  C. Tipton,et al.  Influence of age and sex on the strength of bone-ligament junctions in knee joints of rats. , 1978, The Journal of bone and joint surgery. American volume.

[4]  C. Tipton,et al.  The influence of physical activity on ligaments and tendons. , 1975, Medicine and science in sports.

[5]  F R Noyes,et al.  Biomechanics of ligament failure. II. An analysis of immobilization, exercise, and reconditioning effects in primates. , 1974, The Journal of bone and joint surgery. American volume.

[6]  D L Butler,et al.  The relationship between crimp pattern and mechanical response of human patellar tendon-bone units. , 1985, Journal of biomechanical engineering.

[7]  O. Bar-or,et al.  Growth, Maturation and Physical Activity , 1992 .

[8]  N. Maffulli,et al.  Intensive Training in Young Athletes , 1990 .

[9]  C. Tipton,et al.  Influence of exercise on strength of medial collateral knee ligaments of dogs. , 1970, The American journal of physiology.

[10]  L. Micheli,et al.  Sports injuries in children and adolescents. Questions and controversies. , 1995, Clinics in sports medicine.

[11]  Growth of estimated segment masses between four and sixteen years. , 1987, Human biology.

[12]  P. Sacco,et al.  A cross-sectional survey of upper and lower limb strength in boys and girls during childhood and adolescence. , 1990, Annals of human biology.

[13]  R K Jensen,et al.  Growth of segment principal moments of inertia between four and twenty years. , 1988, Medicine and science in sports and exercise.

[14]  David Cecil Sinclair,et al.  Human Growth After Birth , 1973 .

[15]  C. Tipton,et al.  Influence of physical activity on ligament insertions in the knees of dogs. , 1971, The Journal of bone and joint surgery. American volume.

[16]  S. Orava,et al.  Exertion injuries to young athletes , 1978, The American journal of sports medicine.

[17]  A. Marchi,et al.  Permanent sequelae in sports injuries: a population based study , 1999, Archives of disease in childhood.

[18]  L. Micheli,et al.  Overuse injuries to tendons and apophyses in children and adolescents. , 1992, Clinics in sports medicine.

[19]  E. Wojtys Sports injuries in the immature athlete. , 1987, The Orthopedic clinics of North America.

[20]  Pekka Kannus,et al.  Human Tendons: Anatomy, Physiology, and Pathology , 1997 .

[21]  S. Dalton Overuse Injuries in Adolescent Athletes , 1992, Sports medicine.

[22]  S. Woo,et al.  Mechanical properties of tendons and ligaments. II. The relationships of immobilization and exercise on tissue remodeling. , 1982, Biorheology.

[23]  G. Fleisig,et al.  Elbow injuries in young baseball players. , 1999, The Physician and sportsmedicine.

[24]  F R Noyes,et al.  Functional Properties of Knee Ligaments and Alterations Induced by Immobilization: A Correlative Biomechanical and Histological Study in Primates , 1977, Clinical orthopaedics and related research.

[25]  S L Woo,et al.  The biomechanical and morphological changes in the medial collateral ligament of the rabbit after immobilization and remobilization. , 1987, The Journal of bone and joint surgery. American volume.