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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.
Heat illness and dehydration
Heat illnesses are a recent concern in youth athletics. They include
heat syncope
Heat syncope is fainting or dizziness as a result of overheating (''syncope'' is the medical term for fainting). It is a type of heat illness. The basic symptom of heat syncope is fainting, with or without mental confusion. Heat syncope is caus ...
,
muscle cramps
A cramp is a sudden, involuntary, painful skeletal muscle contraction or overshortening associated with electrical activity; while generally temporary and non-damaging, they can cause significant pain and a paralysis-like immobility of the af ...
,
heat exhaustion Heat exhaustion is a severe form of heat illness. It is a medical emergency. Heat exhaustion is caused by the loss of water and electrolytes through sweating.
The United States Department of Labor makes the following recommendation, "Heat illness ...
,
heat stroke
Heat stroke or heatstroke, also known as sun stroke, is a severe heat illness that results in a body temperature greater than , along with red skin, headache, dizziness, and confusion. Sweating is generally present in exertional heatstroke, ...
and
exertional hyponatremia.
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
A chronic condition is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term ''chronic'' is often applied when the course of the disease lasts for more than three mo ...
, or sleep deprivation.
[Mayo Clinic staff. “Dehydration and Youth Sports: Curb the Risk.” MayoClinic.com. Mayo Clinic, 20 Aug. 2011. Web. 7 Oct. 2011. .] 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
Disability is the experience of any condition that makes it more difficult for a person to do certain activities or have equitable access within a given society. Disabilities may be Cognitive disability, cognitive, Developmental disability, dev ...
, and as such they require immediate medical attention. Symptoms to watch for are dry or sticky mouth,
headache, dizziness,
cramps
A cramp is a sudden, involuntary, painful skeletal muscle contraction or overshortening associated with electrical activity; while generally temporary and non-damaging, they can cause significant pain and a paralysis-like immobility of the aff ...
, unusual fatigue, confusion,
[ and loss of consciousness
]
Eating disorders
Eating disorders are generally not a primary concern amongst youth athletes, however they are unusually prevalent in wrestling
Wrestling is a series of combat sports involving grappling-type techniques such as clinch fighting, throws and takedowns, joint locks, pins and other grappling holds. Wrestling techniques have been incorporated into martial arts, combat ...
and aesthetic sports such as gymnastics
Gymnastics is a type of sport that includes physical exercises requiring balance, strength, flexibility, agility, coordination, dedication and endurance. The movements involved in gymnastics contribute to the development of the arms, legs, shou ...
. 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. 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.” The pressure to please is intense, and correspondingly, 42% of female aesthetic athletes have been diagnosed with eating disorders
An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's physical or mental health. Only one eating disorder can be diagnosed at a given time. Types of eating disorders include binge eating ...
.
Youth athletes employ a variety of methods to lose weight, including dehydration, fasting
Fasting is the abstention from eating and sometimes drinking. From a purely physiological context, "fasting" may refer to the metabolic status of a person who has not eaten overnight (see " Breakfast"), or to the metabolic state achieved after ...
, diet pills
Anti-obesity medication or weight loss medications are pharmacological agents that reduce or control weight. These medications alter one of the fundamental processes of the human body, weight regulation, by altering either appetite, or absor ...
, laxatives
Laxatives, purgatives, or aperients are substances that loosen stools and increase bowel movements. They are used to treat and prevent constipation.
Laxatives vary as to how they work and the side effects they may have. Certain stimulant, lub ...
, vomiting, and the use of rubber exercise suits. These practices result in “decreased plasma and blood volume, reduced cardiac output
In cardiac physiology, cardiac output (CO), also known as heart output and often denoted by the symbols Q, \dot Q, or \dot Q_ , edited by Catherine E. Williamson, Phillip Bennett is the volumetric flow rate of the heart's pumping output: t ...
s, impaired thermoregulatory responses, decreased renal blood flow
In the physiology of the kidney, renal blood flow (RBF) is the volume of blood delivered to the kidneys per unit time. In humans, the kidneys together receive roughly 25% of cardiac output, amounting to 1.2 - 1.3 L/min in a 70-kg adult male.
It ...
, and an increase in the amount of electrolytes
An electrolyte is a medium containing ions that is electrically conducting through the movement of those ions, but not conducting electrons. This includes most soluble salts, acids, and bases dissolved in a polar solvent, such as water. Upon di ...
lost from the body.”
Long-term effects
It has been postulated that wrestlers may suffer impaired growth and development due to their fluctuating body weight.[ However, a study][ 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
Menarche ( ; ) is the first menstrual cycle, or first menstrual bleeding, in female humans. From both social and medical perspectives, it is often considered the central event of female puberty, as it signals the possibility of fertility.
Gir ...
, menstrual irregularities
Irregular menstruation is a menstrual disorder whose manifestations include irregular cycle lengths as well as metrorrhagia (vaginal bleeding between expected periods). The possible causes of irregular menstruation may vary. The common factors of ...
, low body fat, and delayed maturity.[ Of these athletes, 11% are at risk for a ]mental disorder
A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...
, while 40% risk delayed physical maturation.
Injuries
An issue unique to youth athletics is that the participants’ bones are still growing, placing them at highest risk for injury. Around 8,000 children are rushed to the emergency room daily because of sports injuries. High school athletes suffer approximately 715,000 injuries annually. Regarding American football
American football (referred to simply as football in the United States and Canada), also known as gridiron, is a team sport played by two teams of eleven players on a rectangular field with goalposts at each end. The offense, the team with ...
, there are five times more catastrophic injuries in high school than compared to college-level competition.[Werkmeister, Joe. “Health and Fitness: Youth Sports Injuries — A Growing Problem.” North Shore Sun. TimesReview Newsgroup, 3 Jan. 2011. Web. 7 Oct. 2011. .]
Overuse injuries
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. Other risk factors include sleep deprivation, general physical and cognitive immaturity, dietary imbalance and inadequate physical fitness.[ Among young athletes, common overuse injuries are ]stress fracture
A stress fracture is a fatigue-induced bone fracture caused by repeated stress over time. Instead of resulting from a single severe impact, stress fractures are the result of accumulated injury from repeated submaximal loading, such as running or ...
s, which include injury of the:[ According to research, the frequency of injury varies from sport to sport as well as depending on the sex of the athlete. Body alignment can also impact overuse injuries. Types of body alignments are bowlegs, unequal leg lengths or flat/high arched feet, ]femoral neck
The femoral neck (femur neck or neck of the femur) is a flattened pyramidal process of bone, connecting the femoral head with the femoral shaft, and forming with the latter a wide angle opening medialward.
Structure
The neck is flattened from ...
/ pubis, femoral shaft, tibia
The tibia (; ), also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates (the other being the fibula, behind and to the outside of the tibia); it connects ...
, fibula
The fibula or calf bone is a leg bone on the lateral side of the tibia, to which it is connected above and below. It is the smaller of the two bones and, in proportion to its length, the most slender of all the long bones. Its upper extremity is ...
, metatarsals
The metatarsal bones, or metatarsus, are a group of five long bones in the foot, located between the tarsal bones of the hind- and mid-foot and the phalanges of the toes. Lacking individual names, the metatarsal bones are numbered from the medi ...
, calcaneus
In humans and many other primates, the calcaneus (; from the Latin ''calcaneus'' or ''calcaneum'', meaning heel) or heel bone is a bone of the tarsus of the foot which constitutes the heel. In some other animals, it is the point of the hock.
S ...
, and cuboid
In geometry, a cuboid is a hexahedron, a six-faced solid. Its faces are quadrilaterals. Cuboid means "like a cube", in the sense that by adjusting the length of the edges or the angles between edges and faces a cuboid can be transformed into a cub ...
Concussions
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. For people of the age 22 and under, concussions have risen more than 500% since 2010. 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. As the brain of a child or an adolescent is still developing, there is fear that these injuries may have permanent long term consequences.
Positive and Negative Effects
45 million children and adolescents participate in youth sports in the US. 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.[ 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.][ 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.] 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.[
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.] 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. 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. Multiple concussions appear to have a cumulative effect on memory performance.[ 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.] A history of concussion in football players has been linked to sports-related sudden death. The severity of complications from concussion can include brain swelling, blood clots and brain damage. 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. 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.
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. 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. 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.
Sports-related death
Sometimes sports injuries can be so severe as to result in actual death. Over the past year, 48 youths died from sports injuries. The leading causes of death in youth sports are sudden cardiac arrest
Cardiac arrest is when the heart suddenly and unexpectedly stops beating. It is a medical emergency that, without immediate medical intervention, will result in sudden cardiac death within minutes. Cardiopulmonary resuscitation (CPR) and possib ...
, concussion
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 (LOC); memory loss; headaches; difficulty with thinking, concentration, ...
, heat illness
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 mo ...
and external sickling. Cardiac-related deaths are usually due to an undiagnosed cardiovascular disorder. Trauma to the head, neck and spine can also be lethal.[ 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.
]
References
{{Reflist, 2
Sports medicine
Sports nutrition
Youth sport