Overuse Physeal Injuries in Youth Athletes.
BACKGROUND
Despite rising awareness of the risks associated with sports participation, overuse injuries continue to increase in youth athlete populations. Physeal injuries are one type of overuse injury exclusive to pediatric populations that are often sustained during athletic practice or competition. Overuse physeal injuries are, in theory, preventable; however, little consensus has been reached surrounding the risk factors, prevention, and treatment strategies.


OBJECTIVE
This systematic review summarizes the best available evidence concerning overuse physeal injuries in youth and adolescent athletes. It can be used to develop prevention and treatment programs specific to this population.


METHODS
PubMed and Academic Search Complete (EBSCOhost) were explored using the keyword physeal injuries from January 1950 through May 2015 to identify 24 studies.


METHODS
Original research studies of athletic populations with mechanisms of injury related to sport were chosen.


METHODS
Systematic review.


METHODS
Level 3.


METHODS
Data were extracted as available from 24 eligible studies. Study quality was rated using the Oxford Centre for Evidence-based Medicine (OCEBM) guidelines.


RESULTS
Risk factors for injury include periods of accelerated growth, chronological age, body size, training volume, and previous injury. Injury prevention strategies currently emphasize participation limitations and sport-specific training programs in skeletally immature athletes. The most effective treatment after an overuse physeal injury was an extended period of active rest and joint immobilization when necessary.


CONCLUSIONS
Overuse physeal injuries are multifactorial in nature. Muscular imbalances after accelerated growth periods predispose young athletes to overuse injuries. Modifiable risk factors such as flexibility, strength, and training volume should be regularly monitored to prevent these injuries.
University of South Carolina, Greenville, South Carolina.
Amanda
A
Arnold
ATI Physical Therapy, Greenville, South Carolina.
Charles A
CA
Thigpen
University of South Carolina, Columbia, South Carolina.
Paul F
PF
Beattie
Steadman Hawkins Clinic of the Carolinas, Greenville, South Carolina.
Michael J
MJ
Kissenberth
ATI Physical Therapy, Greenville, South Carolina.
Ellen
E
Shanley
D000293:Adolescent; D000367:Age Factors; D001265:Athletic Injuries / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy*; D049628:Body Size; D002648:Child; D012090:Cumulative Trauma Disorders / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy*; D006801:Humans; D035002:Lower Extremity / Q000293:injuries; D064797:Physical Conditioning, Human / Q000009:adverse effects; D012307:Risk Factors; D000072042:Salter-Harris Fractures / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy*; D034941:Upper Extremity / Q000293:injuries
overuse; pediatric injuries; physeal injury; physis; sports injuries