Oversized young athletes: a weighty concern

Abstract

The prevalence of overweight and obesity in children and adolescents is increasing worldwide, with a corresponding decline in physical fitness and general physical activity level. Overweight and obese adolescents are more than twice as likely to be injured in sports and other physical activities compared with non-overweight and non-obese adolescents. Obese adolescent athletes are more than three times as likely to sustain an ankle sprain compared with normal weight adolescent athletes. At the societal level, promoting physical activity for children and improving dietary habits are key strategies for lowering the prevalence of overweight and obesity. The increased risk of injury associated with being overweight or obese may in part be due to low physical activity level. Promotion of physical activity for children can provide neuromuscular training that may be beneficial in decreasing injury risk associated with general play and sports participation. For lower-extremity injuries, specific neuromuscular training interventions, such as balance training, have great potential in reversing the increased injury risk associated with overweight and obesity. Finally, the injured overweight young athlete may have a more prolonged recovery period than non-overweight young athletes. Early aggressive treatment of swelling with physical modalities, prolonged non-weight bearing, limited period of immobilisation and regular repetitive passive joint motion are indicated for the overweight young athlete with a lower-extremity joint injury.

Childhood Obesity Is Associated With Increased Risk of Most Lower Extremity Fractures

“…It is again unclear how, if at all, this affected the study results, but it did decrease the number of overall fractures for the group as a whole. Third, we did not assess activity level, mode of injury, differences in treatment settings, fracture severity, or differences in course of care; all of these are factors important in the frequency, location, and outcome of fractures of the lower extremities [3,27]. This did not affect the study numbers but inclusion of these variables would have provided more information pertaining to fracture risk in this cohort and potential confounding effects on the association between weight class and lower extremity fracture.…”

“…By virtue of having access to an extremely large, self-contained electronic database that is truly a crosssection of our southern California population, we were able to provide stable population-based estimates of the associations between childhood obesity and lower extremity fractures that have not previously been demonstrated in such a way. In addition, rather than purely comparing obese (C 95 th percentile) with nonobese patients or assess the association between obesity and all musculoskeletal complaints, like with all previously referenced studies [2,3,14,26,27,[30][31][32]39, 41], we measured more specific weight classes and assessed only lower extremity fractures to understand how varying degrees of increasing (or decreasing) weight affect fracture risk in the lower extremities. Also, we further assessed fracture risk by both age and lower extremity region as opposed to that of all prior studies on the association of childhood or adult obesity and fracture/injury risk (Table 5).…”

“…Ogden et al [28,29] have documented the increasing number of overweight children in the United States. In addition to putting children at risk for long-term medical issues such as diabetes and hypertension, numerous studies [2,3,14,26,27,30,40] have documented the association between obesity and an increased risk of musculoskeletal injuries. Most of these studies, however, are not populationbased estimates based on the degree of obesity.…”

Long-Term Athletic Development, Part 2

“…The concept of "underuse" injuries suggests that inactivity and a lack of preparatory conditioning is a likely risk factor for the etiology of a number of sports-and physical activityrelated injuries ( 118). In comparison with normal weight youth, data show that overweight and obese children and adolescents are twice as likely to experience an injury when participating in sports or general physical activity ( 72). Con-sequently, it is suggested that overweight and obese youth (57), ultimately placing them at an increased risk of injury ( 106).…”

“…Con-sequently, it is suggested that overweight and obese youth (57), ultimately placing them at an increased risk of injury ( 106). Specifically, low fatigue resistance, lack of postural and neu-romuscular control, inadequate strength levels, and reduced motor control development have all been proposed as potential mechanisms that increase injury risk within this population ( 72). Considering the increased demands of con-trolling an excessively large body mass in response to the unpredictable and dynamic nature of sporting activities, overweight and obese youth should engage in preparatory training, inclusive of both healthand skill-related fitness components before participating in organized sport.…”