When to initiate integrative neuromuscular training to reduce sports-related injuries and enhance health in youth?

Abstract

Regular participation in organized youth sports does not ensure adequate exposure to skill- and health-related fitness activities, and sport training without preparatory conditioning does not appear to reduce risk of injury in young athletes. Current trends indicate that widespread participation in organized youth sports is occurring at a younger age, especially in girls. Current public health recommendations developed to promote muscle strengthening and bone building activities for youth aged 6 yr and older, along with increased involvement in competitive sport activities at younger ages, has increased interest and concern from parents, clinicians, coaches, and teachers regarding the optimal age to encourage and integrate more specialized physical training into youth development programs. This review synthesizes the latest literature and expert opinion regarding when to initiate neuromuscular conditioning in youth and presents a how-to integrative training conceptual model that could maximize the potential health-related benefits for children by reducing sports-related injury risk and encouraging lifelong, regular physical activity.

Figure 1

In youth there are several factors which contribute to motor control and strength expression. In children, motor control and strength may be less related to hypertrophy and more likely associated with neural development. It is proposed that integrative neuromuscular training focused on skill-related fitness (e.g. Agility, reaction time, coordination, power, speed and balance) can maximize neural development during pre-adolescence and optimally prepare youth to capitalize on the consolidated factors which contribute to motor performance following the onset of puberty. Figure modified from Kraemer, W. J., A. C. Fry, P. N. Frykman, B. Conroy and J. Hoffman (1989). “Resistance Training and Youth.”Pediatric Exercise Science 1: 336–350.

Figure 2

Conceptual model which compares the effects of integrative neuromuscular training initiated at different times in youth. “*” represent the initiation of these integrative training techniques during pre-adolescence (Blue) and adolescence (Red) which will likely improve motor capacity and performance beyond natural adult potential (without such training). It is suggested that integrative neuromuscular training initiated in pre-adolescence and maintained into adolescence will maximize the potential to achieve optimal adulthood motor capacity. Broken lines indicate potential detrimental effects of overtraining youth without structured recovery periods included as an integral component of the integrative training model.

Figure 3

Integrative training model indicating a focus on the development of fundamental motor skills through activities which consolidate skill- and health-related fitness, may maximize efficacy of neuromuscular conditioning during pre-adolescence.

Figure 4

Education and Instruction are the key components for effective implementation of integrative neuromuscular training. (Reprinted from Myer, GD, Faigenbaum AD, Chu DA, Falkel J, Ford KR, Best TM and Hewett TE (2011). Integrative Training for Children and Adolescents: Techniques and Practices for Reducing Sports-related Injuries and Enhancing Athletic Performance. Physician and Sports Medicine In Press. Copyright© 2011 JTE Multimedia. Used with permission.)