Sports Medicine Research: In the Lab & In the Field: Is It Wise for Youth Athletes to Specialize? (Sports Med Res)


Monday, July 17, 2017

Is It Wise for Youth Athletes to Specialize?

Association of Competition Volume, Club Sports, and Sport Specialization With Sex and Lower Extremity Injury History in High School Athletes

Post EG, Bell DR, Trigsted SM, Pfaller AY3, Hetzel SJ, Brooks MA, McGuine TA. Sports Health. 2017; Ahead of Print

Take Home Message: An athlete who participates in more than 60 games per year, is a member of a club sport, or highly specialized is more likely to have a lower extremity injury. Additionally, girls are more likely to participate on a club team and be highly specialized potentially increasing their risk of injury.

High school athletes are increasingly participating in year-round school and club sport, which can increase competition volume throughout the year. This could increase the risk of injury. However, there are no studies examining whether females or males are more likely to compete in a club sport and if sport specialization increases risk of lower extremity injury. Therefore, the authors sought to evaluate the association between competition volumes, club sport participation, and sport specialization with sex and lower extremity injuries. For this study, 1,544 high school athletes (girls 51%) from 29 different Wisconsin high schools completed a paper-and-pencil questionnaire at the start of their competitive season (between 2015-2016 academic year) regarding their sport specialization, sport participation (primary sport, how many competitions did they participate in during the year) and history of previous injury (which was validated by athletic trainer’s records). The authors used a 3-point specialization scale (1=low specialization, 2=moderate specialization, 3=high specialization), which was based on year-round training in a single sport. The authors found that 20% of the athletes reported high volume of competition (more than 60 competitions), while 50% of the athletes reported low competition volume (less than 30 competitions). Additionally, 50% of athletes reported participating on both a club and school sport in the same sport. Club participation was greatest for soccer (22%), baseball/softball (19%), and volleyball (17%). Girls were more likely to compete in a higher competition volume and participate on a club sport compared with boys. Girls were also more likely to report previous lower extremity injury compared with boys when considering all sports and when restricted to sex-equivalent sports. Athletes with high or moderate competition volume were more likely to report previous lower extremity injury, even after accounting for sex. Similarly, athletes who were highly or moderately specialized had greater odds of reporting a previous lower extremity injury compared to low-specialization athletes.

There is an increasing pattern of participating year-round in sports; however, this may not be the best for young athletes. The authors found that participating in many competitions (high sport volume) and being highly specialized is related with a history of lower extremity injury. Girls were also more likely to participate in high volumes and be a member of both school and club teams, which exposes them to a higher risk of lower extremity injury compared with boys. It should be noted that the authors did not compare athletes who competed in the same sport all year to athletes who competed in different sports all year. Hence, it is difficult to determine from this study if specialization is bad or if simply participating in more practices and games just leads to more injury. Regardless, these year-round athletes may benefit from injury prevention programs that decrease the risk of injury. Unfortunately, many teams are not performing these simple programs. It would be interesting to see if highly specialized athletes that perform preventive programs sustain fewer injuries than highly specialized athletes that do not preform preventative programs. Medical professionals should be aware and educate youth athletes, parents, and coaches of the potential risks associated with year-round participation in organized sport and take steps to reduce the risk of injury (for example, implement injury prevention programs).

Question for Discussion: Do you notice a trend that the more specialized an athlete the more injuries they sustain? Do you think placing preventive injury programs would help decrease risk of injury in these year-round athletes? 

Written by: Jane McDevitt, PhD
Reviewed by: Jeff Driban

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