yogabook / movement physiology / sport in growth

The health aspects of growing children’s sports in relation to the musculoskeletal system are primarily the domain of paediatric sports orthopaedics. The task of paediatric sports orthopaedics is not only to recognise and treat disorders that have occurred, but also to provide preventative support for children who do sports. This also includes examining fitness for certain sports. It goes without saying that growth-associated disorders that can temporarily impair the ability to do sports must also be dealt with appropriately. Hip dysplasia, osteonecrosis and epiphysiolysis can significantly limit the load-bearing capacity of joints. Spinal diseases such as spondylolisthesis, Scheuermann’s disease and scoliosis can also determine the extent and nature of tolerable training and competition. During growth, there is increased tension on the tendon insertions, which can lead to insertional tendinopathies, possibly with bony avulsions. One of the most common mistakes is to overestimate the load-bearing capacity of the musculoskeletal system and to set the scope and intensity of training too high, which leads to corresponding disorders and, without adapting the approach, often to the end of promising young careers. The development of performance must be managed in a long-term, well thought-out, systematic and in an age-appropriate manner, and regular sports medical care and supervision is required. In the case of disorders in children and adolescents, a distinction must be made as to whether they are stress-induced, i.e. sports-induced, or whether they are related to a certain age or a growth spurt. Other conditions are not related to any of these factors, such as osteogenesis imperfecta, Marfan syndrome or Ehlers-Danlos syndrome. Abnormal flexibility always deserves special attention and must be investigated for Ehlers-Danlos syndrome, Marfan syndrome, hypermobility syndrome, etc., especially as the risk of dislocation may mean that certain types of sport cannot be performed with a sufficiently low risk. The consequences of acute overloading and chronic overloading during the growth phase often only become apparent in adulthood. When assessing the intensity and scope of training, it must be borne in mind that the biological age can differ from the chronological age of a young person by up to two years. There are also gender-specific differences here. The decisive factor is not so much the biological age, but rather objectively ascertainable findings, such as bone X-rays. Proprioceptive and coordinative abilities must also be taken into account, as well as any periods of inactivity in sport or immobilisation due to injury or illness. Although children’s bones may still be more elastic due to a lower degree of ossification, their fracture risk is often increased as the growth plates pose a particular risk. This is particularly true during growth spurts, when they are less tolerant of shear forces. There is an inverse relationship between resilience and growth rate. There are several reasons why children’s joint cartilage is more capable of regeneration than adults: on the one hand it is more elastic, on the other hand it is thicker and binds more water. It is therefore less vulnerable to overloading. However, the hormonal changes during puberty are more likely to cause disorders than the rest of childhood and adolescence. Measured against the average muscle strength of a male adult, that of six-year-olds is largely, independent of gender, at around 20%, that of 10-year-olds at 40%. After that, a stronger differentiation between the sexes develops.