Structured training volume in early adolescence: a risk factor for femoroacetabular impingement?

Abstract

Introduction: To determine whether athletes undergoing surgical intervention for FAI completed more hours of structured training in adolescence than matched healthy athletes. Methods: Sixty-seven athletes (25.53 ± 4.8 years) undergoing surgical intervention for symptomatic FAI were asked to recall the number of hours engaged in structured training between the ages of 10-12 and 13-15 years old (FAI group). Results were compared to an age (24.56 ± 4.5 years), gender and activity level matched control group (n=71) with no history of chronic hip/groin pain or hip stiffness and who were currently engaged in similar levels of training and competition. Results: The FAI group reported significantly more structured training hours between the ages of 10-12 years than controls (6.55 ± 3.1 versus 5.69 ± 3.7 hrs/week, p=0.02) but no differences were observed for training volume between the ages of 13-15 years (8.45 ± 3.4 vs 8.03 ± 3.7 hrs/week, p=.397). Conclusion: Higher volumes of structured training in early adolescence are a potential risk factor for the development of symptomatic FAI later in the player pathway. Level of evidence: IV.

Arthroscopic correction of femoroacetabular impingement improves athletic performance in male athletes

“…The control group underwent individual hip ROM testing (maximal flexion, abduction, and internal rotation in the supine position) at baseline only with a single operator, using a hand‐held goniometer, the intra‐relater reliability (Intraclass correlation coefficients > 0.75) for this measure was published in an earlier manuscript [34, 35]. These measurements were compared with ROM assessment recorded in the FAI group undertaken as part of their routine preop and 1‐year postop consultation using a similar dual‐operator technique.…”

“…The aetiology of the condition is less understood; the role of excessive physical activity during skeletal development has been identified as a possible risk factor for the development of a bony deformity which becomes symptomatic later in the player pathway [1, 34, 42, 51]. The effects of FAI on athletic performance among a cohort of athletes with symptomatic FAI have been previously reported and displayed significantly lower levels of acceleration and agility, increased pain and lower hip range of motion compared to matched controls [35].…”

Training Load Monitoring and Improved Movement Literacy—Overlooked Strategies for Femoroacetabular Impingement Syndrome Injury Incidence in Youth Athletes

“…Multiple studies have documented larger alpha angles in adolescent athletes compared with nonactive controls (2,8–13), especially in hips with an open growth plate (11). Competitive soccer athletes undergoing FAI-S surgery reported a high training volume between the ages 10 and 12 years (10,12). Alpha angle and epiphyseal extension increased most rapidly between 12 and 14 years of age in another sample of soccer athletes; high school or elite level athletes presented 4° to 7° greater angle compared with age-matched peers (2).…”

“…Alpha angle and epiphyseal extension increased most rapidly between 12 and 14 years of age in another sample of soccer athletes; high school or elite level athletes presented 4° to 7° greater angle compared with age-matched peers (2). Therefore, the etiology of cam deformity may be linked to vigorous loading during preadolescence and adolescence, with development resulting from force loads experienced during peak growth periods (6,10–19). Skeletally immature individuals who experience an adaptive response at the proximal femoral physis may be predisposed to cam development immediately before physeal closure (3,11,14,19).…”

“…Measuring the alpha angle through radiographic imaging is commonly used to diagnose cam morphology (7); an angle greater than 55°is abnormal. Multiple studies have documented larger alpha angles in adolescent athletes compared with nonactive controls (2,(8)(9)(10)(11)(12)(13), especially in hips with an open growth plate (11). Competitive soccer athletes undergoing FAI-S surgery reported a high training volume between the ages 10 and 12 years (10,12).…”