Neeru Jayanthi1,2,3, Stacey Schley2, Sean P Cumming4, Gregory D Myer2,3,5,6, Heather Saffel7, Tim Hartwig8, Tim J Gabbett9,10. 1. Departments of Orthopaedics and Family Medicine, Emory School of Medicine, Atlanta, Georgia. 2. Emory Sports Medicine Center, Johns Creek, Georgia. 3. Emory Sport Performance and Research Center, Flowery Branch, Georgia. 4. Department for Health, University of Bath, Bath, United Kingdom. 5. Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia. 6. The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts. 7. South Bend-Notre Dame Sports Medicine Fellowship, Beacon Bone & Joint Specialists, South Bend, Indiana. 8. School of Behavioural and Health Sciences, Strathfield Campus, Australian Catholic University, Strathfield, New South Wales, Australia. 9. Gabbett Performance Solutions, Brisbane, Queensland, Australia. 10. Centre for Health Research, University of Southern Queensland, Ipswich, Queensland, Australia.
Abstract
CONTEXT: Most available data on athletic development training models focus on adult or professional athletes, where increasing workload capacity and performance is a primary goal. Development pathways in youth athletes generally emphasize multisport participation rather than sport specialization to optimize motor skill acquisition and to minimize injury risk. Other models emphasize the need for accumulation of sport- and skill-specific hours to develop elite-level status. Despite recommendations against sport specialization, many youth athletes still specialize and need guidance on training and competition. Medical and sport professionals also recommend progressive, gradual increases in workloads to enhance resilience to the demands of high-level competition. There is no accepted model of risk stratification and return to play for training a specialized youth athlete through periods of injury and maturation. In this review, we present individualized training models for specialized youth athletes that (1) prioritize performance for healthy, resilient youth athletes and (2) are adaptable through vulnerable maturational periods and injury. EVIDENCE ACQUISITION: Nonsystematic review with critical appraisal of existing literature. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 4. RESULTS: A number of factors must be considered when developing training programs for young athletes: (1) the effect of sport specialization on athlete development and injury, (2) biological maturation, (3) motor and coordination deficits in specialized youth athletes, and (4) workload progressions and response to load. CONCLUSION: Load-sensitive athletes with multiple risk factors may need medical evaluation, frequent monitoring, and a program designed to restore local tissue and sport-specific capacity. Load-naive athletes, who are often skeletally immature, will likely benefit from serial monitoring and should train and compete with caution, while load-tolerant athletes may only need occasional monitoring and progress to optimum loads. STRENGTH OF RECOMMENDATION TAXONOMY (SORT): B.
CONTEXT: Most available data on athletic development training models focus on adult or professional athletes, where increasing workload capacity and performance is a primary goal. Development pathways in youth athletes generally emphasize multisport participation rather than sport specialization to optimize motor skill acquisition and to minimize injury risk. Other models emphasize the need for accumulation of sport- and skill-specific hours to develop elite-level status. Despite recommendations against sport specialization, many youth athletes still specialize and need guidance on training and competition. Medical and sport professionals also recommend progressive, gradual increases in workloads to enhance resilience to the demands of high-level competition. There is no accepted model of risk stratification and return to play for training a specialized youth athlete through periods of injury and maturation. In this review, we present individualized training models for specialized youth athletes that (1) prioritize performance for healthy, resilient youth athletes and (2) are adaptable through vulnerable maturational periods and injury. EVIDENCE ACQUISITION: Nonsystematic review with critical appraisal of existing literature. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 4. RESULTS: A number of factors must be considered when developing training programs for young athletes: (1) the effect of sport specialization on athlete development and injury, (2) biological maturation, (3) motor and coordination deficits in specialized youth athletes, and (4) workload progressions and response to load. CONCLUSION: Load-sensitive athletes with multiple risk factors may need medical evaluation, frequent monitoring, and a program designed to restore local tissue and sport-specific capacity. Load-naive athletes, who are often skeletally immature, will likely benefit from serial monitoring and should train and compete with caution, while load-tolerant athletes may only need occasional monitoring and progress to optimum loads. STRENGTH OF RECOMMENDATION TAXONOMY (SORT): B.
Entities:
Keywords:
competition; injury prevention; single sport; young athlete
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