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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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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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The process by which young talents develop to become top-class players once they reach the age of maximum performance is influenced by numerous factors. Among the exogenous factors, the family plays a central role. In the context of a research project carried out in cooperation with the Swiss Football Association SFV, 159 former members of the national youth football team were interviewed retrospectively, among other things concerning their family circumstances. The study is interested in understanding two issues.
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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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