The progress of human physical growth and functional development is not always consistent, and it depends on the different tempos and patterns of body parts, organs, and elements of physical fitness. When coaching and/or supporting young athletes, in addition to considerations of training efficiency, it is also important to consider the physical development of young athletes and their growth and development processes in order to avoid overloading parts of the body that have not fully developed due to their young age. Furthermore, since the speed and tempo of physical growth and development in young athletes differs from person to person it is desirable to avoid a coaching and/or support program that treats all athletes in a uniform manner. In other words, in this article I argue it is more beneficial to privilege considerations of biological maturity over chronical age.
In this article, we focus on the injury characteristics of youth athletes. First, we organize the physical characteristics of children during adolescent growth. Next, grasp the actual condition of injury of youth athlete in Japan. Finally, we summarize activities of sports organizations in Japan on injury prevention of youth athletes who are drawing the attention of sports orthopedic surgeons. During growth spurt phase, children have structurally fragile parts such as epiphysis and epiphyseal line, whose body structure is different from adults. The characteristic of sports injuries during the growth spurt phase occurs due to the fact that the growth of tissues such as the increase in bone mass and surrounding muscle tendons slightly lag against rapid bone growth. The sports injury is a summary of the traumatic injury in which the tissue is damaged by a major external force and the overuse injury in which the tissue gradually becomes damaged due to repeated minor external forces. Youth athletes often cause fractures and sprains in trauma and often develop osteochondrosis or stress fractures in overuse injury. In this study, individual body maturity is not taken into consideration, and it is caused by exercise practice in the physical disparity and over training due to load not matching body maturity. It is important in prevention of sports injuries to change the conditioning method, training and coaching method based on body maturity.
The number of anterior cruciate ligament (ACL) injuries in adolescents is rising. However, there is very little high-quality evidence to guide decision-making in management of pediatric ACL injuries. In October 2017, the International Olympic Committee hosted an international expert group, and the consensus statement on prevention, diagnosis and management of pediatric ACL injuries was posted. The consensus statement topics about 1) injury prevention and 2) high-quality rehabilitation were reported in this article. In addition, mechanism, risk factors, and effective preventive measures for ACL injuries in adolescent athletes were also reviewed. Stiff landings were associated with increased ACL injury risk for young female athletes, and the ACL injury risk could be reduced by neuromuscular control training program that targeted younger participants with high-compliance. Furthermore, we challenged to elucidate the movements requiring greater trunk accelerations and its frequencies during junior badminton games. ACL injuries in badminton have commonly occurred during single-leg landing after an overhead stroke in the backhand-side court. From our researches, the mediolateral physical demand and high-risk posture in the backhand-side court may be associated with a higher incidence of knee injuries during badminton games.
Osgood-Schlatter disease (OSD) is a well-documented clinical condition particularly in adolescent athletes. In recent years, the pathology and the factors associated with the onset has been clarified by applying the new evaluation tools and increasing in the longitudinal studies .On the other hand, there are few reports about the effect of the therapeutic exercises. Detection and intervention in early stage is required for the early return to sports. This article reviewed the scientific evidences about the pathology and the factors associated with the onset , diagnosis and treatment of OSD.
The current consensus on the pathophysiology of OSD is that it is a traction apophysitis of the proximal tibial tubercle resulting from repetitive microtrauma at the stage of relatively weak strength of the tibia tuberosity. Flexibility, muscle strength, growth, and kicking motions are factors that may cause OSD. These factors have generally been reviewed retrospectively and there have been a few prospective studies. For the early detection, it is important to imaging physical examinations such as pain regularly. Current treatment protocol for OSD is conservative, consisting primarily of rest, icing, NSAIDs, and therapeutic exercise. Although therapeutic exercise is the most important treatment that therapists and trainers associate with, the effects of exercises has not been established. In future, the appropriate treatment protocols especially therapeutic exercise according to pathological conditioning and the factors associated with the onset should be established.
Concussion is one of severe injuries in youth sports. Even though concussion has been considered as “mild” among sports-related head injuries and neglected the importance, recent studies clear the neurophysiological pathology. Most of the concussion improve in about 10 days, but it is reported some cases became repeated or chronic. Therefore, management of concussion requires proper evaluation and decision to graduated return to play/sports. According to epidemiological studies, sports with high incidence of concussion in adoselent are collision sports such as rugby, american football, and ice hockey. Especially in rugby, statistics show that one concussion occurred in every three games. In the soccer, the relationship between heading and concussion, and cognitive function has been suggested, but it remains unclear. In addition, it is reported that concussion is a problem with not only high incidence but also high recurrence rate and chronicity, suggesting a relationship with the long-term effects such as chronic traumatic encephalopathy (CTE). Regarding appropriate evaluation and management of concussion, injury assessment using Sports Concussion Assessment Tool (SCAT) and compliance with return to play strategy based on Graduated Return to Play/Sports protocol (GRTP/GRTS protocol) are necessary. In the future, more studies are needed to clear the effect of the concussion among adolescent, and the mechanism of long-term effects including after retirement.
本研究では，高校生サッカー部員190名を対象とし，下肢傷害の既往および大腿部，股関節，膝関節，足関節に分けた各部位の傷害既往の有無とFunctional Movement ScreenTMの各項目の点数，左右差の関連を検討した．傷害既往と関連が認められたのは，Active Straight Leg RaiseとDeep Squat，Trunk Stability Push upであった．股関節の可動性，下肢の協調性，コアの安定性低下が傷害要因となる可能性が示唆された．
本研究は，大学アメリカンフットボール選手の可動性不良群38名と可動性良好群14名を対象とし，可動性の改善を目的としたエクササイズを週3回，12週間実施した．可動性不良群において，Functional Movement Screen（FMS）のスコアは，合計スコアとDeep Squat（DS），Shoulder Mobility Reaching（SMR），Active Straight Leg Raising （ASLR）に12週時点で有意な改善が認められた．SMRとASLRは可動性が必要な動作であり，本研究で実施したエクササイズにより，可動性の項目だけでなく複雑な動作パターンであるDSの改善にも寄与することが示唆された．