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THE YOUNG ATHLETE – Sports Physiotherapy & Rehabilitation

February 19, 2019 by admin - No Comments

Sports medicine care for the younger athletes provides a number of challenges to the sports physiotherapist and clinicians. Sports Physiotherapy and rehabilitation is of utmost importance in the younger athletes.

Younger athletes suffer many of the same injuries as their adult counterparts. However, there are also some significant differences in the type of injuries sustained by children and adolescents because of the differences in the structure of growing bone compared with the adult bone.

Anatomical differences between the adult and growing bone

  1. The articular cartilage of the growing bone is thicker than in adult bone and can remodel.
  2. The junction of metaphyseal and epiphyseal plates are prone to fractures, especially from shearing forces.
  3. The tendon attachment sites (apophyses) provide a relatively weak attachment, predisposing to the development of avulsion injuries.
  4. The long bones in children are more resilient and elastic, withstanding greater deflection without fractures.
  5. During rapid growth phases, bone lengthens before muscles, tendons and before the musculotendinous complex develops the necessary strength and coordination to control the newly lengthened bone. Growth temporarily reduces coordination and this manifests as awkwardness in movement patterns while playing sports.

 

HOW MUCH IS TOO MUCH?

Taking into account the individual variations that occur in the physical, physiological and psychological capacities of the young athlete, it is not appropriate to take a recipe book approach to train them. Prior to puberty, children should be encouraged to participate in a variety of activities so that the general skills can be developed and all the facets of athletic performance enhanced. Specialization at a younger age has to be avoided.

General guidelines

  • Long distance runners:
AGE (years) DISTANCE (km)
Under 9 3
9-11 5
12-14 10
15-16 21 (Half marathon)
17 30
18 42 (Full marathon)
  • Sprints
    • Frequency – Up to 14 years should not exceed 3 times per week.
    • Duration – Not more than 1.5 hours including warm up and stretches
    • Avoid training on hard surfaces and use surfaces such as grass, dirt to reduce the impact on the growing body.
  • Jumping events (long jumps, triple jumps, high jumps, pole vault)
    • Frequency:
      • Up to 14 years should not exceed 3 times per week with a maximum of 10 jumps per session.
      • 15-18 years should not exceed 5 sessions per week with a maximum of 20 jumps per session.
    • Duration – Not more than 1.5 hours including warm up and stretches
  • Gymnastics
    • Recreational and low-level competitive gymnasts should train 2 hours per week.
    • Intermediate competitive and national level gymnasts should train 15 hours per week
    • International gymnasts should train 20-30 hours per week.
  • Swimming

AGE

(years)

FREQUENCY & DURATION DEVELOPMENT
3-4 Whenever in bath/pool/beach To gain confidence in the water, ability to submerge and open eyes.
5-7 Two 20 mins sessions per week To learn basic skills and stroke techniques.
8-9 2-3 sessions per week of 45 mins each To learn advanced skills and techniques.
10-12 3-5 sessions per week of 60-90 mins each For the introduction to competition and strengthen strokes.
13-16 5-9 sessions per week of 90-120 mins each Gear training for seasonal program of competition, to maximize opportunities, to develop all strokes and various distances.
  • Resistance training
    • These guidelines incorporate the International Federation of Sports Medicine, British Association of Sport and Exercise Sciences and the American Academy of Pediatric guidelines on resistance training in children.
    • All training sessions should be preceded by stretching and followed by stretching and a cool-down period.
    • For children up to 12 years, the frequency should not exceed 3 sessions per week and duration of 90 mins.
    • For elite athletes, the total training load may vary according to the sport and level of competition.
    • Training should be directed to high repetitions and low loads involving all muscle group through a full range of movement at each joint.

References

  1. Clinical Sports Medicine, third edition. Peter Brukner and Karin Khan with colleagues.
  2. Micheli LJ, Fehlandt AF Jr. Overuse injuries to tendons and apophyses in children and adolescents. Clin Sports Med 1992; 11 (4): 713-26.
  3. Feldman D, Shrier I, Rossignol M, Abenhaim L. Adolescent growth is not associated with changes in flexibility. Clin J Sports Med 1999; 9 (1): 24-9.
  4. Malina RM. Physical growth and biological maturation of younger athletes. Exerc Sports Sci Rev 1994; 22 : 389-433.
  5. International Federation of Sports Medicine (FIMS). Position statement: Resistance training for children and adolescents. In: Chan KM. Micheli LJ, eds. Sports and Children. Hong Kong: Williams & Wilkins, 1998: 265-70.
  6. Bernhardt DT, Gomez J, Johnson MD, et al. Strength training by children and adolescents. Pediatrics 2001: 107 (6): 1470-2.