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growth

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Competitive and elite sport often challenges the balance between health and performance, especially when it involves youth athletes. As Lausanne was getting ready to host the 2020 winter Youth Olympic Games, we had the opportunity to reflect on these challenges and on what they mean for sports medicine practitioners. Elite sport pushes athletes to the limit, be it through their own intrinsic drive to achieve ever more, or through the pressures of the multiple stakeholders around sport.
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Young competitive athletes are particularly at risk during puberty. Growth plates and apophyses are reduced in their stability by hormone influence. Epiphyses can slip, apophyses can tear out. Therefore, a regular examination of those athletes is important. The examination should focus on muscular asymmetries, or reduced range of motion of a joint. Shortened muscles have to be recon as a risk factor for apophysitis. Dysbalances of the musculature are mainly found in the trunk area. Training plans should be adapted to the increased vulnerability.
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Until now, there have been no studies in Switzerland that investigate differences in the motor performance disposition of children in urban and rural as well as in traditional and physical education kindergartens. A newly developed test instrument (MOBAK-KG) was therefore used in a supra-­cantonal research project in school year 2017/18 to test the motor skills of 4- to 6-year-old children (n = 403, Ø 5,7 years, SD = .56) in the areas of “self-movement” and «object-movement».
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There’s a relatively high prevalence of groin pain in male football players across the literature (ca. 21% of all time-loss injuries per season), and it is considered the third most common injury in football. About 2/3 of all groin injuries are adductor related. Andrea Mosler (former Aspetar, Doha, now at La Trobe University, Melbourne) who presented at the #SportSuisse 2018 conference, completed her PhD with a series of prospective studies on risk factors for groin pain in athletes. The aims were to identify the intrinsic risk factors for hip/groin injury, to determine if the “at-risk” individual can be identified through screening, and to examine the association between bony hip morphology and groin injury risk.
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During the last years, muscle strengthening exercises have been included as an essential part in youth physical activity guidelines of national and international health organisations. It is well-documented that strength training is effective in improving physical fitness and promoting health and psycho-social well-being. Therefore, the purpose of this review article is to present empirical evidence on the effectiveness of strength training in children and adolescents.
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The growing spine is – particularly in performance oriented young athletes – prone to overload: under pubertal hormonal influence the 48 cartilaginous growth zones beneath the vertebral endplates are mechanical as fragil as never before during growth whereas on the other side the impacting forces are becoming higher due to the longer trunk lever arm, the often apparent relative muscular insufficiency, the increasing training hours and intensity as well as the willingness and pressure to perform. The subsequent biomechanical imbalance usually results in simple functional complaints but may also entail structural changes, for example (thoraco-) lumbar Scheuermann’s disease in sports with high axial impact such as alpine skiing oder gymnastics.
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Ideally, the musculosceletal system and it’s components maintain a biologic balance during growth in order to compensate and/or adapt to intrinsic and extrinsic factors. Otherwise, the risk of acute or overuse injuries is increasing. The growth cartilage at the level of the growth plates or apophyses as well as the spine is highly vulnerable to overuse injuries, especially during the pubertal growth spurt. The diagnosis of an overuse injury is often delayed due to the undulant clinical manifestation and the treatment can be extensive and long-lasting, sometimes leading to an early cessation of sports activities.
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Adolescence is triggered by puberty and corresponds to a time of great changes in many fields including biological, psychological, cognitive and social. Participation to a sport activity improves self-esteem, socialisation with peers and physical condition. Yet, it sometimes is associated with suffering, restrictive behaviours and eating disorders when performed at an intensive level. Intensive sport activity during adolescence should take into account young people’s developmental stages as well as their fundamental needs in order to promote a harmonious training. One way to promote such training is to train parents and medical health providers to recognise these specific developmental needs and take them into account.
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Ein junger Athlet sollte seine sportliche Tätigkeit über die gesamte Zeit von Wachstum und Entwicklung möglichst erfolgreich und mit Freuden durchführen können. Gerade sind von einem Expertenteam unter dem Hut des IOC lesenswerte Empfehlungen lanciert worden, wie gesunde, belastbare und fähige junge Athleten entstehen und wie diese optimal betreut werden sollen, jeder auf seinem sportlichen Niveau und mit seinen eigenen Erfolgsvorstellungen.
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Apophysitis are part of the growth-related diseases within youth athlete population. Despite their high incidence within this growing cohort, many doubts remain. The physiopathology is still debated. Initially, the fragmentation of the ossification center was seen as the main factor of the disease. For few years, this theory has been questioned due to consistent signs of tendon suffering. Apophysitis may have some negative long-term effect on a sporting career. There is currently poor scientific evidence on the optimal management and no treatment has been widely accepted.
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