Special Populations and Sports Participation
Pediatric and adolescent athletes
Understand growth plates and apophyseal injuries (Osgood-Schlatter, Sever disease, Little League shoulder). Overuse injuries rise with early specialization and high training volume; recommend diversification and load limits. Trap: treating physeal pain as simple muscle strain-recognize growth-plate involvement and modify activity.
Female athletes
Know the female athlete triad and RED-S: low energy availability, menstrual dysfunction, and low bone density, with increased stress-fracture risk. Screening for disordered eating is essential. Female athletes have higher ACL injury rates, supporting neuromuscular prevention programs.
Older and adaptive athletes
Older athletes benefit from exercise but need cardiovascular screening and load modification; masters athletes can maintain high performance with appropriate training. Adaptive athletes require sport-specific classification knowledge and attention to skin integrity, thermoregulation, and equipment fitting. Rule of thumb: in a growing athlete with focal pain at a tendon attachment, suspect apophysitis and reduce load rather than immobilize indefinitely.