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Cited by 816Sports injuries and preventionLower Extremity Biomechanics and PathologiesInjury Epidemiology and Prevention

Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine

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DiFiori, John P, Benjamin, Holly J, Brenner, Joel S, Gregory, Andrew, Jayanthi, Neeru, Landry, Greg L, Luke, Anthony·2014·British Journal of Sports Medicine
DOI 10.1136/bjsports-2013-093299
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Abstract

### Background Youth sport participation offers many benefits including the development of self-esteem, peer socialisation and general fitness. However, an emphasis on competitive success, often driven by goals of elite-level travel team selection, collegiate scholarships, Olympic and National team membership and even professional contracts, has seemingly become widespread. This has resulted in an increased pressure to begin high-intensity training at young ages. Such an excessive focus on early intensive training and competition at young ages rather than skill development can lead to overuse injury and burnout. ### Purpose To provide a systematic, evidenced-based review that will (1) assist clinicians in recognising young athletes at risk for overuse injuries and burnout; (2)delineate the risk factors and injuries that are unique to the skeletally immature young athlete; (3) describe specific high-risk overuse injuries that present management challenges and/or can lead to long-term health consequences; (4) summarise the risk factors and symptoms associated with burnout in young athletes; (5)provide recommendations on overuse injury prevention. ### Methodology Medical Subject Headings (MeSHs) and text words were searched on 26 March 2012 from MEDLINE, CINAHL and PsycINFO. The search yielded 953 unique articles. Additional articles were found using cross-referencing. The process was repeated on 10 July 2013 to review any new articles since the original search. Screening by the authors yielded a total of 208 relevant sources that were used for this article. Recommendations were classified using the Strength of Recommendation Taxonomy (SORT) grading system. ### Definition of overuse injury Overuse injuries occur due to repetitive submaximal loading of the musculoskeletal system when rest is not adequate to allow for structural adaptation to take place. Injury can involve the muscle-tendon unit, bone, bursa, neurovascular structures and the physis. Overuse injuries unique to young athletes include apophyseal injuries and physeal stress injuries. ### Epidemiology It is estimated that 27 million US youth between 6 and 18 years of age participate in …

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  • There is some risk of injuries or overuse injuries among children and adolescents who participate in physical activities and sports, as well as organised and unorganised leisure-time physical activity.

    “There is some risk of injuries or overuse injuries among children and adolescents who participate in physical activities and sports,123 as well as organised and unorganised leisure-time physical activity,1 2”

    From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [123]

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  1. Consensus statement on July 9, 2023 by guest. Protected by copyright. http://bjsm.bmj.com/ Br J Sports Med: first published as 10.1136/bjsports-2013-093299 on 24 January 2014. Downloaded from DiFiori JP, et al. Br J Sports Med 2014;48:287-288. doi:10.1136/bjsports-2013-093299 Consensus statement on July 9, 2023 by guest. Protected by copyright. http://bjsm.bmj.com/ Br J Sports Med: first published as 10.1136/bjsports-2013-093299 on 24 January 2014. Downloaded from Consensus statement on July 9, 2023 by guest. Protected by copyright. http://bjsm.bmj.com/ Br J Sports Med: first published as 10.1136/bjsports-2013-093299 on 24 January 2014. Downloaded from Consensus statement on July 9, 2023 by guest. Protected by copyright. http://bjsm.bmj.com/ Br J Sports Med: first published as 10.1136/bjsports-2013-093299 on 24 January 2014. Downloaded from · DOI
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Authors
DiFiori, J. P., Benjamin, H. J., Brenner, J. S., Gregory, A., Jayanthi, N., Landry, G. L., & Luke, A.
Affiliations
  • University of California, Los Angeles (US)
  • University of Chicago (US)
  • Eastern Virginia Medical School (US)
  • Vanderbilt University (US)
  • Loyola University Chicago (US)
  • University of Wisconsin–Madison (US)
  • University of California, San Francisco (US)
Corresponding author
DiFiori, John P
ORCID
Venue
British Journal of Sports Medicine
Publisher
BMJ
Published
2014-01-24
Volume
48
Issue
4
Pages
287-288
ISSN
  • 0306-3674 (ISSN-L)
  • 1473-0480
DOI
10.1136/bjsports-2013-093299
OpenAlex
W2069941864
Cited by
816
References
209
Citations by year
2026: 61 · 2025: 55 · 2024: 74 · 2023: 95 · 2022: 67 · 2021: 86 · 2020: 85 · 2019: 87 · 2018: 65 · 2017: 59 · 2016: 36 · 2015: 34 · 2014: 9 · 2013: 1
FWCI
47.62
Type
journal article
Language
en
Open access
Locations
  • British Journal of Sports Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
  • Northwestern University
  • University of South Dakota
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
  • Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
Keywords
overuse injuries, burnout, youth sports, youth athletes, skeletally immature athletes, apophyseal injuries, early specialization, injury prevention, risk factors, competitive pressure, injury epidemiology
MeSH terms
Adolescent, Athletic Injuries, Burnout, Professional, Child, Humans, Cumulative Trauma Disorders, Risk Factors, Sports Medicine, Risk Assessment, Consensus, Musculoskeletal Development

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