Selected Issues in Pediatric Sports Medicine Practice in USA

Participation in sports by children in the United States over the past 3 decades has seen a move from spontaneous and fun activity by children and adolescents to a more organized and competitive activity largely governed by adults and sports governing organizations. With this shift we have also seen a trend in participation in organized sports at younger age, increase in intensity in activity level, and specialization in a single sport from an early age. These and other factors contribute to an increased incidence of sport related overuse injuries in children and adolescents. Another area of intense debate and scrutiny is the long term neurocognitive impact in adolescents of sport-related concussions. Recognition of adverse long term impact of sport related concussions on developing brain has resulted in increased education efforts, prevention strategies, and legislative activity. Screening of young athletes for cardiovascular disease to prevent sudden cardiac death also continues to be a subject of ongoing intense debate in the United States.