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Review
. 2022 Jan-Feb;14(1):142-153.
doi: 10.1177/19417381211056088. Epub 2021 Nov 11.

Developmental Training Model for the Sport Specialized Youth Athlete: A Dynamic Strategy for Individualizing Load-Response During Maturation

Neeru Jayanthi  1   2   3 , Stacey Schley  2 , Sean P Cumming  4 , Gregory D Myer  2   3   5   6 , Heather Saffel  7 , Tim Hartwig  8 , Tim J Gabbett  9   10
Affiliations
Review

Developmental Training Model for the Sport Specialized Youth Athlete: A Dynamic Strategy for Individualizing Load-Response During Maturation

Neeru Jayanthi et al. Sports Health. 2022 Jan-Feb.

Abstract

Context: Most available data on athletic development training models focus on adult or professional athletes, where increasing workload capacity and performance is a primary goal. Development pathways in youth athletes generally emphasize multisport participation rather than sport specialization to optimize motor skill acquisition and to minimize injury risk. Other models emphasize the need for accumulation of sport- and skill-specific hours to develop elite-level status. Despite recommendations against sport specialization, many youth athletes still specialize and need guidance on training and competition. Medical and sport professionals also recommend progressive, gradual increases in workloads to enhance resilience to the demands of high-level competition. There is no accepted model of risk stratification and return to play for training a specialized youth athlete through periods of injury and maturation. In this review, we present individualized training models for specialized youth athletes that (1) prioritize performance for healthy, resilient youth athletes and (2) are adaptable through vulnerable maturational periods and injury.

Evidence acquisition: Nonsystematic review with critical appraisal of existing literature.

Study design: Clinical review.

Level of evidence: Level 4.

Results: A number of factors must be considered when developing training programs for young athletes: (1) the effect of sport specialization on athlete development and injury, (2) biological maturation, (3) motor and coordination deficits in specialized youth athletes, and (4) workload progressions and response to load.

Conclusion: Load-sensitive athletes with multiple risk factors may need medical evaluation, frequent monitoring, and a program designed to restore local tissue and sport-specific capacity. Load-naive athletes, who are often skeletally immature, will likely benefit from serial monitoring and should train and compete with caution, while load-tolerant athletes may only need occasional monitoring and progress to optimum loads.

Strength of recommendation taxonomy (sort): B.

Keywords: competition; injury prevention; single sport; young athlete.

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Conflict of interest statement

The following authors declared potential conflicts of interest: N.J. received hospitality fees from WTA Medical advisor Player Development Panel, USTA Sport Science Committee; has received American Medical Society for Sports Medicine Foundation grant $20,000 for Injury Outcome Study in young athletes; Emory Intramural grant (for same study); royalties from Up To Date Royalties (topic tennis/golfer’s elbow); and payments for lectures from Washington University CME. S.P.C. is a consultant of Premier League, reports grants from ESRC FA British Academy, and has received payment for development of educational presentations from FA. G.D.M. has consulted with commercial entities to support application to the US Food and Drug Administration but has no financial interest in the commercialization of the products. G.D.M.’s institution receives current and ongoing grant funding from National Institutes of Health/NIAMS Grants U01AR067997, R01 AR070474, R01AR055563, R01AR076153, R01 AR077248 and has received industry-sponsored research funding related to brain injury prevention and assessment with Q30 Innovations, LLC, and ElMinda, Ltd. G.D.M. receives author royalties from Human Kinetics and Wolters Kluwer. G.D.M. is an inventor of biofeedback technologies (2017 Non Provisional Patent Pending–Augmented and Virtual reality for Sport Performance and Injury Prevention Application filed 11/10/2016 (62/420,119), Software Copyrighted) designed to enhance rehabilitation and prevent injuries with potential for future licensing royalties. T.J.G. is a consultant to high-performance organizations.

Figures

Figure 1.
Figure 1.
Use of PPAH (EASA) to determine location in adolescent growth curve. EASA, estimate adult stature attained; PPAH, percentage of predicted adult height; YPHV, years from peak height velocity. Reproduced with permission from Towlson C, Salter J, Ade JD, et al. Maturity-associated considerations for training load, injury risk, and physical performance in youth soccer: one size does not fit all. J Sport Health Sci. 2021;10(4):403-412. doi:10.1016/j.jshs.2020.09.003. Copyright 2021.
Figure 2.
Figure 2.
Workload progression flowchart for uninjured and injured elite specialized youth athletes.
Figure 3.
Figure 3.
Youth Athlete Action Plan: risk stratification and return to sport for the specialized adolescent athlete. ACWR, acute:chronic workload ratio; PPAH, percentage of predicted adult height.
See this image and copyright information in PMC

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