The September 2011 (Issue 45)  of the BJSM  is devoted to how sport can be used as a setting to ensure fitness and health for all children.  Too often, discussion of this topic has ignored the vexed issue of injury risk in such activity, presumably because physical activity promoters do not want any possible adverse side of affects to mar their messages for people to get more active.  This is despite the fact that there is now sufficient evidence that injuries can be a barrier toward sustained participation in sport and may also cause parents to fear for the safety in children in sport. 

Injury prevention professionals and researchers, know that most injuries can be prevented or reduced by appropriately designed and targeted interventions – even in sport!  So there should be ample opportunities to both remove the injury barrier and to allay parental concerns.  It is therefore pleasing to see that one of the papers in this issue by Carter and Micheli does address the injury issue in relation to the training loads that young athletes are placed under. 

The article stresses that injuries in youth sport can arise because a) some children are untrained or unfit for the sports activity they are undertaking or b) skilled children are overtraining and pushing their physical capacities to achieve high sports performance.

Carter and Micheli also rightly point out that youth sports injury is the responsibility of all of those involved in the delivery of, and support for, sport to this age group – parents, coaches, trainers and teachers – as has been previously noted by others.  They also stress that interventions in this age-group need to be individual-specific, sports-specific and context-specific.  However, like much other sports-medicine orientated research, their prime focus is mainly on addressing individual or intrinsic risk factors. 

There is a clear opportunity for the application and development of broader injury prevention strategies, perhaps through application of the Haddon 10 countermeasures framework, to be applied to sports injury prevention.  This should take the emphasis away from relaying mainly on individual behaviour change strategies to a more ecological approach towards reducing injury risk.  Anyone up for the challenge?

Caroline Finch is an injury prevention researcher specialising in implementation and dissemination science applications for sports injury prevention.  She is the Senior Associate Editor for Implementation & Dissemination for the British Journal of Sports Medicine and a member of the Editorial Board of Injury Prevention; both journals are published by the BMJ Group.  Caroline can be followed on Twitter @CarolineFinch