Injury surveillance in youth sport: scope, injury pattern and risk factors. (Doctoral thesis)

hroughout the world physical activity is promoted for its many health benefits. Thus, already from an early age on, children are encouraged to participate in organised sports. However, exposure to intensive sports practice with high training volumes increases the risk to sustain an injury. As adolescence is characterized by significant physiological and morphological changes due to the pubertal growth spurt, special attention should be given to the young athlete. Additionally to the potential long-term consequences of sports injuries on later life, related healthcare costs represent a serious public health problem. Therefore, awareness of the extent of the injury problem as well as comprehension of the mechanisms of sports injuries are essential before considering preventive measures. As the sports injury problematic in the adolescent population has not been explored so far in the Grand-Duchy of Luxembourg, the present thesis focuses on young Luxembourgish athletes. The general purpose is to establish an injury surveillance system and to identify some risk factors specific for the adolescent athlete.
The first chapter of this work provides the reader with general background information on sports injuries. Chapter 2 points out the specificity of sports injuries in youth population with reference to the well-known model of the “sequence of prevention” of van Mechelen. Successively, the extent of the injury problem, the aetiology and the mechanism of sports injuries as well as examples of active prevention measures are described.
Chapters 3 to 6 represent our personal contribution. First the occurrence of traumatic injuries and overuse lesions related to sports practice is retrospectively investigated in young athletes (aged 12-19 years) from twelve different sport disciplines (chapter 3). Special interest is directed towards the influence of gender on injury incidence, injury characteristics and some risk factors. In chapter 4, a prospective follow-up over one sport season in young soccer players (U15-U19) is presented. An extensive test battery assessing physical and physiological parameters is performed at preseason. The focus of this study is to find an association between these preseason functional performance parameters and soccer injuries occurring during the subsequent season. Chapter 5 investigates the establishment of an extensive injury surveillance program in a sport school. Besides an epidemiological description of different injury features, the focus of this prospective design consists in defining specific risk factors related to sports activity, such as frequency and intensity of practice sessions. Chapter 6 evaluates the long-term consequences of such an injury surveillance system and its influence on the occurrence of sports injuries. Therefore, 372 athletes from 16 sports are prospectively followed-up during 3 years in a sports school, and critical data regarding injury incidence are collected through a personal sports diary.
Chapter 7 constitutes the 3rd part of the present thesis. In this general discussion, the results from the current work are analysed in an integrated and critical manner and some recommendations concerning risk factors for sports injuries are formulated. Finally, future perspectives considering sports injury surveillance and prevention are expressed.