Oversized young athletes: a weighty concern

The prevalence of overweight and obesity in children and adolescents is increasing worldwide, with a corresponding decline in physical fitness and general physical activity level. Overweight and obese adolescents are more than twice as likely to be injured in sports and other physical activities compared with non-overweight and non-obese adolescents. Obese adolescent athletes are more than three times as likely to sustain an ankle sprain compared with normal weight adolescent athletes. At the societal level, promoting physical activity for children and improving dietary habits are key strategies for lowering the prevalence of overweight and obesity. The increased risk of injury associated with being overweight or obese may in part be due to low physical activity level. Promotion of physical activity for children can provide neuromuscular training that may be beneficial in decreasing injury risk associated with general play and sports participation. For lower-extremity injuries, specific neuromuscular training interventions, such as balance training, have great potential in reversing the increased injury risk associated with overweight and obesity. Finally, the injured overweight young athlete may have a more prolonged recovery period than non-overweight young athletes. Early aggressive treatment of swelling with physical modalities, prolonged non-weight bearing, limited period of immobilisation and regular repetitive passive joint motion are indicated for the overweight young athlete with a lower-extremity joint injury.