The benefits of physical activity and sports participation in youth are well documented. Unfortunately, there are significant disparities in physical activity level and sports participation with lower rates of participation in minority youth, youth from lower socioeconomic status, youth assigned female at birth, LGBTQ youth and youth with disabilities. It is important for medical providers to advocate for physical activity that is fun, safe and accessible to all youth. In order to do so effectively, providers should be familiar with existing disparities and the most common barriers to participation. Healthcare providers can promote physical activity in the clinic and on the sidelines by acknowledging biases, keeping the encounter athlete-centered, preparing for common questions and sharing resources. Resources like the Long-Term Development in Sport and Physical Activity framework can help guide anticipatory guidance for parents of youth across a range of abilities and goals. Healthcare providers can also make a large impact on their communities and local policy by staying informed, connecting with their legislators and contributing to research focused on advancing advocacy and equity in youth sports.

Rock climbing is a popular and upcoming sport. Injuries in rock climbing athletes are common. Understanding the most common rock-climbing injuries requires a general understanding of the sport. This chapter introduces the common terminology, relevant information, and current research on rock climbing in youth climbers. First, we will go over common terminology and rock-climbing basics. Next, we will discuss current research. We hope by the end of the chapter you will have a general understanding of common rock-climbing injuries, understand how to clinically assess climbing athletes, and are comfortable counseling youth climbers on injury prevention. As rock climbing continues to grow as a popular sport among youth athletes, pediatric sports medicine providers need to have a general knowledge of climbing to manage and prevent sport-specific injuries.

injuries are common in youth athletes and can have significant psychosocial sequela. While stress may predispose an athlete to injury, getting injured can also perpetuate stress. Factors like an athlete's personality traits, history of prior stressors, and coping mechanisms mediate the relationship between stress and injury. Negative emotional responses to injury are common, but these symptoms become problematic if they persist or interfere with recovery. Interventions utilizing cognitive behavioral therapy techniques or focused on physiologic stress reduction may enhance recovery. Healthcare providers working with injured youth athletes can support healthy coping by promoting autonomy, sharing information, encouraging self-reflection, and reaffirming competence. When a youth athlete discloses more serious or prolonged mental health symptoms, it may be necessary to escalate care. Providers also have an important role in advocating for systems-level changes, with a particular focus on injury prevention and improving the provision of mental health care for all youth.

The COVID-19 pandemic unfolded onto a preexisting national mental health crisis, resulting in significant increases in mental health problems among youth. Pediatric primary care practices subsequently faced an influx of families presenting for behavioral health concerns with few accessible options for evidence-based treatment. Youth CopeNYP was launched as a short-term, virtual intervention program using evidence-based principles offered to children, adolescents, and parents within the pediatric primary care setting. We describe the development and implementation of this service, including establishing a workforce, creating a referral workflow and handoff system with pediatricians, and developing a clinical manual using evidence-based practices. Adaptation from a crisis response service to a sustainable program to address the ongoing youth mental health crisis in pediatric primary care is discussed.

CONTEXT:Physical activity has shown to be beneficial for the overall physical and mental health of youth. There has been an increasing focus on youth sports moving from a recreational activity to becoming a launching pad for participation at elite levels. Several models of athlete development have emerged to guide specialized and nonspecialized athletes at an age-appropriate level, taking into consideration their physical and mental development. The purpose of this review is to summarize the current evidence and theoretical models regarding youth athlete development and discuss broader initiatives for sports participation and future directions for the field.EVIDENCE ACQUISITION:An electronic databases search, including PubMed, Google Scholar, ScienceDirect, National Institutes of Health, UpToDate, and Springer was conducted. Articles from 1993 to 2021 were included. The search terms long term athlete development, LTAD model, youth physical development, youth athlete development, sports specialization, and pediatric athlete, among others, were used.STUDY DESIGN:Narrative review.LEVEL OF EVIDENCE:Levels 4 and 5.RESULTS:Several models of youth athlete development are discussed in this article. More recent models have built on previous models to incorporate more age- and development-specific recommendations; however, no singular model could be identified as the gold standard for youth athlete development, especially given the lack of empirical data to support these models.CONCLUSION:Youth athlete development currently consists of several theoretical models, each with their own strengths and weaknesses, that can guide the training of young athletes to maximize their performance. Those involved in this process-physicians, athletic trainers, coaches, physical educators, and parents-should understand these various models and trial their various features to see what works best for their individual athlete with consideration given to factors such as their stage of development. Ultimately, more empirical data are required to definitively state which is the optimal approach.

Abstract Musculoskeletal (MSK) and sports-related conditions are relatively common in the pediatric population. Pediatric residencies should provide residents with the knowledge and skills to assess and manage both acute and chronic MSK and sports injuries and complaints. Residents should develop the competencies and attitudes to safeguard and promote a healthy and active lifestyle for youth. Programs can use a variety of educational tools, both in the clinic and on the field, to provide a well-rounded MSK curriculum throughout the residency years. This article provides a review of general pediatric sports medicine curriculum guidelines and suggested implementation strategies.