By: Dustin Baldwin, PT, DPT, Cooperman Barnabas Medical Center Rehabilitation at the JCC MetroWest
Sports Specialization
Around 60 million children participate in competitive sports with many youth athletes specializing in one sport in their early adolescence. Sport specialization has been defined as intentional and focused participation in a single sport for a majority of the year that restricts opportunities for engagement in other sports and activities.
There is a perception held by many athletes, parents and coaches that focusing on a single sport will increase the athletes’ skill development in that sport. In communities, many coaches choose their teams based on familiarity with the athletes. For instance, if a particular youth athlete wants to join a team, there is pressure to join early and grow within the system to gain attention from coaches and scouts early on. Between the pressure and perception, it is easy to see why so many athletes specialize in a particular sport despite the advice of health professionals.
How does only participating in one sport increase your injury risk?
While specialization may increase skill development, it has been consistently linked to increased burnout rate and higher injury risk. The primary cause is that athletes are performing the same movements repetitively which in turn increases the risk of overuse injuries. Recent research has shown that athletes who specialize before puberty have decreased coordination and movement. This lack of coordination decreases the athlete’s ability to react to opponents on the field, which is a primary cause of acute injuries such as ACL injuries. In addition to risk of injury, a review of multiple studies concluded that there is no correlation between sport specialization and future career performance. This means that specializing in a single sport does not increase your chance of playing in college or professional sports.
If it increases risk of injury and does not help with getting to the next level, why specialize? As noted above, there is a lot of pressure on these youth athletes from an early age, so it is not always an easy decision. There may be people reading this right now that have a youth athlete who has already specialized or is currently considering specializing. The important thing to recognize is that while this may increase the risk of injury, it is not a foregone conclusion. There are many steps that can be taken to reduce this risk as well as improve the athlete’s performance as a whole.
Considerations for the Youth Athlete
First, it is important to recognize that an adolescent is both mentally and physically not yet an adult. Physically, an adolescent goes through growth spurts. It is during these growth spurts that a high percentage of overuse injuries occur. With this in mind, it is important to frequently monitor the height of the athlete to determine when a rapid increase is occurring. Once a growth spurt has been determined, the next step is to modify the athletes training loads. The first course of action should be to decrease training frequency and implement an exercise routine focused on core, balance/coordination, strength, and retraining functional and sport specific movements in the athlete's new body.
In addition to height, another important construct to measure is the ratio between training time and competition time. A higher percentage of competition time compared to training time is associated with increased injury risk. This is mainly due to the higher occurrence of injuries during competition compared to training. Less training time will decrease the athlete’s physical capacities, which are protective factors against injury.
Another consideration is the athlete’s emotional and mental health. Most school age children are under significant academic and social pressure. This can lead to a poor sleep routine which has been associated with higher injury risk. One study showed that if an adolescent was getting less than eight hours of sleep a night, they were almost two times more likely to sustain an injury. Another study demonstrated that injury risk increases even more if the lack of sleep was combined with an increase in training load. While it may be challenging to modify the stress levels of these young athletes, it is important to recognize that training loads should be reduced during particularly high stress times (ie. standardized tests, or school application periods).
While it is widely acknowledged that early sports specialization can be harmful for adolescents, it is not always avoidable. With this in mind, it is important to touch on strategies to support highly specialized athletes. The first is a well-rounded strength and conditioning program which improves an athlete’s physical qualities and decreases their injury risk. It is also beneficial for an athlete to have at least one secondary sport. This increases the athlete’s movement capacities and has been associated with enhanced ability to anticipate plays. Moving forward every athlete/coach/parent team should be monitoring their athlete’s level of specialization, height, training/competition volume and mental health. Monitoring these will allow for appropriate changes to be made to improve performance and decrease injury risk. The youth athlete participates in sports to have fun and compete for a chance to get to the next level. Let’s do our job to put our children in the best environment for success.
The Cooperman Barnabas Medical Center Rehabilitation centers are open and ready to help you achieve your goals. With four locations in West Orange, Millburn and Livingston, the experienced and compassionate staff at Cooperman Barnabas Rehabilitation offers adults and children the specialized care they need to resume an active life after surgery, injury or illness. They are committed to providing patients with the most advanced services in a safe, caring and soothing environment. For high-risk patients who are unable to visit in person, telehealth is an option. Patients do not need a prescription for physical therapy services.
For more information, or to schedule an appointment, call 973-322-7500.
References
- Bell DR, DiStefano L, Pandya NK, McGuine TA. The public health consequences of sport specialization. J Athl Train. 2019;54:1013-1020.
- Kliethermes SA, Nagle K, Côté J, et al. Impact of youth sports specialisation on career and task-specific athletic performance: a systematic review following the American Medical Society for Sports Medicine (AMSSM) Collaborative Research Network’s 2019 Youth Early Sport Specialisation Summit. Br J Sports Med. 2020;54:221-230
- Bell DR, Snedden T, Biese K, et al. Consensus definition of sport specialization in youth athletes using a Delphi approach. J Athl Train. Published online March 31, 2021. doi:10.4085/1062-6050-0725.20
- DiCesare CA, Montalvo A, Barber Foss KD, et al. Lower extremity biomechanics are altered across maturation in sport-specialized female adolescent athletes. Front Pediatr. 2019;7:268
- Jayanthi, N., Schley, S., Cumming, S., Myer, G., Saffel, H., Hartwig, T., & Gabbett, T. (2021). Developmental Training Model for the Sport Specialized Youth Athlete: A Dynamic Strategy for Individualizing Load-Response During Maturation. Sports Health: A Multidisciplinary Approach, 14(1), 142-153. doi: 10.1177/19417381211056088
- Milewski MD, Skaggs DL, Bishop GA, et al. Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. J Pediatr Orthop. 2014;34:129-133.
- Von Rosen P, Frohm A, Kottorp A, Fridén C, Heijne A. Multiple factors explain injury risk in adolescent elite athletes: applying a biopsychosocial perspective. Scand J Med Sci Sports. 2017;27:2059-2069.
- Jayanthi, N., Schley, S., Cumming, S., Myer, G., Saffel, H., Hartwig, T., & Gabbett, T. (2021). Developmental Training Model for the Sport Specialized Youth Athlete: A Dynamic Strategy for Individualizing Load-Response During Maturation. Sports Health: A Multidisciplinary Approach, 14(1), 142-153. doi: 10.1177/19417381211056088