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Context: As youth sport participation grows, athletic trainers (ATs) continue to be important health care providers in managing growth-related injuries. Objective: To examine secondary school ATs' reported knowledge on diagnosing and treating growth-related injuries and reported confidence for determining growth status and to report methods secondary school ATs use to determine patient growth status. Design: Cross-sectional. Setting: An online questionnaire was distributed to secondary school ATs in the United States. Data collection occurred in the summer of 2021 over a 6-week period. Patients or Other Participants: A total of 430 secondary school ATs (highest degree earned: master's degree 5 66%). Main Outcome Measures: The questionnaire contained secondary school ATs' confidence in determining if an athlete was going through a growth spurt, level of knowledge on diagnosing and treating growth-related injuries, methods secondary school ATs use to determine growth status in their athletes, and demographics. Results: Most secondary school ATs believed that growth spurts affected sport-related injury risk (88%); however, only 37% of secondary school ATs were "fairly" or "completely" confident in their ability to determine if an athlete was going through a growth spurt. For those 37% of secondary school ATs, 89% of them used history or observation over time, but no formal method, for determining growth status of their patients. Patient self-assessed Tanner stages (32%) and clinical evaluation of Tanner stages (28%) were the next most used methods for assessing growth. Conclusions: In accord with Domain I of athletic training, secondary school ATs could benefit from improved knowledge on how to measure and manage growth in their patient population. To aid education in this area, future researchers should focus on assessing barriers secondary school ATs face in implementing methods for measuring growth and exploring secondary school ATs' knowledge levels on risk management programs for youth athletes going through growth spurts.

Sport specialization was thought to affect a relatively small number of elite athletes, but it is now a common practice in youth sport culture. Recent research in the field of sport specialization has led to a better understanding of the influence this issue is having on youth (ie, younger than 19 years of age) today. This review focuses on sport specialization from a public health perspective to elucidate the effect that this practice is having within the United States. The specific goals of this review are to describe (1) the prevalence of sport specialization and the factors that may affect the decision to specialize, (2) the costs of youth sport-related injuries in the context of sport specialization, (3) the financial costs that sport specialization has for families, and (4) how sport specialization may be affecting physical literacy.

Immediate athletic trainer (AT) availability for acute injuries is essential as worse long-term outcomes are associated with delays in receiving medical care. Several factors have been found to influence AT availability between secondary schools, but few studies have evaluated how medical coverage varies between athlete groups. The purpose of this project was to identify factors that impact the time to AT evaluation following acute sport-related injury in a secondary school setting. Cross-sectional study. Retrospective analysis of deidentified patient records via the Athletic Training Practice-Based Research Network. High school athletes diagnosed with an acute sport-related injury during in-season play from 2010 to 2023. Time to AT evaluation was measured as the number of days between injury onset, reported by the patient, and AT evaluation. This report consists of 17 354 patient cases representing 20 different sports. Overall, 46.9% (n = 8138) of patients who sustained an injury during in-season play were evaluated by an AT the same day (range, 0–14 days). Significant group differences were reported for sex (P <.001), setting (P <.001), and sport level (P <.01), with female athletes and in-game injuries associated with longer times to AT evaluation. Freshmen were evaluated sooner than junior varsity (P <.01) and varsity (P <.001) athletes. No difference was observed between junior varsity and varsity athletes (P =.34). Almost half of patients received medical care within 24 hours following an acute injury during in-season play, highlighting how qualified health care is accessible for many student-athletes through ATs in the secondary school setting. Differences in time to AT evaluation may be attributable to sex discrepancies in immediate medical coverage between sports and injury reporting patterns among athletes. [ABSTRACT FROM AUTHOR]

Background: Youth sport specialization is a growing trend in youth sports and is associated with an increased risk of injuries and burnout. However, it is unknown how sport specialization is perceived to be affecting the working environment of secondary school athletic trainers (ATs). The purpose of this paper is to describe how ATs perceive youth sport specialization impacting their workload and whether they perceive it to impact patient safety. Hypothesis: ATs will perceive that youth sport specialization impacts their workload and could impact patient safety. Study Design: A sequential, explanatory mixed methods design with 2 phases: (1) cross-sectional surveys and (2) individual interviews. Level of Evidence: Level 3. Methods: A total of 487 secondary school ATs completed the online survey (access rate, 8.4%; completion rate, 85.4%). The survey consisted of Likert questions and included sections about aspects of workload impacted by specialization, impacts on patient safety, demographics. Ten participants were selected to complete a semi-structured interview via video conference. Results: Approximately two-thirds of ATs perceive that sport specialization impacts their workload. (Somewhat, 38.6%; Quite a bit, 25.5%; A great deal, 5.5%) Attempts to reduce or modify patient activity and a patient's time for rehabilitation were the highest rated aspects of workload impacted by sport specialization. Approximately 30% ATs (29.9%) perceive that sport specialization impacts their workload to where it may influence patient safety (Somewhat, 21.6%; Quite a bit, 6.4%; A great deal, 1.9%). Three themes and subsequent subthemes were identified from the qualitative interviews: (1) current youth sport expectations, (2) conflict between school and club sports, and (3) AT job impacts. Conclusion: Secondary school ATs perceive their workload to be negatively impacted by youth sport specialization and some believe it may impact patient safety. Clinical Relevance: Youth sport specialization is impacting youth sport stakeholders, including ATs, in a variety of ways. [ABSTRACT FROM AUTHOR]

Context: Studies have illustrated that overuse injuries occur in adolescent athletes more often than previously reported. The general purpose of this study was to provide a thorough report of secondary school athletic trainers encounters, practices, and perceptions of overuse injury in adolescent athletes. Design: Cross-sectional. Methods: An anonymous online questionnaire was distributed via email to athletic trainers in the secondary school setting. The questionnaire was sent to participants during the summer of 2021 and 430 participants (highest educational degree earned: master's degree = 66%) completed the survey. Various survey methods were used to evaluate athletic trainers (1) demographics, (2) estimations about what percentage of injuries evaluated and treated were classified as overuse, (3) methods for treating overuse injuries, (4) confidence in treating overuse injuries and the complete implementation of their treatment plan, (5) perceptions of various barriers to treating overuse injuries, and (6) perception as to why patients did not want to reduce activity to treat their overuse injuries. Results: Participants reported that about half of all evaluations and treatments in a year were overuse injuries and they were "fairly" or "completely" confident (90%) in their ability to treat these injuries. The most common treatments cited were stretching (91%) and reducing activity (90%). Only 61% of participants were "fairly" or "completely" confident in the complete implementation of their treatment plan. Participants believed that patients' reluctance to reduce sport activities (82% "moderate" or "extreme" barrier) was the most significant barrier to treatment. Participants cited athletes' avoidance of missing games as the most common reason athletes were reluctant to reduce sporting activity. Conclusions: Participants felt confident in treating overuse injuries yet faced significant barriers in treating these injuries. Clinicians should be prepared to have conversations about the importance of reducing sporting activity to allow proper healing for overuse injuries in adolescent athletes. [ABSTRACT FROM AUTHOR]

Early sport specialization is a growing concern among youth sport athletes, particularly in baseball. Motivation to participate in sports is an important factor in determining which sports youth athletes participate in and why. To qualitatively investigate the youth sport participation behaviors and motivations of collegiate baseball players. Qualitative study. Online teleconference. We conducted 25 semistructured interviews with collegiate baseball athletes who were classified as high-level (n = 8), moderate-level (n = 9), or low-level (n = 8) specialists before college. Participants completed individual semistructured interviews to allow us to develop an understanding of their youth and high school sports experiences and associated motivations to engage in those experiences. A framework analysis approach was used to analyze the transcript data and identify themes among the 3 specialization groups. From our interview analysis, 6 overall themes emerged: (1) motivation, (2) stress, (3) quitting, (4) barriers, (5) facilitators of success, and (6) future directions. Moderate- and high-level specialists described greater levels of passion, participating in deliberate practice, greater levels of performance-related stress, and more desire to quit sports than low-level specialists. None of the groups cited parents as an overbearing external motivator to participate in sport at an early age. Participants who were classified as low-, moderate-, or high-level specialists noted different experiences related to their motivation, stress level, desire to quit, barriers to participating in baseball, facilitators of success, and their overall future career goals after completing baseball. This information may be useful for parents, coaches, and health care professionals to better communicate the benefits and risks associated with sport specialization to youth athletes. Future research is needed to determine if differences in motivation levels exist in younger populations. [ABSTRACT FROM AUTHOR]

Context: Sport specialization among youth athletes has been associated with increased risk of overuse injuries . Previous research demonstrates that children perceive specialization to be beneficial in making their high school team and receiving athletic college scholarships. Previous research demonstrates that parents play a significant role in their child's sport experience. However, it is unknown if parents and children answer questions related to specialization factors in a similar manner . Objective: To evaluate the beliefs of youth athletes and parents on factors related to sport specialization and evaluate the level of agreement between dyads on sports specialization . Design: Cross-sectional . Setting. Online and paper surveys . Patients or Other Participants : Aim 1 : 1998 participants (993 children and 1005 parents ). Aim 2 : 77 paired parent-child dyads . Interventions : Sel f-administered survey . Main Outcome Measures : The responses were summarized via frequency and proportions (%). Chi - squares were calculated between parent and child responses. Kappa coefficients were calculated for dyads to determine level of agreement. Sport specialization was classified using a common 3-point scale. Results: The parents were more concerned about risk of injury in sports compared with children (P < .001, X2 = 231.4; parent: extremely: 7.1%; child: extremely: 3.7%). However, children were more likely to believe that specialization was associated with their chances of obtaining an athletic college scholarship compared with parents (P < .001, %2 = 201.6; parent: very/extremely likely: 13.7%; child: very/extremely likely: 15.8%). Dyad subanalysis indicated a moderate level of agreement for "quitting other sports to focus on one sport" (E= .50) and a low level of agreement for " identifying a primary sport " (x =. 30) and "training >8 months per year in primary sport" (K =. 32 ). Conclusions : Parents and youth athletes had differing beliefs on the factors related to sport specialization. Dyad analysis shows that parents and children answer sport specialization classification questions differently. Health care providers should be aware of these differences, and messaging should be individualized to the audience. [ABSTRACT FROM AUTHOR]