Shooting Sport Injuries in Youth and Junior athletes

Introduction

While few will argue that participation in sport is beneficial to all children in many regards, participation in competitive sport generally poses risk of injuries and raises some concerns about the physical health of youth and junior athletes [2]. Sport injuries can be defined as injuries that prevent athletes from doing sports actively after the injury occurs [4]. 

As shooting sport training may start for children at a very young age, attention must be given to health problems and sport injuries that affect competitive youth athletes and junior athletes [ISSF Youth: 15 - 18 years/ ISSF Juniors <21 y] because these often have a direct impact on their development into elite athletes [2]. While it is impossible to prevent all shooting sport injuries in youth and junior athletes, attempts to reduce injuries are warranted to lessen their potential burden on athletes and their health teams [5].  This article provides a brief review of various health issues that may affect shooting sport youth and junior athletes and how these maybe prevented.

Physiology in youth and junior athletes

Youth and Junior athletes risk sustaining sporting injuries due to their varying physical and physiological  growth and development [2]. Children have underdeveloped coordination, skill, and perception; their vertebral column is unstable and susceptible to injury [6]; their  muscle strength is not optimal. All of these can lead to body and gun imbalance and instability. Youth and junior athletes should ideally progress through three phases in order to gradually improve their skills at the same time as their physiological development: basic (training of fundamentals), intermediated (progress towards maximum performance), and advanced (reaching an international level of competition).

As for adolescent athletes, because circulating androgens promote the fast development of muscle mass and enhance movement velocity and power, rapid and significant changes are likely to influence self-control and injury risk perception. Yet, studies show that the incidence of shooting sport injuries increases significantly in athletes aged 12-14 years due to physical changes that occur during adolescence [6]. Thus, even if more developed in many ways and notwithstanding that it is the time that they develop more complex motor skills required for shooting[9], adolescent athletes are more susceptible to injury than prepubescent athletes [8]. 

Elite Training  

A healthy body with good physiological, psychological, technical and tactical components is required for optimal performance. Shooting training for youth and junior athletes should consider biological, methodological and pedagogical principles in order to achieve the highest levels of efficiency and performance in shooting sport. 

A good training program should incorporate both technical and physical components [1]. A robust physical conditioning program mixed with good technique training has of course been found to increase the ability to stabilize the gun and improve performance [10].

Regardless of how important strength conditioning is, short- and long-term planning for an elite athlete must incorporate alternating periods of training load with recovery for avoiding overtraining or excessive fatigue or sport injuries. Figure 1 shows some trainable (physiology, psychology and biomechanics), and some technical (tactics) factors that affect an elite athlete’s performance. Almost 800-1000 hours of shooting training per year for almost 10 years is required to achieve elite performance. 

Figure 1 . Main factors for the best performance in shooting sport [11].

Shooting Sport injuries in junior and youth athletes

Although studies show that almost 25% of all youth elite athletes in other sports reported a health problem at any given time [12, 13],  shooting sport is one of the safest sports for children [4].  The overall prevalence of shooting sport injuries is less than 6.6% in competition time and less than 5.5 % in training time [6] with studies showing that approximately 50% of incidents being preventable [12]. 

Sport injuries in children are usually limited to mild sprains and strains [6,17]. Because children’s developing bones are more cartilaginous resulting in injuries unique to their age groups such as growth plate fractures and greenstick fractures in comparison to mature adult bones [2].

As in all sports, higher training volumes, increased performance levels and a high competition load may exacerbate injury risk [13-15].   Shooting sport injuries may also negatively affect athletes’ physical, mental and psychological well-being. 

Risk factors for shooting sport injuries can be extrinsic or intrinsic, modifiable or non-modifiable (See Table 1)[4,8,16].  

Table 1 Potential risk factors involved in shooting sport injury causation [5, 8, 16]. 

Shooting Sport Injuries overall

Figures 1 & 2 depict the types of injuries athletes reported in a study in which 729 athletes participated between the ages of 12-65[6]. Studies on athletes show that shoulder pain is the most common injury affecting athletes’ training and records [6, 14, 15].  Muscle tears and severe injuries such as dislocation, tendinitis and shoulder impingement syndrome happen predominantly because of muscle overuse and inadequate warm-up and stretching exercises [1,14,15]. Like many sports, shooting athletes injury risk is higher in competition compared to training [5].

Injuries can occur acutely with a macro traumatic event, such as fractures and sprains, or arise gradually due to a repetitive micro traumatic event, such as stress fracture or tendinopathies [16]. Acute trauma is not common in shooting sport [2].

Figure 1. Injury types sustained during competition versus training [6].

Figure 2. Comparative ratios of injuries sustained to specific body parts [6].

Considerations for youth and junior shooting sport athletes 

Talent identification and early shooting sport specialization 

Children must not be pushed in shooting sport only by chronological age since their structure, function, and performance can differ significantly. Early and single sport specialization not only fails to improve future shooting performance but is also detrimental both physically and emotionally [7]. Although there is no consensus, specialization before the age of 13 is not recommended for shooting sport athletes[3]. Children should be encouraged to participate in a variety of sports [16].

Gender

Girls reported a greater prevalence of health problems (52%) than boys (39%) [13]. Generally, studies show the type of injury differs with girls incurring more sustain and strain-type injuries and boys mostly incurring contusion type injuries [6, 13, 17]. 

Discipline 

Rifle:  The standing position is associated with a typical scoliotic body posture and lumbar hyperlordosis which can cause back injury [18]. In the prone position, supporting the weight of the rifle, they position themselves in a spine rotational and hyperextension shooting position, with excessive flexion of the hip which can cause back and hip injuries [3, 14]. If shooting posture is not compensated with suitable exercises after competition or training, mild asymmetry in trunk musculature and non-structural scoliosis may occur. These disorders are mostly accompanied by back pain in Rifle athletes [3]. Improper posture such as holding the rifle lower than normal can also increase shoulder injuries [1].

Pistol: Pistol athletes typically must hold their position for prolonged periods, with the weight of the pistol differing and the distances being shot being varied. Stability is thus imperative [10]. Studies show that the muscle power importance in shooting performance oscillates between 67%–79% when athletes used a 0.22- caliber standard pistol at 25 meters and 1%–3% when athletes used an air pistol at 10 m[1]. As injuries can be reduced and performance significantly impacted by improving wrist and deltoid strength, training programs are imperative for pistol athletes to improve relative handgrip strength and relative isometric shoulder abduction strength [10]. This highlights the importance of well devised muscular strength training programs. 

Shotgun

To follow the target before and whilst executing the shot, shotgun athletes must energetically move and rotate the upper body in a unique way which places additional acute strain on musculoskeletal system. Although shotgun athletes should place more visual focus (both eyes open) on the moving target, most instinctively focus on barrel direction, as a result the athlete’s shoulders and back usually end up absorbing the brunt the strain[15]. 

Training sessions

As in all sports, regular training is recommended for progression. Higher training volumes, increased performance levels, and a high competition load amongst talented athletes may exacerbate injury risk [13].Therefore, coaches should specify when to increase or slow down shooting training intensity. A standard training is based on 10% rule for training intensity per week [16]. 

Psychosocial factors

Environmental stress is a strong predictor of injury [19]. Studies report that high levels of life stress are associated with injury occurrence in girl athletes while physical fatigue caused by sports practice is found to be predictive in boy athletes [5]. The major life events, such as the death of a family member, or the separation from a close friend or parents, can increase the risk for a sport injury by up to 70% in children[8].

Shooting Sport experience

Athletes with more experience in shooting sports have less injuries. 55% of the injuries occurred during the first 10 years of active shooting sport life. That means that athletes learn to protect themselves and prevent injuries during the training and competitions with time [6]. Studies show rates of injury per 1000 exposure hours are between 0.5 and 34.4[8].

Reducing youth and junior athlete injuries

In order to prevent a chronic medical condition or sport injury, early diagnostics and intervention with conservative types of therapy are helpful. 

In the pre-participation physical examination, a team physician should detect: (i) any condition that may pre-dispose an athlete to injury; (ii) any injury or condition that may be life threatening or disabling; (iii) any musculoskeletal problem such as scoliosis that requires rehabilitation prior to participation [9].

On this last point, physicians are recommended to evaluate for an asymmetry in trunk musculature. The muscle hypertrophy on the dominant side can give the impression of scoliosis. Careful examination is essential to distinguish the hypertrophy (non- structural scoliosis) from a real scoliosis. A full PA (postero-anterior) spine X-ray should be performed to confirm structural scoliosis. In children with non-structural scoliosis (a deviation less than 10 degrees), there are no restrictions on sports participation [20].

Injury prevention

Injury prevention in youth and junior athletes should not solely be focused on acute injuries, but also on overuse injuries and illness. 

Proper Technique

Teaching proper posture positions to athletes will decrease injury numbers. Attention to development and training techniques, rather than emphasizing competition and winning, can reduce overscheduling injuries [13]. 

Avoid Overscheduling

Studies show that 30- 60% of sport injuries in youth and junior athletes are the result of overscheduling[16]. An overscheduling injury can be defined as an injury related to excessive planned physical activity without adequate time for rest and recovery, including between training sessions/competitions and consecutive days[21]. When scheduling youth shooting competitions, training and activity intensity over any 48-hour period, recovery time must be considered to optimize safety [21]. 

Proper Hydration

Youth and Junior athletes also do not tend to drink enough water. Dehydration increases number of injuries [12]. Proper hydration must be constantly monitored in youth and junior athletes to prevent injury.

Conclusion

As is the case in all sports, the reduction of injuries in shooting sport is of utmost importance for the development of youth and junior athletes. Keeping in mind the contents of this brief article, coaches should modify their training programs considering age, gender, discipline and degree of physical development of their athletes with performances levels guiding the intensity of training and competition schedules. 

Reducing injuries allows athletes’ health teams to focus on developing their anthropometric, physiological, psychological, perceptual, and technical strength. Conversely, reducing and preventing injuries allows youth and junior athletes to focus on their training, competition schedule and enjoyment of the sport.

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