The health issues of youth sports are concerns regarding the health and wellbeing of young people between the ages of 6 and 18 who participate in an organized sport. Given that these athletes are physically and mentally underdeveloped, they are particularly susceptible to heat illness, eating disorders and injury; sufficiently severe conditions can result in death. Awareness and prevention are key factors in preventing many health issues in youth sports. [1]
Heat illnesses are a recent concern in youth athletics. They include heat syncope, muscle cramps, heat exhaustion, heat stroke and exertional hyponatremia. [2] Heat illness and dehydration are typically brought on by conditions of high temperatures and high humidity. These conditions carry increased risk for young athletes, particularly if at the beginning of a season when they are less fit. Other factors which increase vulnerability include: heat-retaining clothing, recent illness, previous experience with heat illness, chronic conditions, or sleep deprivation. [3] Additional precaution is to be taken if the child is taking supplements or using cold medication.
Heat illnesses are among the primary causes of sports-related death or disability, and as such they require immediate medical attention. Symptoms to watch for are dry or sticky mouth, [3] headache, dizziness, cramps, unusual fatigue, confusion, [2] and loss of consciousness
Eating disorders are generally not a primary concern amongst youth athletes, however they are unusually prevalent in wrestling and aesthetic sports such as gymnastics. These place heavy emphasis upon weight and body image as ingredients for success in competition. In order to compete, 81% of wrestlers will deliberately lose weight. [4] This involves shedding 3% to 20% of their body weight — most of which being dropped within a short period of time. For rhythmic gymnasts, “success is strongly influenced by visual appeal and body aesthetics. Rhythmic gymnasts are often required to meet certain weight targets to attain and maintain a thin shape.” [5] The pressure to please is intense, and correspondingly, 42% of female aesthetic athletes have been diagnosed with eating disorders.
Youth athletes employ a variety of methods to lose weight, including dehydration, fasting, diet pills, laxatives, vomiting, and the use of rubber exercise suits. These practices result in “decreased plasma and blood volume, reduced cardiac outputs, impaired thermoregulatory responses, decreased renal blood flow, and an increase in the amount of electrolytes lost from the body.” [6]
It has been postulated that wrestlers may suffer impaired growth and development due to their fluctuating body weight. [6] However, a study [4] examining high school wrestler growth patterns concluded that participation does not stunt growth. In relation to eating disorders, young female gymnasts may suffer from delayed menarche, menstrual irregularities, low body fat, and delayed maturity. [5] Of these athletes, 11% are at risk for a mental disorder, while 40% risk delayed physical maturation.
An issue unique to youth athletics is that the participants’ bones are still growing, [7] placing them at highest risk for injury. Around 8,000 children are rushed to the emergency room daily because of sports injuries. [8] High school athletes suffer approximately 715,000 injuries annually. Regarding American football, there are five times more catastrophic injuries in high school than compared to college-level competition. [9]
Nearly half of all injuries in pediatric sports medicine are due to overuse. Such injuries can be attributed to inappropriate workout intensity and overlong athletic seasons. [10] Other risk factors include sleep deprivation, general physical and cognitive immaturity, dietary imbalance and inadequate physical fitness. [10] Among young athletes, common overuse injuries are stress fractures, which include injury of the: [7] According to research, the frequency of injury varies from sport to sport as well as depending on the sex of the athlete. [11] Body alignment can also impact overuse injuries. Types of body alignments are bowlegs, unequal leg lengths or flat/high arched feet, [12] femoral neck/pubis, femoral shaft, tibia, fibula, metatarsals, calcaneus, and cuboid
Although there has been a longstanding association between repetitive head injuries and subsequent brain damage amongst professional athletes such as boxers and football players, a possible association amongst youth and adolescent amateur sport participants has only recently been taken more seriously. [13] For people of the age 22 and under, concussions have risen more than 500% since 2010. [14] Concussions and serious brain injuries were previously considered important if there was an association with loss of consciousness but there is mounting evidence to suggest that injury may occur even when there are more subtle signs and symptoms such as dizziness and confusion. [15] As the brain of a child or an adolescent is still developing, there is fear that these injuries may have permanent long term consequences.
45 million children and adolescents participate in youth sports in the US. [16] There are many positive and negative impacts on young athletes. Participation in sports raises energetic physical activity. The Center for Disease Control reported that in 1999 only 50% of youths engaged in regular exercise. [16] Youth participation in sports can influence high-risk health-related impacts for boys and girls. A 2000 study showed the relationship between participation in sports and health-related behaviors in US youth athletes. [16] Both boys and girls were more likely to eat fruits and vegetables and less likely to engage in smoking and illicit drug-taking.
There is a risk of injury for athletes of all ages when participating in sports. Young athletes are vulnerable to a variety of traumatic and overused injuries due to increased growth velocity and closure of the growth plates. Between the ages of 5-24, each year there are 2.6 million emergency room visits. Coaches and parents can put a lot of pressure on a youth athlete which can cause injury, burnout, over-scheduling, and the pressure to succeed. In the past, the New York Times ran an online debate on children’s sport-life balance. [17] Some think that youth sports has become too competitive and too serious while others think youth sports are the best way to teach teamwork and discipline.
Not only do health issues affect athletes, but the financial burden that impacts their families is also significant. This can cause a strain in the family relationship. Vacations, savings, and normal family structure are sacrificed in order to support the athlete. Siblings can have positive and negative effects on the youth athlete. Siblings can be supportive and act as role models, but they can also experience feelings of bitterness, jealousy, and isolation. [17]
Many high school students will experience some form of head injury during their experiences in amateur sports and the majority of these can be classified as concussions. [18] Even by the beginning of high school, 53% of athletes will have already suffered a concussion. Less than 50% of them report it in order to stay in the game. Many concussions may be subtle and go undiagnosed. [19] While the majority of these minor injuries will recover without consequence within 3 to 7 days, it is the repetitive injury that is associated with neurological sequela. [20] Multiple concussions appear to have a cumulative effect on memory performance. [20] If an athlete returns to competition before being completely healed, they are more susceptible to suffer another concussion. A repeat concussion can have a much slower recovery rate and be accompanied by increased symptoms and long-term effects. This “second impact syndrome” has, in some cases, been fatal. [19] A history of concussion in football players has been linked to sports-related sudden death. [21] The severity of complications from concussion can include brain swelling, blood clots and brain damage. [22] Ice hockey, soccer, wrestling and basketball carry a high risk for concussion however, football is the most dangerous. Concussion causing situations that involve leading with the head, hitting head to head and striking a defenseless athlete have become subject to penalty in order to discourage players and coaches from this type of play. [23] These rule changes have resulted in technique changes at the youngest levels of sports, and youth athletes are now being trained in methods avoiding illegal contact. Youth sport organizations have also made equipment changes to better protect players. A widespread myth is that helmets protect athletes from concussions; they are actually worn to prevent skull fractures. Facts like this have prompted trainings on proper equipment use and not utilizing helmets as an implement of contact. [22]
Following the 2013 “second impact syndrome” death of 17 year-old Rowan Stringer, an Ottawa high school female rugby player, a coroner’s inquest took place and led to the development of the Rowan’s Law Advisory Committee which put forth 49 recommendations regarding the prevention and management of head injuries in amateur sports. [24] Recommendations were made for mandatory training on the recognition and treatment of concussions for teachers, coaches and healthcare providers. Sport organizations are advised to develop rules of conduct amongst their players and to enforce a zero tolerance policy for aggressive play. [25] In 2016, the Canadian federal government allotted 1.4 million dollars for the development of national amateur sport guidelines related to back-to-play and back-to-study protocols following concussion injuries.
Sometimes sports injuries can be so severe as to result in actual death. Over the past year,[ when? ] 48 youths died from sports injuries. [26] The leading causes of death in youth sports are sudden cardiac arrest, concussion, heat illness and external sickling. Cardiac-related deaths are usually due to an undiagnosed cardiovascular disorder. [27] Trauma to the head, neck and spine can also be lethal. [21] Among young American athletes, more than half of trauma-related deaths are to football players, with track and field, baseball, boxing and soccer also having relatively high fatality rates.
A football player or footballer is a sportsperson who plays one of the different types of football. The main types of football are association football, American football, Canadian football, Australian rules football, Gaelic football, rugby league, and rugby union.
Sports injuries are injuries that occur during sport, athletic activities, or exercising. In the United States, there are approximately 30 million teenagers and children who participate in some form of organized sport. Of those, about three million athletes age 14 years and under experience a sports injury annually. According to a study performed at Stanford University, 21 percent of the injuries observed in elite college athletes caused the athlete to miss at least one day of sport, and approximately 77 percent of these injuries involved the knee, lower leg, ankle, or foot. In addition to those sport injuries, the leading cause of death related to sports injuries is traumatic head or neck occurrences.
Myalgia is the medical term for muscle pain. Myalgia is a symptom of many diseases. The most common cause of acute myalgia is the overuse of a muscle or group of muscles; another likely cause is viral infection, especially when there has been no trauma.
A concussion, also known as a mild traumatic brain injury (mTBI), is a head injury that temporarily affects brain functioning. Symptoms may include loss of consciousness; memory loss; headaches; difficulty with thinking, concentration, or balance; nausea; blurred vision; dizziness; sleep disturbances, and mood changes. Any of these symptoms may begin immediately, or appear days after the injury. Concussion should be suspected if a person indirectly or directly hits their head and experiences any of the symptoms of concussion. Symptoms of a concussion may be delayed by 1–2 days after the accident. It is not unusual for symptoms to last 2 weeks in adults and 4 weeks in children. Fewer than 10% of sports-related concussions among children are associated with loss of consciousness.
Disordered eating describes a variety of abnormal eating behaviors that, by themselves, do not warrant diagnosis of an eating disorder.
Health issues in American football comprise a large number of health risks associated with participating in the sport. Injuries are relatively common in American football, due to its nature as a full-contact game. Injuries occur during both practice and games. Several factors can affect the frequency of injuries: epidemiological studies have shown older players can be at a greater risk, while equipment and experienced coaches can reduce the risk of injury. Common injuries include strains, sprains, fractures, dislocations, and concussions. Concussions have become a concern, as they increase the risk of mental illnesses like dementia and chronic traumatic encephalopathy (CTE). In individual leagues like the National Football League (NFL) and National Collegiate Athletic Association (NCAA), a public injury report is published containing all injured players on a team, their injury and the game-day status of each player.
Post-concussion syndrome (PCS), also known as persisting symptoms after concussion, is a set of symptoms that may continue for weeks, months, years after a concussion. PCS is medically classified as a mild traumatic brain injury (TBI). About 35% of people with concussion experience persistent or prolonged symptoms 3 to 6 months after injury. Prolonged concussion is defined as having concussion symptoms for over four weeks following the first accident in youth and for weeks or months in adults.
Relative energy deficiency in sport (RED-S) is a syndrome in which disordered eating, amenorrhoea/oligomenorrhoea, and decreased bone mineral density are present. It is caused by eating too little food to support the amount of energy being expended by an athlete, often at the urging of a coach or other authority figure who believes that athletes are more likely to win competitions when they have an extremely lean body type. RED-S is a serious illness with lifelong health consequences and can potentially be fatal.
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease linked to repeated trauma to the head. The encephalopathy symptoms can include behavioral problems, mood problems, and problems with thinking. The disease often gets worse over time and can result in dementia.
Second-impact syndrome (SIS) occurs when the brain swells rapidly, and catastrophically, after a person has a second concussion before symptoms from an earlier one have subsided. This second blow may occur minutes, days, or weeks after an initial concussion, and even the mildest grade of concussion can lead to second impact syndrome. The condition is often fatal, and almost everyone who is not killed is severely disabled. The cause of SIS is uncertain, but it is thought that the brain's arterioles lose their ability to regulate their diameter, and therefore lose control over cerebral blood flow, causing massive cerebral edema.
Concussion grading systems are sets of criteria used in sports medicine to determine the severity, or grade, of a concussion, the mildest form of traumatic brain injury. At least 16 such systems exist, and there is little agreement among professionals about which is the best to use. Several of the systems use loss of consciousness and amnesia as the primary determinants of the severity of the concussion.
Heat illness is a spectrum of disorders due to increased body temperature. It can be caused by either environmental conditions or by exertion. It includes minor conditions such as heat cramps, heat syncope, and heat exhaustion as well as the more severe condition known as heat stroke. It can affect any or all anatomical systems. Heat illnesses include: Heat stroke, heat exhaustion, heat syncope, heat edema, heat cramps, heat rash, heat tetany.
Health issues of athletics concern the health and well-being of athletes who participate in an organized sport. If athletes are physically and mentally underdeveloped, they are susceptible to mental or physical problems. Athletes trying to improve their performance in sports can harm themselves by overtraining, adopting eating habits that damage them physically or psychologically, and using steroids or supplements.
Concussions and play-related head blows in American football have been shown to be the cause of chronic traumatic encephalopathy (CTE), which has led to player deaths and other debilitating symptoms after retirement, including memory loss, depression, anxiety, headaches, stress, and sleep disturbances.
Concussions, a type of mild traumatic brain injury, are a frequent concern for those playing sports, from children and teenagers to professional athletes. Repeated concussions are known to cause neurological disorders, particularly chronic traumatic encephalopathy (CTE), which in professional athletes has led to premature retirement, erratic behavior and even suicide. A sports-related concussion is defined as a "complex pathophysiological process affecting the brain, induced by biomechanical forces". Because concussions cannot be seen on X-rays or CT scans, attempts to prevent concussions have been difficult.
A catastrophic injury is a severe injury to the spine, spinal cord, or brain. It may also include skull or spinal fractures. This is a subset of the definition for the legal term catastrophic injury, which is based on the definition used by the American Medical Association.
A sports-related traumatic brain injury is a serious accident which may lead to significant morbidity or mortality. Traumatic brain injury (TBI) in sports are usually a result of physical contact with another person or stationary object, These sports may include boxing, gridiron football, field/ice hockey, lacrosse, martial arts, rugby, soccer, wrestling, auto racing, cycling, equestrian, rollerblading, skateboarding, skiing or snowboarding.
A traumatic brain injury (TBI) is a blow, jolt or penetration to the head that disrupts the function of the brain. Most TBIs are caused by falls, jumps, motor vehicle traffic crashes, being struck by a person or a blunt object, and assault. Student-athletes may be put at risk in school sports, creating concern about concussions and brain injury. A concussion can be caused by a direct blow to the head, or an indirect blow to the body that causes reactions in the brain. The result of a concussion is neurological impairment that may resolve spontaneously but may also have long-term consequences.
A pediatric concussion, also known as pediatric mild traumatic brain injury (mTBI), is a head trauma that impacts the brain capacity. Concussion can affect functional, emotional, cognitive and physical factors and can occur in people of all ages. Symptoms following after the concussion vary and may include confusion, disorientation, lightheadedness, nausea, vomiting, blurred vision, loss of consciousness (LOC) and environment sensitivity. Concussion symptoms may vary based on the type, severity and location of the head injury. Concussion symptoms in infants, children, and adolescents often appear immediately after the injury, however, some symptoms may arise multiple days following the injury leading to a concussion. The majority of pediatric patients recover from the symptoms within one month following the injury. 10-30% of children and adolescents have a higher risk of a delayed recovery or of experiencing concussion symptoms that are persisting.
Early sports specialization is the phenomenon of a child or teenaged athlete intensively pursuing a single sport or athletic activity year-round, instead of participating in a wide variety of activities. Premature emphasis on a single sport is associated with physical injuries, mental health problems, and psychosocial harm to young athletes. Many young athletes who are pushed to excel in a single sport quit playing prematurely, or are forced to stop because of injuries.