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      Developmental Training Model for the Sport Specialized Youth Athlete: A Dynamic Strategy for Individualizing Load-Response During Maturation

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          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.

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          Most cited references98

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          Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study.

          Female athletes participating in high-risk sports suffer anterior cruciate ligament injury at a 4- to 6-fold greater rate than do male athletes. Prescreened female athletes with subsequent anterior cruciate ligament injury will demonstrate decreased neuromuscular control and increased valgus joint loading, predicting anterior cruciate ligament injury risk. Cohort study; Level of evidence, 2. There were 205 female athletes in the high-risk sports of soccer, basketball, and volleyball prospectively measured for neuromuscular control using 3-dimensional kinematics (joint angles) and joint loads using kinetics (joint moments) during a jump-landing task. Analysis of variance as well as linear and logistic regression were used to isolate predictors of risk in athletes who subsequently ruptured the anterior cruciate ligament. Nine athletes had a confirmed anterior cruciate ligament rupture; these 9 had significantly different knee posture and loading compared to the 196 who did not have anterior cruciate ligament rupture. Knee abduction angle (P<.05) at landing was 8 degrees greater in anterior cruciate ligament-injured than in uninjured athletes. Anterior cruciate ligament-injured athletes had a 2.5 times greater knee abduction moment (P<.001) and 20% higher ground reaction force (P<.05), whereas stance time was 16% shorter; hence, increased motion, force, and moments occurred more quickly. Knee abduction moment predicted anterior cruciate ligament injury status with 73% specificity and 78% sensitivity; dynamic valgus measures showed a predictive r2 of 0.88. Knee motion and knee loading during a landing task are predictors of anterior cruciate ligament injury risk in female athletes. Female athletes with increased dynamic valgus and high abduction loads are at increased risk of anterior cruciate ligament injury. The methods developed may be used to monitor neuromuscular control of the knee joint and may help develop simpler measures of neuromuscular control that can be used to direct female athletes to more effective, targeted interventions.
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            The Importance of Muscular Strength in Athletic Performance

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              Is Open Access

              The Role of Puberty in the Developing Adolescent Brain

              Adolescence refers to the period of physical and psychological development between childhood and adulthood. The beginning of adolescence is loosely anchored to the onset of puberty, which brings dramatic alterations in hormone levels and a number of consequent physical changes. Puberty onset is also associated with profound changes in drives, motivations, psychology, and social life; these changes continue throughout adolescence. There is an increasing number of neuroimaging studies looking at the development of the brain, both structurally and functionally, during adolescence. Almost all of these studies have defined development by chronological age, which shows a strong—but not unitary—correlation with pubertal stage. Very few neuroimaging studies have associated brain development with pubertal stage, and yet there is tentative evidence to suggest that puberty might play an important role in some aspects of brain and cognitive development. In this paper we describe this research, and we suggest that, in the future, developmental neuroimaging studies of adolescence should consider the role of puberty. Hum Brain Mapp, 2010. © 2010 Wiley-Liss, Inc.
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                Author and article information

                Journal
                Sports Health: A Multidisciplinary Approach
                Sports Health
                SAGE Publications
                1941-7381
                1941-0921
                November 11 2021
                : 194173812110560
                Affiliations
                [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
                Article
                10.1177/19417381211056088
                34763556
                329c31c4-1650-45f4-bd5a-8803e6b09556
                © 2021

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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