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Overuse Injuries and Burnout in Youth Sports: APositionStatementfromtheAmericanMedicalSocietyfor Sports Medicine

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TLDR
This review aims to provide a systematic, evidenced-based review that will assist clinicians in recognising young athletes at risk for overuse injuries and burnout, andelineate the risk factors and injuries unique to the skeletally immature young athlete.
Abstract
### Background Youth sport participation offers many benefits including the development of self-esteem, peer socialisation and general fitness. However, an emphasis on competitive success, often driven by goals of elite-level travel team selection, collegiate scholarships, Olympic and National team membership and even professional contracts, has seemingly become widespread. This has resulted in an increased pressure to begin high-intensity training at young ages. Such an excessive focus on early intensive training and competition at young ages rather than skill development can lead to overuse injury and burnout. ### Purpose To provide a systematic, evidenced-based review that will (1) assist clinicians in recognising young athletes at risk for overuse injuries and burnout; (2)delineate the risk factors and injuries that are unique to the skeletally immature young athlete; (3) describe specific high-risk overuse injuries that present management challenges and/or can lead to long-term health consequences; (4) summarise the risk factors and symptoms associated with burnout in young athletes; (5)provide recommendations on overuse injury prevention. ### Methodology Medical Subject Headings (MeSHs) and text words were searched on 26 March 2012 from MEDLINE, CINAHL and PsycINFO. The search yielded 953 unique articles. Additional articles were found using cross-referencing. The process was repeated on 10 July 2013 to review any new articles since the original search. Screening by the authors yielded a total of 208 relevant sources that were used for this article. Recommendations were classified using the Strength of Recommendation Taxonomy (SORT) grading system. ### Definition of overuse injury Overuse injuries occur due to repetitive submaximal loading of the musculoskeletal system when rest is not adequate to allow for structural adaptation to take place. Injury can involve the muscle-tendon unit, bone, bursa, neurovascular structures and the physis. Overuse injuries unique to young athletes include apophyseal injuries and physeal stress injuries. ### Epidemiology It is estimated that 27 million US youth between 6 and 18 years of age participate in …

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Citations
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Monitoring the athlete training response: subjective self-reported measures trump commonly used objective measures: a systematic review.

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Sports-Specialized Intensive Training and the Risk of Injury in Young Athletes A Clinical Case-Control Study

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References
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Variations in the Pattern of Pubertal Changes in Boys

TL;DR: Mixed longitudinal data on the physical changes at puberty in 228 normal boys are presented together with normal standards for stages of genital and pubic hair development, finding that boys' genitalia begin to develop only about 6 months later than the girls' breasts and Pubic hair appears about 1½ years later in boys than in girls.
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Evidence based physical activity for school-age youth.

TL;DR: School-age youth should participate daily in 60 minutes or more of moderate to vigorous physical activity that is developmentally appropriate, enjoyable, and involves a variety of activities.
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Growth, Maturation, and Physical Activity

TL;DR: This book introduces the Basics of Growth, Maturation, and Performance, and discusses age- and sex-Associated Variation in Growth and Performance.
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Physical activity and clustered cardiovascular risk in children: a cross-sectional study (The European Youth Heart Study)

TL;DR: Assessment of associations of objectively measured physical activity with clustering of cardiovascular disease risk factors in children from Denmark, Estonia, and Portugal found levels should be higher than the current international guidelines of at at least 1 h per day of physical activity of at least moderate intensity.
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American College of Sports Medicine position stand. The female athlete triad.

TL;DR: The female athlete triad (Triad) refers to the interrelationships among energy availability, menstrual function, and bone mineral density, which may have clinical manifestations including eating disorders, functional hypothalamic amenorrhea, and osteoporosis.
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