KT Blog: Physical Literacy & Preventing Injury in Youth Athletes

Matthew Miller, MSc, CAT(C), PhD Student, Concordia University

Obesity and sedentary behavior are becoming a major problem in todays society, especially among children (put those phones down and move!). Health care interventions and physical educators focus on promoting physical activity using the concept of physical literacy. Physical literacy is a theoretical concept that suggests physical activity is as important as reading and writing. Physical literacy is defined using four main concepts,

1) physical competence,

2) confidence and motivation to participate in physical activity,

3) daily behavior, and

4) the knowledge and understanding to participate in physical activity throughout life.1


If we’re going to use physical literacy as a model to promote activity in children, it’s important to understand how we evaluate how “physically literate” a child is. There are many excellent resources that evaluate physical literacy in children, including the Canadian Assessment of Physical Literacy (CAPL) that evaluates the four domains of physical literacy.2 Many other physical literacy assessments focus on the physical competence domain, which refers to fundamental movement skills (e.g. balancing on one leg, running, or throwing a ball) that are required to participate in any basic activity. Most assessments evaluate children based on how many repetitions they can complete or how fast they can perform a certain skill (e.g. hop on one leg). This is a great way to get an idea of how one child’s performance compares to another. However, it doesn’t provide any information about the quality of movement. How does the child move during a certain skill?  Are their knees caving in when they jump? Is their back straight when the bend over?


How fast a child is moving or how many times they can hop on one leg is a performance-based assessment. In contrast, evaluating body position and movement technique is considered a process-based assessment. The differences between these assessment types are important because technique and body position have been indicated as key aspects of injury prevention.3 As children get older and participate in more competitive sports and activities, the risk of injury increases. Therefore, it’s important to identify and reduce the risk of injury in young athletes. Evaluating physical competence using a process-based assessment creates a link between physical literacy and established injury prevention programs like the FIFA 11+.4 Check out my recent publication for more detailed information about the relationship between physical literacy and injury prevention. 5


Evaluating a child’s movement technique and body position can be difficult. My current PhD research is focused on solving this problem. For practitioners, educators and coaches, I would recommend using previous knowledge about movement technique and teaching children how to move, as opposed to how fast to move. More specifically, instead of seeing how high children jump, make sure they can land without their knees caving in first!

Performance versus process-based approaches are also applicable in rehabilitation. Often, patients are asked to perform 3 sets of 10 repetitions of a specific exercise. Instead of prescribing a set range, why not assess how the patient is moving and stop them when their movement technique breaks down. Movement technique and body position are key for to reducing the risk of musculoskeletal injury (quality over quantity!).

As a final note, the performance versus process conversation doesn’t really matter unless we get more children to become more engaged in physical activity. Getting children, teenagers, or adults, to put their phones down, get outside and move is the first step to being more ‘physically literate’.

Biography: Matthew Miller is a Certified Athletic Therapist and Lab Instructor at Concordia University. He has a master’s degree from Memorial University of Newfoundland and is currently working on his PhD at Concordia University.

Article Citations:

  1. Whitehead M. The concept of physical literacy. European Journal of Physical Education. 2001;6:127-138.
  2. Longmuir PE, Boyer C, Lloyd M, et al. The Canadian Assessment of Physical Literacy: methods for children in grades 4 to 6 (8 to 12 years). BMC Public Health. 2015;15:767.
  3. Padua DA, DiStefano LJ, Hewett TE, et al. National Athletic Trainers’ Association Position Statement: prevention of anterior cruciate ligament injury. J Athl Train. 2018;53:5-19.
  4. Soligard T, Myklebust G, Steffen K, et al. Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial. BMJ. 2008;337:a2469.
  5. Miller MB, Jimenez-Garcia JA, Hong CK, DeMont RG. Process-Bases Assessments of Physical Literacy and the Connection to Injury Prevention Programs. Athletic Training & Sports Health Care. 2018;10(6):277-284.


Published by katiemitchell08

I'm a Registered Physiotherapist and Certified Athletic Therapist CAT(C) working in the Waterloo Region, with a focus on sport-related concussion, vestibular-ocular conditions, and orthopaedic injuries. I am the Lead Therapist for Sledge Hockey Team Ontario and also have worked with Waterloo County Rugby Football Club, Rugby Canada and as a member of the medical team for the 2015 Parapan Am Games. Currently, I am a PhD candidate in the Kinesiology program at Wilfrid Laurier University with a focus on visual perception and balance control for individuals with sport-related concussion. My goal is to provide evidence for objective measures of dynamic visual acuity and balance control to improve clinical decision-making for return to sport, work, school, and life!

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