Physiological mechanisms and organism response in youth sports activities-related musculoskeletal injuries

Musculoskeletal injuries in young athletes arise within a biological context that is fundamentally distinct from that of adults, because rapid growth, physeal vulnerability, immature osteochondral structures, endocrine shifts, and asynchronous adaptation of bone, muscle, and tendon reshape both injury susceptibility and tissue recovery. This mini-review synthesizes current evidence showing that injury risk in youth sport is driven not by load alone but by the interaction between developmental biology and sporting exposure: growth-related weak points such as physes and traction apophyses predispose to unique injury patterns; low energy availability and hormonal disturbance can impair bone accrual and increase stress injury risk; and mismatched gains in muscle strength and tendon stiffness may amplify overuse pathology, particularly during periods of accelerated growth. These risks are further modified by skeletal maturity, sex, early sport specialization, psychosocial influences, and abrupt changes in training volume. Preventive strategies have therefore moved beyond generic advice towards neuromuscular training, education, and increasingly individualized load-management models, although important controversies persist regarding treatment thresholds for common injuries, the true benefits and harms of early specialization, and the extent to which screening and prevention should be sport-specific. Future progress in youth sports medicine will depend on a developmental, precision-oriented framework that integrates biomechanics, endocrinology, psychology, and implementation science to enable age-aware risk stratification, personalized prevention, and better long-term outcomes.