From Risk to Rehab: Understanding Bony Stress Injuries in Youth Athletes

In our previous blog we explored the complexities surrounding athleticism in youth sport. Based on the National Strength and Conditioning Association definition of athleticism we proposed the development of athleticism in youth athletes could be optimised via the collective insight and agreement on a working definition of athleticism across all stakeholders and support for development of physical and psychological aspects of athleticism across a range of motor tasks and environments. In this blog we look more specifically at bony stress injuries in youth athletes and explore management and prevention options to optimise engagement in sport for our youth athletes.

High volumes of sport and more so repetitive running can carry the risk of developing overuse injuries in youth sport, including bony stress injuries (BSI). A BSI can be broadly defined as the inability to withstand repetitive mechanical loading, resulting in structural fatigue and localised bone tenderness and pain.  BSI occur along a continuum beginning with micro stress reactions, which overtime can progress to a stress fracture and further progression can lead to a complete fracture (See Warden et al., 2014 for further details on BSI). The purpose of this blog therefore is to discuss the management options for BSI in youth athletes.

High and Low Risk BSI

Treatment and recovery can vary depending on which bone is affected, where the injury is on the affected bone and the blood supply to that bony area. The location of the stress injury will determine whether it is at a low or high risk of progressing to a fracture.

High-risk BSI

Occur at specific bony areas that typically have poor blood supply

Result longer healing timeframes

Require prolonged immobilization

Low-risk BSI

Rehabilitation healing timeframes can vary depending whether it is a minor stress reaction or if it is a more advanced stress fracture

Usually resolve with modified training loads and strengthening exercises

Healing time-frames range between 6-8 weeks

Diagnostic Imaging is it necessary?

For low risk injury areas, imaging does not change the intervention strategy. X-rays do not always show a BSI, therefore, when imaging high risk injury areas, research suggest MRI is the most optimal choice when it comes to diagnostic imaging.

Rehabilitation

The first step to returning to sport is to ensure that the youth athlete is pain-free during daily life activities, such as walking. If the youth athlete is not pain-free while walking, crutches or a boot may be administered for temporary use. During these initial stages of rehabilitation, if walking is painful, the youth athlete can maintain basic fitness with aqua running and stationary bike sessions. The first step to returning to sport is to ensure that the youth athlete is pain-free during daily life activities for five days or more.

Factors Affecting Treatment Prognosis

Recovery can be delayed if an athlete progresses through their graduated loading rehabilitation program too quickly, ignoring pain as a result of their current training load. Additionally, factors such as diabetes, poor nutrition, endocrine disorders/dysfunctions, relative energy deficiency syndrome. Addressing the factors that have contributed to the BSI will have a positive effect on treatment prognosis. To have long-term positive treatment outcomes it is to assess the following:

Current training program design

Student athletes must modify training volumes, frequency and intensities of their land/pool training sessions as well as their gym strengthening sessions. Research recommends that acute training loads (increased within one week) should not exceed a 10% increase higher than their chronic training loads (load over four weeks).

Nutrition and General Bone Health

Nutrition should be monitored to avoid nutritional and energy deficits. Promoting healthy eating behaviours and detecting any nutritional, caloric, calcium or vitamin D intake deficiencies will prevent BSI.

Biomechanics

It can be beneficial to address running biomechanics while simultaneously reducing the amount of loaded impact that the youth athlete is exposed to through their sport.

In summary, BSI can occur through high volumes of sport and highly repetitive sporting activities. BSI can occur as high and low risk BSI and in low risk BSI, the early management of pain during activities of daily living will be important to proceed with a return sport. Positive long term outcomes can be optimised through managing training loads (volume and intensity), promoting healthy eating behaviours  and addressing running and movement deficiencies.   

References for Further Reading

Arndt A, Westblad P, Ekenman I, Lundberg A. A comparison of external plantar loading and in vivo local metatarsal deformation wear- ing two different military boots. Gait Posture.

Barton, C.J., Bonanno, D.R., Carr, J., Neal, B.S., Malliaras, P., Franklyn-Miller, A. and Menz, H.B., 2016. Running retraining to treat lower limb injuries: a mixed-methods study of current evidence synthesised with expert opinion. British journal of sports medicine50(9), pp.513-526.

Bennell KL, Malcom SA, Thomas SA, et al. Risk factors for stress fractures in track and field athletes. A twelve-month prospective study. American Journal of Sports Medicine.

Warden, S.J., Davis, I.S. and Fredericson, M., 2014. Management and prevention of bone stress injuries in long-distance runners. journal of orthopaedic & sports physical therapy, 44(10), pp.749-765.

Out of Complexity, find Simplicity: Understanding the Complexities of Athleticism in Youth Sport

In our previous blog we explored the importance of influencing behaviours and shaping the environment to promote positive changes in dietary behaviours with youth athletes. We identified the importance of a nutrition philosophy, instruction for ideal behaviours, consistency in approach and actioning behaviours in practice. In this blog we delve into the field of physical development to explore the concept of athleticism in youth sport, dissecting the definition of athleticism and how we may be able to enhance our practice through this process.

In 2016 the National Strength and Conditioning Association position statement on long-term athletic development defined athleticism as, “…is the ability to repeatedly perform a range of movements with precision and confidence in a variety of environments, which require competent levels of motor skills, strength, power, speed, agility, balance, coordination, and endurance.” Thus, the complexities of developing athleticism in youth athletes become apparent given the extensive and wide range nature of this definition.

The critical aspects of this definition may be:

Repeatedly perform – The development of athleticism may require reliability in the skills and/or capacities to perform a given task. This may require purposeful, deliberate and consistent practice and exposure to such tasks. Thus, athleticism may take time to be presented in an individual.

Precision and confidence – The development of athleticism can occur above and below the neck. Athleticism has physical skills and capacities which are often clear to see and define one’s perception of athleticism. However, athleticism may also reside in an individual’s willingness and desire to express their physical skills and capacities, i.e. skills and capacities above the neck.

Variety of environments – The development of athleticism should be the responsibility of many and not a few. From physical training practitioners to physiotherapists to sports coaches, we can all contribute to the deliberate development of athleticism within the context and opportunities provided by our practice.

Competent levels – The development of athleticism can be referenced against individual and/or cohort norms to establish the degree to which competency has been expressed or is developing. These norms may be in the form of products (outcomes of physical/psychological attributes of athleticism, i.e. how far or how fast) or processes (how individuals achieve the outcome they have attained, i.e. technical execution).

Skills, strength, power, speed, agility, balance, coordination and endurance – The development of athleticism spans a wide range of physical qualities. Within each quality or identified qualities, profiling for competent levels of outcomes or processes may help support a more coherent and targeted approach to training.

Taken collectively, athleticism is complex term which spans both physical and psychological domains, a range of attributes and environments and may be profiled against outcomes and processes. Given this, an important part of the development process in supporting athleticism in youth sport may be gaining collective insight and agreement on a working definition of athleticism based on the opportunities and constraints of your coaching environment. Collaboration in defining and deliberately developing athleticism may be utopia in supporting the development of physical and psychological skills and capacities related to athleticism in youth athletes.

Our Behaviour May Be More Honest Than Our Words: Shaping the Environment to Promote Positive Changes in Dietary Behaviours with Youth Athletes

In our previous blog we explored early years career development in performance analysis. We suggested that a balance of academic rigour, applied practical experience and willingness to be conscientious and committed to personal develop may stand developing analyst in good stead for a career in the field. In this blog we explore nutrition support for youth athletes and consider if our dietary behaviour can be adapted to support fuelling for sport and more.  

Numerous approaches have been taken to try and understand the factors which influence an individual’s behaviours in relation to food choice and dietary intake. As a sport nutritionist the primary objective of your role is to support and guide your athletes to better performance, health and development through optimising their nutritional intake. Therefore, an integral part of the role will be designing and implementing dietary interventions to bring about positive changes in the dietary behaviours of your athletes (Bentley et al., 2019; Costello, 2018).  

As with all nutrition practices, a one size fit all approach is both unreasonable and inappropriate. However, it is often perceived that suboptimal dietary behaviours is simply a result of a knowledge deficit. Whilst nutrition education programmes have a place in the toolbox of a competent practitioner, that alone is often not sufficient to change behaviour (Kelly & Barker, 2016). Rather appreciating the complexity of the factors potentially driving food choices, specific to both the population and environment you are facing can allow you to take a more holistic intervention approach to try and induce positive change.

Common factors reported to influence Food choices include the environment, personal beliefs and skills, and social influences (Birkenhead & Slater, 2015). Whilst the boarding nature of Millfield facilitates food availability, our objectives then shift to shaping these key feeding environments to be conducive to our target behaviours.  

Literature investigating youth athlete dietary intakes commonly report suboptimal intakes of Carbohydrates and fruit and vegetables (Baker et al., 2014; Burrows et al., 2016). With demanding, multi-layered sporting programmes with our athletes, effective and appropriate fuelling is a priority.  Of course, education focus in the classroom of the ergogenic effects of carbohydrates is appropriate, how can we reinforce this in our key feeding locations?  

Creating a Nutrition Philosophy – “EAT TO EXCEL”

Group Culture can significantly shape member cognition, behaviour, development, wellbeing and performance (Andersen, 2011) 

Here at Millfield we view every feeding time is an opportunity to excel both in and out of the classroom. We wanted to create a positive nutrition culture conducive to our school wide sport vision of leading the development of children both on and off the sport field.  

Instruction for Ideal Behaviours – Performance plates

Scattered across our dining hall are dynamic plate compositions, highlighting how our students can make effective independent food choices to meet their energetic requirements at every mealtime

Actioning Those Ideal Behaviours – Effective food labelling & layout

“small changes in the food environment, including choice architecture interventions to make healthy items more visible and convenient, can result in better food choices(Thorndike et al., 2014)

Understanding our focus points of fuelling and nutrient density, choice architecture changes relating to food layout and implementing a colour coded food labelling system have been effective means to reinforce desired food behaviours at the focal point of where students make those decisions.  

Consistency

From dining hall, tuck shop, team workshops down to individual consultations, my aim to create a common language and clarity in my delivery style and resources utilised which is reflective of our Nutrition philosophy.

The Future Belongs to Those Who Prepare for it: Early Years Career Development in Performance Analysis

In our previous blog we explored the accuracy and reliability of screening for injury in youth sport. Given the limitations around sensitivity, specificity and predictive ability, our tendency was to promote the implementation of injury risk reduction strategies and particularly those centred around movement skill, strength development, proprioception and explosiveness. In this blog we focus our attention on the field of performance analysis. We offer insights for early years performance analysts and those with ambitions to enter the field on how to optimise their development in the competitive world of analysis in sport.

Our Performance Analyst at Millfield has provided a series of responses to the following key questions:

Do I need to go to university to become a sports analyst? 

A highly debated question and a difficult one to answer. I appreciate that there are many pathways into the sports analysis industry. I would promote the value and benefit of an undergraduate degree. This belief is also supported by the majority of sports clubs/organisations that advertise analysis jobs listing a degree as an essential requirement for any applicant. I believe that gaining an undergraduate degree offers an aspiring analyst the opportunity to network with other likeminded sports enthusiasts, along with offering the opportunity to gain the necessary theoretical knowledge to help kick start their career.  

From personal experience, I undertook an undergraduate degree in sports coaching and performance before moving onto a more specific sports analysis masters later in my career once I was 100% sure a career in analytics was what I was aiming for. I believe this was the right move for my own personal development and offered me a wider perspective on the sport industry.

With regarding to a master’s degree, I personally don’t believe this is essential for many analysts, but I did a masters after taking a year out of education as I honestly believed it would make me a better analyst. For example, the ability to understand and be able to perform deeper levels of critical thinking, to think more openly about sports research and to justify my workflows with stronger academic rigour.

How important is gaining experience?

Again a very difficult question to answer, as mentioned above I believe university offers a theoretical learning environment to gain enough knowledge to help kick start your career, however I don’t believe universities can offer the practical exposure you’ll require to fulfil the role of a modern analyst. This can only be achieved, I believe, through getting involved within a real life sporting environment.

My advice would be to try and work under someone who’s got a good background in analysis as opposed to taking on a position where you’re the only one at the club. This will offer you the opportunity to ask questions, see how others lead an analysis program and to gradually take on more roles and responsibilities.

From a personal perspective I started out in an unpaid position which was fine with me as it gave me the opportunity to work within a professional rugby team working under some really good mentors. I’m glad I took this route as opposed to the route of getting a few quid filming and analysing a lower level team. Eventually once I’d learned the trade a little more, I was able to start getting some part-time paid roles and my career progressed from there.

What are the top skills needed to be an analyst?

From my experience people who become analysts are often extremely hard working and passionate about what they do. The analysis industry is tough and we often forget about the need to sit back, relax, reflect and rewind on occasions. This is something I’ve certainly needed to learn over time and I’m still guilty of the odd late night analysis session.

One skill that I feel has often helped me during my time as an analyst is the ability to work well under pressure. As mentioned above, the analysis industry is tough and not only do the coaches want you, but also the players and when you work across multiple sports that pressure increases. I’m very fortunate to naturally be a relaxed person, but I do believe this is a skill you develop and improve over time.

Organisation skills are incredibly important, the role of the modern analyst is busy and you need to be in control of what you’re doing to help benefit the over-all environment you’re in.

Attention to detail is a must for an analyst, not only to ensure no mistakes are made but also this skill helps significantly in the day to day role of the analyst.

Finally, attitude is the single most important attribute that makes or breaks an analyst. i.e. showing the teams your willingness and motivation to provide a good service, staying humble and embracing others views and input and showing gratitude and respect to others around you whilst also showing the confidence and strength to embrace yourself and promote your values and input is a skill that will help any analyst become a valued member of the team.

What advice would you give to an analyst for his/her first interview?

The industry is over-populated and analysts who interview for a role are usually against a high volume of other applicants which means your chance of getting the job is always slim. 

Someone once told me that ‘interviewing is an art’ and it is. It’s a skill you can only develop by going through the process a few times, leaving the interview kicking yourself on what you didn’t say or how you answered a question is not a bad thing. 

I think attempting to oversell yourself and your skillset can be an easy trap to fall for when nervous at an interview. You need to be able to present what your current skillset is and how you think it can have an immediate benefit to the team/organisation you’re applying for and how overtime, you hope to develop and progress that impact.

I also think you need to understand the organisation you’re applying to work for, understand their history, understand their values and culture, try and find out about who works there, what their backgrounds are etc. The more you can find out, the more you can understand what they’ll be looking for, what type of person they’re hoping to attract and what impact you believe you’ll have on that environment. I also believe that if an interviewee has done their homework it really does show they care about the role. 

In summary, academic rigor will provide a foundation for future development in performance analysis. Build a wide range of practical experiences and tap into networking opportunity as these will service you well when you are applying for jobs. Be conscientious with your work and commit yourself to becoming a better analyst every day. When you get the opportunity to interview for your dream role, make sure you have done your homework on the organisation and use that knowledge to your advantage.

To Screen or Not to Screen? That is the Question.

In the last blog we pressed pause and reviewed the work we conduct at Millfield Institute of Sport and Wellbeing and its impact on our understanding of our student population and the wider context of youth sport. The start of the new academic year provides a platform to reflect on best practice within this context. This process allows us to constantly check and challenge our practice. It is in this vein that we visit a well trodden path, screening.

Screening, for injury risk identification and risk reduction has see a substantial rise and fall over recent years. Evidence has been able to substantially disprove the initial theories that we would be able to identify and effectively predict those who may be at increased risk of a certain injury by assessing them while healthy. Some tests described in the literature demonstrate a high level of statistical significance in identifying the targeted risk factor, however they still provide little value in being able to predict if an injury will occur. Furthermore, the test in question must be applicable to the groups being tested. If the studies demonstrating statistical significance to the risk factor in question have only been in conducted in adults, then their extrapolation to youth populations only diminishes their statistical value.

A more critical piece of the puzzle was muted by Bahr (2016). The outcome of an injury prevention screen is an injury risk reduction programme. This is an exercise-based intervention designed to address the identified risk factors from the screen, thus reducing the impact of that risk factor and therefore reducing the risk of injury occurring. As pointed out there has been no study to date which has compared or shown, that a targeted injury risk reduction programme (based upon an injury prevention screen) is more effective than the same programme given to all athletes.

Considering the significant practical limitations to screening, a more valuable use of practitioner and student time would be to implement, on mass, proven injury risk reduction programmes. Programmes such as the FIFA 11+ and RFU Activate have been able to show up to a 75% reduction in injury in youth populations following relatively modest exposure. These benefits were seen in both healthy individuals and those with injury history, and presumably existing risk factors.

Physiotherapists are often seen as a those who have knowledge or understanding of humans that transcend others within the medical field. Screening may have been seen as a magic bullet to rid athletic populations of injury. As we have seen there are many flaws in the ability of screening to predict injury risk. In contrast mass exposure to injury risk reduction strategies appear to be effective at reducing risk in both those with and without injury risk factors making them a much more efficient option at attempting to rid athletes of the often-inevitable risk of injury. Injury risk reduction strategies are inexpensive to run, time efficient, evidenced, effective and should be included in all youth sports programmes.

Long Term Consistency Beats Short Term Intensity: Key Take Homes from our UKSCA Posters 2020

In our first blog of the 2020/21 academic year we will summarise the five conference posters that we successfully submitted to the United Kingdom Strength and Conditioning Association Poster Week 2020. The aims of this blog will be to disseminate our findings and sharing insights into the profile, development and wellbeing of pupils (and coaches) within our domain of practice. In this blog we will press pause and consider some broader take home messages from our projects.

From the analysis our of 2020 conference posters, this is what we think we have found:
• Considering the in-season load of a school based rugby programme, alongside the academic and pastoral demands of a boarding school environment, we can maintain acceleration, body mass and momentum in a school rugby union programme through a 15 week in season phase. The regular exposure to strength training and speed training during the season within this cohort may be advantageous for maintaining such physical qualities – Maintaining Mass in Motion
• With youth athletes, specific range of motion interventions may be required according to sport category, chronological age and gender. As such, efforts should be may to individualise range of motion interventions depending on the needs of the youth athlete – Better to Bend than to Break
• The early and deliberate preparation, effective communication and alignment of expectations may assist in the development of movement skill and competency through a talent pathway. As such, efforts should be may to support the long term development of these physical qualities for all youth athletes – Working Together to Make Youth Athletes Move Better
• A holistic and general physical preparation programme may reduce the risk of lower limb injury irrelevant of age or playing position within the context of youth netball – What’s Good for Them is Good for Us
• To facilitate job satisfaction in early years strength and conditioning coaches, organisations may consider providing high quality supervision, a sense of community and opportunities for successful and independent coaching practice – If Success is Satisfaction, What is Satisfaction?

In summary, consistency in approach with physical preparation in youth athletes across a range of physical training aims may provide the best platform for successful athletic development moving forwards. However, practitioners may consider the individual context of youth athletes around range of motion interventions. To support the next generation of strength and conditioning coaches, employers should ensure technical and personal supervision meets the needs of the early years coaches and the environment is supportive of opportunities for independent practice.

Better to Bend Than to Break: An Analysis of Joint Range of Motion by Gender, Chronological Year Group and Sports Categorisation of Youth Athletes in a Leading Talent Development Programme

Introduction
Reduced joint range of motion (ROM) has been associated to an increased likelihood of injury and a reduced expression of optimal physical performance. There is a paucity of data in the literature pertaining to the lower limb joint ROM for youth athletes across genders, chronological year groups and sport categories. An analysis of joint ROM in this cohort may assist in the optimal delivery of targeted interventions for a range of physical training outcomes. As such, this study aimed to analyse joint ROM across multiple lower extremity sites in youth athletes across genders, chronological year groups and sports categorisations.


Methods
Data was analysed retrospectively for the time period 2017 to 2019. Across year (YR) groups 10-13, 449 datasets were collected. Hip flexor ROM was measured via the modified Thomas test. Ankle ROM motion was measured via the knee to wall test. Hip internal rotation (IR) was measured via the seated medial hip rotation test. Hamstring ROM was measured via the 90/90 active extension test. A goniometer was used to measure ROM. Data was analysed via magnitude-based inferences, comparing genders, year groups and sport categories. Sports were split into team sports (TS), striking sports (SS) and centimetres, grams and seconds sports (CGS).


Results
Girls have a likely trivial difference to boys in hip flexor ROM and possibly greater ankle, hip IR and hamstring ROM. YR11, 12 and 13 showed possibly to likely greater ankle ROM compared to YR10. Hip IR in YR13 compared to YR12 was possibly to likely lower. There were unclear comparisons between all YR groups in hamstring ROM. Striking sports showed possibly to likely greater hip flexor ROM, possibly to very likely lower hip IR, possibly to likely lower ankle ROM, and trivial to possibly lower hamstring ROM compared to CGS and TS.


Practical Applications
The results suggest ROM interventions targeting youth male athletes may be advantageous, with an emphasis at the ankle and posterior thigh. In addition, advanced chronological age may be a consideration for interventions to enhance proximal joint ROM, but not distal joint ROM of the lower extremity. Finally, results suggest that sports categories may display compromised joint ROM relative to others, whereby SS may benefit from targeted ROM interventions involved hip IR, ankle and hamstring ROM. Therefore, specific ROM interventions in youth sport, based on categorisations of gender, chronological age and sport type may be warranted.

If Success is Satisfaction, What is Satisfaction? Self-Reported Satisfaction of Early Years Strength and Conditioning Coaches in a Formalised Coach Development Programme

Introduction
Evidence across a number of industries suggests that job satisfaction (JS) can positively influence employee performance and commitment (Abdelmoula & Boudabbous, 2020; Badrianto & Ekhsan, 2020; Platis et al., 2015; Saridakis et al., 2018). However, there is a paucity of evidence identifying the JS of early years strength and conditioning (S&C) coaches and the factors associated to JS. Given the importance of JS on performance and commitment, understanding JS in this demographic may be important in optimising development in the formative years of the coaching journey. Thus, the aim of this study is to provide a retrospective analysis of JS in early years S&C coaches in a formalised coach development programme. It is hoped the finding of this analysis may provide the opportunity for a more targeted and supportive approach to optimising the development of early years S&C coaches.

Methodology
12 S&C coaches completed the Minnesota Satisfaction Questionnaire (MSQ). The MSQ is a valid and reliable instrument that measures satisfaction with several specific aspects of work and the work environment (Weiss et al., 1967). The participants had all graduated through a formalised S&C coach development programme. Participants completed the long-form MSQ consisting of 100 items with response alternatives as per the 5-point Likert scale. All participants received instruction on how to complete the MSQ. Respondents were encouraged to answer the questions rapidly as per the MSQ instruction manual (Weiss et al., 1967) and responses were anonymised.

Results
Mean general satisfaction was 88.6 ± 11.8. Referenced against normative data (employed non- disabled) from the manual for MSQ this represented a high degree of JS and a score at the 88th percentile. Items scoring in the 90th percentile or above against the reference population were supervision – technical (Mean 24.1 ± 1.7), supervision – human relations (Mean 24.0 ± 2.2), co-workers (Mean 24.3 ± 1.8), achievement (Mean 23.67 ± 2.2) and responsibility (Mean 22.67 ± 2.5). Apart from compensation (Mean 14.58 ± 5.03), all other items scored an average to high degree of satisfaction.

Practical Applications
These results provide a novel insight into JS in early years S&C coaches in a formalised and full-time coach development programme. Overall, participants reported a high degree of satisfaction with their early years S&C coach development programme. Participants reported high satisfaction with the technical skills and support provided by their supervisor, the interaction with their co-coaches, the feeling of accomplishment from their coaching and having freedom to use their own judgement in their coaching practice. As such, early years development programmes in the field of S&C should ensure high quality supervision is in place to support both S&C and non S&C related practice, develop a sense of community within the coaching group, provide opportunities for successful and independent coaching and ensure compensation is in line with national association guidelines. Such factors may contribute to the satisfaction, commitment and performance of early years S&C coaches in formalised coach development programmes.

Working Together to Make Them Move Better: The Importance of Coherence in the Development of Fundamental Movement Skill and Movement Competency within a Talent Pathway

Introduction
The importance of fundamental movement skill (FMS) and movement competency (MC) through childhood and adolescence has been well established in the research literature (Collins et al., 2010; Lloyd and Oliver, 2012; Lubens et al., 2010; Robinson et al., 2015). In addition, the constructs of effective talent development environments have been identified previously (Martindale et al., 2007). However, there is little evidence outlining FMS and MC performance as youth athletes transition through stages of a talent pathway and whether FMS and MC are enhanced if youth athletes have already been part of a talent pathway, albeit at a more junior stage (i.e. an effective talent development environment). Thus, the aim of this study is to provide retrospective analysis of FMS and MC from Millfield Prep School (MPS) and Non-Millfield Prep School (NMPS) youth athletes as they transition into Millfield Senior School (MSS). It is hoped the finding of this study provide the opportunity to consider a coherent, developmental and effective approach to enhance FMS and MC within a talent pathway.

Methodology
59 youth athletes were recruited in the study. 27 joined MSS from MPS and 29 joined MSS from a NMPS. All participants completed an assessment of FMS and MC. Both assessments satisfied the criteria for FMS and MC as outlined by Hulteen et al. (2018). The FMS assessment consisted of A-walk and hold, arabesque walk and hold, lunge walk and hop and stick. The FMS assessment was scored from 0-4 points per exercise and collectively out of 16 points. The MC assessment was an overhead squat. The MC assessment was scored from 0-6 points. Both FMS and MC assessments were completed by a qualified physical training practitioner.

Results
In order to compare FMS and MC performance between MPS and NMPS, an independent samples t-test was conducted. For FMS, this test was found to be statistically significant (p < 0.05). The effect size for this analysis (d = 0.38) was found to exceed Cohen’s (1988) convention for a small effect (d = 0.2). These results indicate that individuals in the NMPS group (M = 22.58, SD = 4.1) performed better, with a low practical significance in the FMS assessment than individuals in the MPS group (M = 20.94, SD = 4.62). For MC, this test was found to be statistically significant (p < 0.05). The effect size for this analysis (d = 0.19) did not exceed Cohen’s (1988) convention for a small effect (d = 0.2). These results indicate that individuals in the MPS group (M = 3.70, SD = 1.50) performed better, but with trivial practical significance in the MC assessment than individuals in the NMPS group (M = 3.95, SD = 1.0).

Practical Applications
These results provide a novel insight into the FMS and MC of two cohorts of youth athletes transitioning onto a talent pathway. These results suggest youth athletes that transitioned within the talent pathway (i.e. MPS to MSS) performed no better in FMS or MC compared to youth athletes transitioning into the talent pathway (i.e. NMPS to MSS). Authors have previously highlighted the importance of vertically orientated and coherent coaching practice within a talent pathway to support the longitudinal development of youth athletes (Webb, 2019). Given the findings presented in this study, physical training practitioners with a talent pathway should work coherently to ensure the long-term development and quality preparation of FMS and MC for all youth athletes at all ages. This process may be enhanced through the early and deliberate preparation of FMS and MC, the effective communication of training aims and an alignment of expectations at each stage of development.

What’s Good for Them, Maybe Good for Us: Physical Differences of Youth Netball Players Across Age Categories and Playing Positions.

Introduction Authors have recently outlined the significant differences in activity profiles and movement demands across playing positions in youth netball (van Gogh et al., 2020). In addition, Smith and colleagues (2020) identified high injury rates in community level netball, with lower limb injuries most common. Finally, authors suggest injury prevention strategies should mirror the positional demands of netball (McNamus et al., 2005), while injury incidence is greater in more junior compared to senior age categories (Sinclair et al., 2020). As such, the aim of this study is to explore the differences in physical qualities between junior vs senior and attackers vs defenders in youth netball across a range of assessments associated to injury risk of the lower extremity (Read et al., 2016). It is hoped the findings of this study provide netball coaches and physical training practitioners with the opportunity to consider a bespoke and targeted approach to reducing injury risk in youth netball.

Methodology 53 youth netball players were recruited for the study. Participants ranged from 13-18 years of age and were assigned as an attacker or defender based on their most common playing position and junior or senior based on their school year. In line with the injury risk factor hierarchical model as proposed by Read et al. (2016), four physical assessments were chosen to assess the difference in performance between junior vs senior and attackers vs defenders for tasks related to lower extremity injury risk. The assessments were the single leg riser, anterior reach, horizontal hop and lateral trunk hold. All assessments were administered by a qualified physical training practitioner. Following familiarisation, participants complete the single leg riser and lateral trunk hold for one maximal effort. For the anterior reach and horizontal hop assessments, participants completed three tests with the average of the three used for analysis.

Results In order to compare performance between age categories and playing positions an independent samples t-test was conducted. For the single leg riser, anterior reach and horizontal hop, tests were not found to be statistically significant between junior vs senior netballers (p < 0.05). For anterior reach and horizontal hop, tests were not found to be statistically significant between attackers and defenders (p < 0.05). For the single leg riser and lateral trunk hold, the test was not found to be statistically significant between attackers and defenders for the left leg but was statistically significant for the right leg (p < 0.05), with the attackers performing better with moderate practical significance compared to the defenders. For the lateral trunk hold, the test was not found to be statistically significant between junior vs senior netballers for the left side but was statistically significant for the right side (p < 0.05). The test was also not found to be statistically significant between attackers and defenders for the right side but was statistically significant for the left side (p < 0.05).

Practical Applications These results provide a novel insight into the physical differences between junior vs senior youth netball players and attackers vs defenders in a series of applied lower extremity and trunk physical assessments. These results suggest that there may be little difference in the lower extremity strength, explosive strength, proprioception and trunk strength of youth netballers across divergent age categories and playing positions. Authors have previously highlighted the importance of developing such qualities for improving the physical preparedness of netball players (Barnes et al., 2020), whilst a bespoke and tailored injury prevention programme has been promoted (McNamus et al., 2005). Given the findings of this study, physical training practitioners may be warranted in ensuring a holistic and general physical preparation programme is implemented with youth netball players to reduce the risk of lower extremity injuries, irrelevant of age or playing position. It is advised that such physical preparation considers the physical demands of netball as outlined previously (van Gogh et al., 2020) given the high risk of low extremity injuries in this sport.