Brenner, Joel S.

"Overuse Injuries, Overtraining, and Burnout in Child and Adolescent

Athletes."Pediatrics 119.6 (2007). Pediatrics. American Academy of Pediatrics. Web. 2
Nov. 2015.
Dr. Joel Brenner practices in sports and adolescence medicine. In the article, he argues
that overuse injuries are a prominent injury with adolescent athletes and prevention
should be monitored more closely. Dr. Brenner explains what overuse injuries are, how
they occur and what is bringing about more of these injuries in young athletes. He then
explains how they can be prevented. The author is writing to pediatricians, with the
hope to help with identifying and helping children who are likely to develop overuse
injuries. If children can avoid overuse injuries, they are less likely to burnout and more
likely to pursue athletics throughout their lives.
Keywords
Overuse Injuries
Overtraining
Burnout
Athlete
Adolescents
Passages
An overuse injury is microtraumatic damage to a bone, muscle, or tendon that has been
subjected to repetitive stress without sufficient time to heal or undergo the natural
reparative process.
Yet, youth continue to specialize in 1 sport while participating on multiple teams and risk
overuse and/or burnout if there is no break from athletics during the year. Young athletes
who participate in a variety of sports have fewer injuries and play sports longer than
those who specialize before puberty.1
Regardless, a clearly devised weekly plan, ensuring that safe running conditions are in
place, and the provision of proper education on endurance activities (including
environmental conditions and appropriate hydration) should all be part of the training
process. A critical environmental safety concern is the ambient temperature and relative
humidity, because a child is less able than an adult to handle heat stress.13 Weatherrelated guidelines have been set for all marathons, and these guidelines should be
strictly enforced by the medical director for all youth endurance events.14 Ultimately,
there is no reason to disallow participation of a young athlete in a properly run marathon
as long as the athlete enjoys the activity and is asymptomatic.15
Uses
Common manifestations may include chronic muscle or joint pain, personality changes,
elevated resting heart rate, and decreased sports performance.6,7 The pediatric athlete
may also have fatigue, lack of enthusiasm about practice or competition, or difficulty with
successfully completing usual routines.
The risks of overuse are more serious in the pediatric/adolescent athlete for several
reasons. The growing bones of the young athlete cannot handle as much stress as the
mature bones of adults.4,5
Preventing burnout is important for the enjoyment of the sport.
Limits

Marathon training requires a gradual increase in total weekly mileage, which may be
less than or equal to the total weekly distance that is generally logged by high school
cross-country teams (3540 miles).
The age range of youth is not precisely specified.
It is possible that the article discusses athletes at the high school age, but it is not
specified. However, the general guidelines should still apply.
Calfas, Karen J., and Wendell C. Taylor. "Effects of Physical Activity on Psychological Variables
in
Adolescents." Pediatric Exercise Science 6 (1994): 406-23. Print.
Karen J. Calfas received her doctorate in clinical psychology with an emphasis in
behavioral medicine. Wendell C. Taylor received his doctorate in social psychology.
They collaborated on Effects of Physical Activity on Psychological Variables in
Adolescents, which researches the psychological benefits of physical activity in youth,
which is supported from the results of studies. They are attempting to identify the most
consistent relationships between psychological variables and physical activity in youth.
The article is addressing pediatricians. The article brings further insight into the
importance of physical activity in youth for their psychological well-being.
Keywords
Physical Activity
Self-esteem, self-concept
Anxiety, stress
Youth
Aerobic
Anaerobic
Passages
Similarly, runners were found to have low anxiety (9). p.417
Perceived stress was lower among participants of a vigorous activity program compared
to those of a moderate activity program. p.417
Physical activity can contribute to improvements in self-concept and self-esteem (1 1,
12, 13). In fact, self-concept has been described as the variable with the "highest payoff"
in physical activity and personality research (14). p.417
Uses
The most consistent effect was for self-esteem/self-concept and anxiety/stress
variables. p.416-7
Petruzzello et al. (10) found that only aerobic physical activity produced reductions in
anxiety and that the effects were generally independent of subject characteristics.
p.417
These uses briefly explain the results of the study. With respect to the community
ethnography, these uses directly relate to the topic that will be analyzed.

Limits
The potential for negative effects of physical activity merits further study. The available
literature suggests that physical activity creates no psychological harm in adolescents.
p.418
There are several methodological problems with the data reviewed. p.418
These limits briefly describe sources of error present it the studies that were analyzed.
This must be taken into account when discussing the findings.

Douglas, Scott. "How Much Exercise Is Best for Mental Health?" Runner's World (2012).
Runner's World. Runner's World. Web. 2 Nov. 2015.
Scott Douglas is the senior content editor for the online magazine, Runners World. In
his article, How Much Exercise is Best for Mental Health, he argues that minimal running
will provide sufficient mental health benefits, as well as the idea that the benefits do not
continuously increase as more running is implemented. Douglas references an article
from Preventive Medicine to support his claim. The author is trying to support the idea of
regular exercise, specifically running. Considering the fact that he works for an online
magazine, he is addressing the casual runner who does not suffer from serious mental
illnesses. The article further supports the claim of regular exercise being beneficial to a
persons health.
Keywords
Mental health
Physical activity
Sedentary
Benefits
Exercise
Passages
Not surprisingly, mental health was better in people who reported some physical activity
than in those who said they were sedentary.
Moreover, as you can see in the graph below, there were marked differences in mental
health with just a little physical activity, supporting the notion that the biggest gains from
exercise often come from moving from being sedentary to just slightly active.
You're probably well aware of running's and other activities' positive effect on your
mental health.
Uses
But if some exercise is good at warding off the blues, is more inherently better?Not
necessarily

[t]he optimal threshold volume for mental health benefits was of 2.5 to 7.5 [hours] of
weekly physical activity, the researchers concluded.
These uses coincide with other sources, supporting the mental benefits of running,
which can be used to analyze the Harwood Union Cross Country team.
Limits
Only one study is referenced.
Researchers compared self-reported data from more than 7,600 Americans on two
matters
These two limits could be sources of error in the study. If there is only one study, then
its possible error could be involved, especially if the data was self-reported.
Eime, Rochelle M, Janet A Young, Jack T Harvey, Melanie J Charity, and Warren R Payne. "A
Systematic Review of the Psychological and Social Benefits of Participation in Sport for
Children and Adolescents: Informing Development of a Conceptual Model of Health
through Sport."International Journal of Behavioral Nutrition and Physical Activity 10
(2013): 98. International Journal of Behavioral Nutrition and Physical Activity.
International Journal of Behavioral Nutrition and Physical Activity. Web. 2 Nov. 2015.
Rochelle Eime received her doctorate in epidemiology. Janet Young received her
doctorate in sports psychology. Jack Harvey received his doctorate in human movement
and sport science. Melanie Charity is a senior research assistant who works on data
management, statistical analysis and reporting. Warren Payne received his doctorate
from Kent State University and has researched and taught in a variety of exercise
science and health promotion areas. They are arguing for the claim that physical activity
provides psychological and social health benefits. They support their argument by
analyzing studies that meet certain criteria identified in the article. The authors state that
current health guidelines do not address these benefits and they wish to analyze them
further. The authors are writing to health and sport specialists in the attempt to address
the mental benefits of physical activity.
Keywords
Physical Activity
Social Health
Psychological Health
Sport
Quality of Life

Passages

Whilst some studies highlighted the benefits of extracurricular sport, the focus was more
commonly on team sport in general, without distinguishing between in-school and outof-school settings [42,43,46,50,51,58,59,61]. p.16
The most frequently adopted construct (n=3) was the theory of Positive Youth
Development [36,40,41], which propounds the notion that children are resources to be
developed rather than problems to be solved, and that all youth have the potential for
positive development [66]. p.15
There are specific guidelines regarding the level of physical activity (PA) required to
provide health benefits. However, the research underpinning these PA guidelines does
not address the element of social health. Furthermore, there is insufficient evidence
about the levels or types of PA associated specifically with psychological health Abstract
Uses
There were few (n=2) qualitative studies, and similar health benefits of participation in
sport were also reported in the quantitative studies. The study by Holt et al., (2011)
provided more depth than was captured in the other studies reviewed. Interviews with
parents and children unearthed a wide range of developmental benefits, both personal
and social benefits [36]. Psychological aspects of emotional control and exploration were
reportedly related to sport participation. In addition, social benefits of relationships with
coaches and friends were reported in this study [36]. p.13
Few differences were evident between the conclusions of studies of higher and lower
quality or of different study design. There were however, clear differences in the reported
health outcomes associated with different contexts of participation. Therefore the
following presents and discusses the reported psychological and social health benefits of
participation in sport in the different contexts of: extracurricular activities; team sport;
school or club sport; and sport in general. These categories, which are not mutually
exclusive, were based upon the definitions or categorisation made within each individual
study. Furthermore, the health benefits according to different types of participation are
discussed. p.15
The article fully evaluates the studies used and supports their claim appropriately.
Limits
The investigation of health benefits through participation in physical activity mainly
involved cross-sectional surveys conducted through schools. In most cases the students
were not allocated to a participation group prior to the study, and as such there were no
control groups. This limits the capacity to attribute causality of participation on health
outcomes. p.13
Sport was sometimes defined as school sport, club sport or team sport; however no
studies investigated associations between specific types of sport and psychological or
social health domains. p.13
The article addresses the weaknesses of the studies and how they affect their claim.

Harrison, Patricia A., and Gopalakrishnan Narayan. "Differences In Behavior, Psychological

Factors, And Environmental Factors Associated With Participation In School Sports And
Other Activities In Adolescence." Journal Of School Health 73.3 (2003): 113.
Professional Development Collection. Web. 2 Nov. 2015.
Dr. Patricia Harrison is currently a research director and Gopalakrishnan Narayan
specializes as a biostatistician epidemiologist. They argue that students who are
involved in sports have a higher quality of life, especially if the extracurricular is a sport.
They support their claim by referencing the results of the Minnesota Student Survey.
They hoped to find beneficial effects for student involvement in sports on quality of life.
The authors are addressing those that hope to improve school health, specifically mental
health and personal well-being, who likely work in the education system. The survey
reveals a correlation between involvement in sports that could be used to help students
improve their lives.
Keywords
Sports
Extracurricular Activities
Family and School Connectedness
Self-Esteem
Emotional Distress and Suicidal Behavior
Passages
This study found that adolescents from single-parent homes were less likely to
participate in either sports or other activities, and especially less likely to participate in
both types of activity.
Engagement in activities beyond academic pursuits has been shown to be positively
associated with health-enhancing behavior. For example, a study of urban middle school
and high school students found that involvement in family activities, volunteer activities,
and school clubs was positively associated with higher scores on a health-enhancing
behavior index which included healthy diet and regular exercise.5 Another study of
adolescents found that sports participants were more likely than nonparticipants to report
consumption of fruits and vegetables.6 Exploring the relationship between sports
participation and health, a study of suburban high school students found that sports
participation was associated with fewer mental health and general health problems.7
With respect to the relationship between involvement in activities and risk-taking
behavior, findings are mixed. In one study, participation in extracurricular activities was
associated with a lower risk of smoking but not drinking.8 However, another study found
that greater involvement in prosocial activities was associated with less involvement in
problem drinking and a lower likelihood of becoming a problem drinker in subsequent
years.9

Uses

Those involved in team sports at school (alone or combined with other activities) had
the highest rates of exercise and milk consumption, were most likely to believe their
parents care a great deal about them, were most likely to report high self-esteem, and
were least likely to report sadness, anxiety, and suicidal behavior.
This statewide student survey revealed that participants in any type of extracurricular
activity were significantly more likely than nonparticipants to exercise and consume
nutritious foods, to like school and do homework, and to express positive attitudes about
self, peers, teachers, and parents. Involved students also were less likely to skip school,
get into fights, vandalize property, smoke cigarettes or marijuana, binge drink, or have
sexual intercourse
This article suggests that student involvement in extracurricular activities can increase
the quality of life for individual students.
Limits
The sample did not include students absent the day the survey was administered,
students in alternative or private schools, or home-schooled students, so it is not
possible to determine whether the findings would hold up in these groups.
It is possible that better adjusted adolescents are more likely to become engaged in
prosocial activities.' One study that followed preadolescents into early adolescence
found this result to be the case.15 Yet, it might be true that participation has beneficial
influences on participants by providing a context for personal growth, exposure to healthrelated messages, and interactions with supportive adults and peers.7
The results of this study require further investigation to develop a stronger argument.
Hogan, Michael, et al. "The Interactive Effects of Physical Fitness and Acute Aerobic Exercise
on
Electrophysiological Coherence and Cognitive Performance in Adolescents."
Experimental Brain Research 229.1 (2013): 85-96. ProQuest. Web. 2 Nov. 2015.
Michael Hogan received his doctorate in psychology and now works as a lecturer at the
National University of Ireland, Galway. Markus Kiefer received his privatdozent in
psychology. Sabine Kubesch is a Postdoctoral Fellow at the Harvard Graduate School
of Education. Liam Kilmartin is a lecturer in the Department of Electronic Engineering at
the National University of Ireland, Galway. Peter Collins works at the National University
of Ireland, Galway. Their study suggests that physical exercises increases cognition in
adolescents. Their result is based on data that they collected and research of other
studies. The authors noted that research on this subject has been focused on older
people and not enough on adolescents; they wish to address this trend. Their research
is directed towards neuropsychologists who wish to understand how an adolescent's
brain reacts to certain stimuli. The article offers suggestions as to how the findings, if
more research is done, could be used to aid in the education of children.

Keywords
Electroencephalogram
Coherence
Fitness
Exercise
Cognitive Performance
Passages
More recently, the beneficial effects of physical fitness on cognitive functioning have
been examined. Many studies in this area have focused on elderly adults with an
emphasis on the protective function of physical activity in the context of age-related
cognitive decline (Churchill et al. 2002) p.85
More specifically, high fit participants had significantly faster [reaction times] in the
exercise condition in comparison with the rest condition. Furthermore, unfit, but not fit,
participants had higher error rates for NoGo relative to Go trials in the resting condition
p.92
As the group differences were less pronounced after a bout of exercise, this suggests
that acute exercise might improve cognitive performance efficiency particularly in less fit
individuals (see also Colcombe and Kramer 2003). p.93
Uses
Although the sample size of the current study was small, which had implications for the
power of our statistical analyses, behavioural and coherence effects we observed
suggest that, overall, unfit adolescents may perform cognitive tasks at the same level as
fit participants in certain conditions (exercise condition, Go trials), but possibly at the
expense of greater cortical effort reflected in higher coherence. In situations where
attentional demands are high, relatively higher levels of coherence were coupled with
higher error rates in the unfit group, suggesting a link between higher coherence and
higher error rates in the sample as a whole. p.93
In conclusion, the present study revealed an interaction between an acute bout of
exercise and long-term physical fitness in adolescence. Although fit adolescents showed
better performance in the Erisken flanker task than unfit adolescents, unfit adolescents,
but not fit adolescents benefited from an acute bout of exercise. p.94
This study suggests some benefit of cognitive function from physical activity, but more
research is needed.
Limits
It is unclear to what degree effects of exercise on [electroencephalogram] coherence
and behavioural performance would be comparably observed in children and
adolescents. Some researchers suggest that physical activity may produce more global
effects in children in comparison with those observed in the adult population (Hillman et
al. 2005). p. 94

The effects of fitness and both chronic and acute exercise interventions on brain activity
and behavioural performance should be replicated in larger samples of children and
adolescents while controlling for a variety other factors that might be related to both
fitness levels and brain and behavioural measures (e.g. intelligence, academic
achievement, socioeconomic status). p.94
The sample size of the study was small and is not enough to make a large claim. More
research is needed to support the correlation noticed in this study.
Rhind, D. J. A., S. Jowett, and S. X. Yang. "A Comparison of Athletes' Perceptions of the
Coach-Athlete Relationship in Team and Individual Sports." Journal of Sport Behavior
35.4 (2012): 433-52. ProQuest. Web. 2 Nov. 2015.
Dr. David Rhind is a lecturer in the School of Sport and Education at Brunel University,
who specializes in the development of interpersonal relationships in sport. Dr. Sophia
Jowett is affiliated with the School of Sport, Exercise and Health Sciences at
Loughborough University and researches the affective, cognitive and behavioural
aspects of interpersonal relationships in sport. Dr. Sophie Yang received her doctorate
in Sport Psychology from Loughborough University. Their study argues that there are
differences in how athletes from individual and team sports form a relationship with their
coaches. They suspect that the athlete-coach relationship has a direct effect selfconcept and passion for the sport. Their study is directed towards coaches and sports
associations so that they can improve coach and athlete relationships. By improving this
relationship, sports teams could improve their performance.
Keywords
Individual Sports
Team Sports
Relationship
Athletes
Coach
Passages
Recent years have witnessed a growth in the body of evidence which demonstrates the
importance of the role played by the coach-athlete relationship in sport (Jowett &
Poczwardowski, 2007). LyIe (1999) explained that this relationship is at the very heart of
coaching and that coaches who fail to acknowledge the importance of it risk not
developing their athletes to their full potential.
The coach-athlete relationship has been linked with a number of intrapersonal
outcomes. For example, qualitative evidence has suggested that the quality of me
relationship can have a significant effect on performance accomplishments (Jowett &
Cockerill, 2003). Relationship quality has also been found to be positively correlated with
psychological outcomes such as athletes' perceptions of their physical self-concept

(Jowett, 2008), their level of passion for sport (LafFraniere, Jowett, Vallerand, Donahue
& Lorimer, 2008), and dieir level of satisfaction (Jowett & Ntoumanis, 2004).
Researchers have explained that the dynamics between a coach and an athlete may be
influenced by whether they are participating in a team or individual sport (Bloom,
Durand-Bush, Schinke & Salmela, 1999; Jowett, Pauli & Pensgaard, 2005).
Uses
In examining the athletes perceptions of relationship quality, further differences were
evident. In terms of direct perceptions, athletes from individual sports reported being
closer and more committed to their coach. However, no significant differences were
found in relation to complementarity. In other words, both individual and team sport
individuals were similarly responsive, friendly and ready to do their best in training. In
relation to meta perceptions, only one significant difference was found between athletes
in team versus individual sports. Athletes who participated in individual sports believed
that their coach felt more trust, respect, and appreciation for them than what athletes in
team sports believed for their coaches .
These differences between team and individual sports may have been found as a result
of athletes (and their coaches) of individual sports spending more time together or
through interacting more frequently on a one-on-one basis.
These uses suggest that there is a difference in the perception of the coach-athlete
relationship, but not in quality, between team and individual sports.
Limits
There are also some limitations of the present research which may be overcome
through further investigation. For instance, [the] present study only obtained a snapshot
of how an athlete was feeling, thinking and behaving. As relationships are dynamic,
assessing perceptions on a series of occasions may afford information on how
relationship quality changes over time and how this may be influenced by the changing
situation which surrounds me coach and [athlete].
One could incorporate measures of related factors such as performance and
satisfaction to investigate how [they] may be associated with relationship quality in
different contexts. Finally, [there] is a move towards viewing the coach-[athlete] dyad as
the unit of analysis (e.g., Poczwardowski, Baratt & Jowett, 2006). By only considering
athletes' perceptions, the coaches views are not accounted for and hence an impression
of the relationship as a whole is not possible. Replicating [this] study with coach-athlete
dyads would help to overcome this limitation.
These limits explain why further testing is needed in order to strengthen the claim.
Taylor, C B, J F Sallis, and R Needle. The Relation of Physical Activity and Exercise to Mental
Health. Public Health Reports 100.2 (1985): 195202. Print.

Dr. Taylor is associate professor of psychiatry (clinical) in the Department of Psychiatry

and Behavioral Sciences at the Stanford University School of Medicine. Dr. Sallis is
assistant adjunct professor in the Division of General Pediatrics at the University of
California at San Diego, La Jolla. Dr. Needle is associate professor in the College of
Education and School of Public Health at the University of Minnesota, St. Paul. The
authors argue that physical activity and exercise can have a positive effect on selfconcept, self-confidence and mental well-being, and suggest ways that these effects can
be studied further. They analyze different studies on the effects of physical activity and
exercise to strengthen their argument. The authors hope to use physical activity and
exercise to help with certain mental disorders. They are addressing public health
professionals. The work suggests that there physical activity and exercise are beneficial
for mental health.
Keywords
Mental disorders
Physical activity and exercise
Mental Health
Depression
Anxiety
Passages
In controlled studies, children and adolescents improved self-confidence after exercise
(51,52). p.197
Two major Canadian population surveys (64,65) report positive associations between
exercise and psychological well-being as measured by Bradburn's index. Two U.S.
fitness surveys (66,67) contain data on exercise and general well-being that, if analyzed,
would provide additional cross-sectional data on this issue. Physical activity and
exercise might have different psychological benefits in different age or population
groups. For example, elderly patients might show greater benefit than younger patients,
or persons with chronic illness might show greater benefit than able-bodied persons.
p.199
Women in an exercise group reported large increases in self-confidence that were
correlated with changes in fitness (33). However, in a study conducted in the workplace,
changes in self-concept were not related to fitness changes (36). In a well designed
study, running by itself did not improve self-concept, but running plus group discussion
did p.198
Uses
A number of cross-sectional studies (73-75) and two randomized trials (76,77) showed
that acute and chronic exercise reduce physiological responses to stress. These studies
suggest that physical fitness training may produce improvements in physiological
responses to stress comparable to or greater than those produced by some relaxation
techniques. p.199

A number of negative psychological effects have been attributed to exercise (3) (see
box). For instance, Morgan (78) Proposed psychological harms of exercise described
eight persons with running addiction, in whom commitment to running assumed a
higher priority than commitments to work, family, interpersonal relationships, and
medical advice. This obligatory running has been characterized as neurotic (79) and
akin to the excessive running evident in many anorectic patients (80,81). It is not clear if
the running causes the negative behavior or if certain personalities are predisposed to
abuse running as a way of avoiding or perhaps even coping with other problems. p.199
These uses suggest that running can aid with stress relief, but only until a certain point.
Limits
For both psychiatric and nonclinical populations, physical activity and exercise would
seem to offer some benefit. Yet despite the great public health importance of this
potential benefit, surprisingly few studies meeting acceptable standards of methodology
have been reported to help explain how physical activity and exercise might be useful (a)
to reduce morbidity in psychiatric populations and (b) to prevent psychological problems
and even improve mental health in nonclinical populations. p.199
Even the controlled studies have been short term, involving small samples, and few
studies have addressed possible mechanisms. Our knowledge in the area can best be
advanced through a variety of studies that both address a variety of populations and
combine excellent psychological and physiological methodology with equally careful
description and assessment of physical activity and exercise. p.199
More studies are required in order to make a stronger claim about the effects discussed
in the article.