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Return to Sport: Running Injuries in Student-Athletes: Summary
Puberty for girls ranges from 9 to 13 and for boys from 9 to 14. Puberty relates to the release of sex hormones, allowing athletes to increase muscle mass and promote hypertrophy. Unlike adults, this is also the time of growth spurts, which can lead to muscle imbalance and coordination deficits. As the bones are growing, it can take time for muscles to grow in length and flexibility as well to match the new growth, leading to increased risk of injury. This is also the time of increases in bone mass and bone development which will impact their future health. Unlike adult athletes, who are skeletally mature, a quarter of all bone mass is developed in the two years of puberty. For that reason, it is important to be adequately loading the bones by encouraging a variety of sports, weight training, and multidirectional loading to allow for maximized bone health. Questions for injured runners should include five categories: medical, psychological, lifestyle, nutrition, and training specifics (Table 1). Energy deficiency/proper nutrition is a major topic to discuss with athletes as it can help predict risk for injuries. Generally, caloric intake required for female runners ranges from 30 to 45 kcal/kg of fat free mass to allow for proper energy availability.
INTRODUCTION
Running is the most common physical activity for girls and the second most common activity for boys. However, 79% of recreational runners report a history of running related injuries. In youth athletes, specifically, there is a growing rate of emergency room visits being seen due to running-related injuries. Of these, females are more likely to have running-related injuries than males; therefore close attention should be paid to gender-specific causes. Finally, high- volume endurance sports in youth athletes can commonly lead to overuse injuries, overtraining, and increased risk for illness. Considerations for Youth Runners There are several considerations with regards to youth runners, including chronological age, training age, running experience, and biological age. Chronological age is simply the number of years someone has been alive. Training age, on the other hand, is the number of years someone has been participating in sports in general. Similarly, running experience refers to the length of time the athlete has been running specifically. Finally, biological age refers to the athlete’s physical maturity as it relates to puberty and growth spurts.
LEARNING TIP!
Prior to puberty, strength gains in youth athletes are the result of improved neuromuscular activation.
Table 1. Five Categories for Screening Risk Factors in Youth Athletes Medical Psychological Lifestyle Nutrition
Training
• Prior injury • Delayed menarche (onset after age 15) • <175 body mass index (BMI) • Menstrual dysfunction
• Burn out • Perfectionist (in athlete, coach, or parent)
• Sleeping
• Adequate energy availability • Lack of calcium rich foods/day
• Sports specialization (running >8 months/ year) • >90 miles/week • Lack of rest days • Improper footwear
<8 hours/night • Smoking • Supplement use • Poor study postures
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