Abstract des Autors

lntense training places a demand on the musculoskeletal system that may lead to overt clinical damage as well as functional and biomechanical adaptations that may be detrimental to sport performance. These adaptations can be seen to some extent in all athletes, but the overtrained athlete is possibly at the highest level of risk. The types of injuries identified range from the overt, that are obvious injuries that will usually prevent athletic performance for some period of time, to the subclinical, that decrease performance but may be seldom recognized. These injuries apparently may be avoided or lessened in severity by a combination of several methods. A thorough preparticipation evaluation is important to detect subtle adaptations in strength and flexibility that can result from inappropriate overload and that may increase the athlete's chances of injury. A sport-specific conditioning program is necessary to give the athlete a strong musculoskeletal base on which to build athletic skills and decrease the risk of maladaptation. In many sports, prehabilitation exercises can be performed for those musculoskeletal areas that are under high stress in a particular sport. Also, a maintenance conditioning program that extends through the season may be important to maintain fitness throughout the season. Following proper principles of conditioning including specificity, recovery, and progression are important. The exact point where "training" becomes "overtraining" is difficult to define, especially prospectively. An exciting area of sports medicine research will be to define the anatomic parameters and exercise doses that may be a factor in the development of the overtraining syndrome, allowing maximal performance with minimal overload risk. At present, retrospective studies indicate that adaptations do occur in muscles, tendons, and bones in response to high training loads, and that some of these adaptations are not beneficial to performance and may be associated with increased injury risk. Musculoskeletal maladaptations and injuries can be a warning signal to the athlete and coach that the volume or intensity of training is too high, and overtraining is a possible causative factor. Verf.-Referat