Original research
Monitoring of sport participation and injury risk in young athletes

https://doi.org/10.1016/j.jsams.2013.01.008Get rights and content

Abstract

Objectives

Careful modulation of training characteristics in high-level sports optimizes performance and avoids inappropriate workloads and associated sports injury risk. The aims of this study were to compare sport participation characteristics in different youth sport categories and to investigate their relationship with injury.

Design

Prospective cohort follow-up.

Methods

Young (12–19 years) high-level athletes (n = 154) from a regional sport school were followed during 41 weeks regarding sport participation characteristics and traumatic and overuse sports injuries (time-loss definition). All data were self-recorded by the athletes in an electronic system “TIPPS” (Training and Injury Prevention Platform for Sports) and subject to a systematic data quality control. Volume and intensity (self-rated perceived exertion) of each sport session were used to compute weekly load, monotony and strain. Sport categories were defined as team, racket, and individual sports.

Results

All sport participation characteristics were dependent on sport category (p < 0.05). Weekly intensity, load and strain were dependent on age (p < 0.05). Racket and individual sports were associated with lower injury risk (HR = 0.37 and 0.34, p = 0.001 and p < 0.001, respectively) compared to team sports. Average sport participation characteristics were not related to injury according to the survival analysis. However, intensity during the week prior to injury was significantly higher (p < 0.01) compared to that of the 4 preceding weeks.

Conclusions

This study investigated for the first time the relationship between sport participation pattern and injury risk in young athletes. The monitoring method was sensitive to variations according to pertinent variables and might help identify athletes with increased sports injury risk.

Introduction

Improvement in athletic performance is highly correlated to the training load of the athlete1, 2 and to the alternation between periods of intense and light training.3, 4, 5 Indeed, sport participation characteristics in high-level sports require careful modulation of both training volume and intensity, in the short term and the long term, to help athletes reach their highest performance level.6 Monitoring of training load is fundamental for trainers to fine-tune the athlete's daily program.7 Although periodization of training should be quantifiable, there is no single indicator or methodology applicable to different training types. Endurance athletes generally use volume as the main outcome, but this does not account for training intensity. Similarly, the latter aspect also deserves attention in sports characterized by high demands in strength and power.

A feasible and well-accepted method is the recording of self-reported rating of the overall workout intensity, called session rating of perceived exertion (RPE), using the Borg scale.8 Training load is subsequently determined by multiplying session intensity by its duration, expressed in arbitrary units. This method was originally proposed by Foster and co-workers2, 8, 9 who concluded that it was a valid method to quantify sport participation in a wide variety of exercise types. Significant correlations have recently been reported between this approach and objective measurements of training intensity in individual high-intensity disciplines,10, 11 in endurance sports12 and in team sports.13, 14, 15

This method could be helpful to monitor sport participation characteristics (e.g. volume and intensity of training and competition) in the field of competitive youth sport. Indeed, many disciplines are characterized by increasingly early specialization, combined with an ever growing training load.16, 17 As a consequence, young athletes encounter many sports-related injuries when practicing at a high level. As previously suggested,16, 17, 18 inappropriate training load and scheduling could be risk factors for sports injuries. Applying the session RPE method in youth sport could therefore provide an opportunity to analyze training load more precisely and to study the relationship between specific characteristics of sport participation and sports injuries.

Therefore, the primary aim of this study was to compare, for the first time, sport participation characteristics of different sport categories in youth sport as evaluated by self-reported rating of overall working intensity and training volume. We hypothesized that sport participation characteristics would be different in team, racket and individual sports. A secondary hypothesis was that sport participation characteristics would be related to injuries.

Section snippets

Methods

This prospective cohort study focused on 269 young elite athletes (12–19 years) enrolled in a regional sport school and followed for 41 weeks (from the 20th of September until the 1st of July). The sport school provides a typical high school curriculum but proposes an adapted time schedule permitting two daily training sessions, some of which are organized within the school program. All pupils were athletes enrolled in the national training center of their respective sport federation and

Results

From the 269 young athletes enrolled at the sport school, 154 athletes (57%) met our inclusion criteria. Compliant and the non-compliant subgroups were similar regarding the proportion of injured athletes (66.3 and 68.8%, respectively), as well as sex distribution and sport categories represented.

All data presented hereafter are from the subsample of compliant athletes. On average, athletes were 14.1 years old, males accounted for 64.9%, and the proportion of athletes engaged in team, racket

Discussion

The most important finding of this study was that the youth sport categories investigated here were defined by largely distinct sport participation characteristics. This observation confirms our main hypothesis which stipulated that sport participation patterns would be different in team, racket and individual sports. Moreover, the methodology applied here allowed for identification of variations of weekly load over the sport season (Fig. 1). Additionally, differences of several sport

Conclusion

This study investigated, for the first time, the relationship between sport participation pattern and injury risk in youth sport. The method applied here to describe sport participation behavior was sensitive to display the weekly load variations over the whole sport season, to discriminate between different sport categories, and to highlight age-related differences. Team sports had the lowest training load but the highest injury risk. Apart from short-term modifications in intensity, no

Practical implications

  • The monitoring of both volume and intensity of sport participation is important to optimize the training schedule in youth sports.

  • Intensity can be evaluated by the session rating of perceived exertion.

  • The methodology applied in this study allows for more accurate determination of true training load and is sensitive to distinguish between different sport categories and identify seasonal variations.

  • This methodology has the potential to identify athletes who are at an increased risk of sports

Acknowledgments

The present study was financially supported by the National Research Fund (AFR ref.1189878) via a post-doc grant for the first author, the National Ministry of Sport, and the National Olympic Committee.

References (27)

  • P.B. Laursen

    Training for intense exercise performance: high-intensity or high-volume training?

    Scand J Med Sci Sports

    (2010)
  • C. Foster et al.

    Athletic performance in relation to training load

    Wis Med J

    (1996)
  • I. Mujika

    The influence of training characteristics and tapering on the adaptation in highly trained individuals: a review

    Int J Sports Med

    (1998)
  • V.B. Issurin

    New horizons for the methodology and physiology of training periodization

    Sports Med

    (2010)
  • J. Garcia-Pallares et al.

    Performance changes in world-class kayakers following two different training periodization models

    Eur J Appl Physiol

    (2010)
  • D.J. Smith

    A framework for understanding the training process leading to elite performance

    Sports Med

    (2003)
  • J. Borresen et al.

    The quantification of training load, the training response and the effect on performance

    Sports Med

    (2009)
  • C. Foster et al.

    A new approach to monitoring exercise training

    J Strength Cond Res

    (2001)
  • C. Foster

    Monitoring training in athletes with reference to overtraining syndrome

    Med Sci Sports Exerc

    (1998)
  • M.L. Day et al.

    Monitoring exercise intensity during resistance training using the session RPE scale

    J Strength Cond Res

    (2004)
  • C. Minganti et al.

    The validity of sessionrating of perceived exertion method for quantifying training load in teamgym

    J Strength Cond Res

    (2010)
  • S.G. Psycharakis

    A longitudinal analysis on the validity and reliability of ratings of perceived exertion for elite swimmers

    J Strength Cond Res

    (2011)
  • T.J. Gabbett et al.

    Relationships between training load, injury, and fitness in sub-elite collision sport athletes

    J Sports Sci

    (2007)
  • Cited by (65)

    • Training load characteristics and injury and illness risk identification in elite youth ski racing: A prospective study

      2021, Journal of Sport and Health Science
      Citation Excerpt :

      Another key finding in the present study was that volume and intensity did not represent a risk factor for injuries. Malisoux et al.31 found that only training intensity, and not training volume, was associated with a higher injury risk in young rugby players. It can be assumed that the skiing-specific training in particular may be insufficiently intense to contribute to a higher risk of injury.

    • Youth sport: Friend or Foe?

      2019, Best Practice and Research: Clinical Rheumatology
      Citation Excerpt :

      This is based on one study that demonstrated a sharp increase in injury risk past 16 h of weekly training across a variety of high school sports [60]. Conversely, other studies have shown no association between higher training loads and injury [40,61,62]. Further, Theisen et al. outline the potential importance of sport type, reporting that a higher number of competitions per 100 days were positively associated with injury in team sports, yet negatively associated with injury in individual sports [63].

    • Training, Wellbeing and Recovery Load Monitoring in Female Youth Athletes

      2022, International Journal of Environmental Research and Public Health
    View all citing articles on Scopus
    View full text