Physical Health Risks of Early Sport Specialization
There has been a noticeable trend towards early sports specialization in youth athletes. This trend has been directed by the belief that focusing on just one sport will increase the likelihood of athletic success in their chosen sport. Contributing factors to this belief include perceptions of Eastern European sport programs, a parent's desire to give his or her child an edge, labeling youth as talented at an early age, pursuit of scholarships and professional contracts, the sporting goods and services industry, and expertise research.5 However, research shows that specializing in one sport from an early age can be detrimental to the athletes physical and psychological health. This blog will focus on the physical consequences of early sports specialization as it relates to injury and rehab.
What is sports specialization?
Sports specialization is defined as:1
Year-round training (greater than 8 months per year)
choosing a single main sport
And/or quitting all other sports to focus on 1 sport
Along these lines, the degree of sports specialization can be defined as low, moderate, or high based on the number of definition components. If someone identifies with just one of the definitions listed above they are considered low, if they identify with two of the definitions listed above they are considered moderate, and if they identify with all three they are considered a high degree of specialization.
Potential Risks of Early Sport Specialization
Overall, the lack of diversified activity has been shown to not allow young athletes to develop the appropriate neuromuscular skills that are effective in injury prevention, and does not allow for the necessary rest from repetitive use of the same segments in the body.1 This may be due to the fact that specialized athletes expose their neuromuscular systems and musculoskeletal tissues to only one set of motor patterns (eg, throwing or serving in overhand sports such as baseball and tennis) and thus are more likely to develop imbalances in muscle strength and flexibility and repetitively load similar structures, which put them at higher risk for injury. It is also possible that specialized athletes may be more likely to push themselves harder and play through pain to achieve their goals.2
The risk of injury is of course, multifactorial, and includes training volume, competitive level, and pubertal maturation stage.4 However multiple studies have demonstrated that sports specialization alone, independent of age and training volume, increases the risk for overall injury and serious overuse injury in young athletes. The risk of injury, overuse injury, and serious overuse injury increases as the degree of specialization increases.2
One study of 1190 young athletes, 7 to 18 years old, compared training patterns of injured athletes at sports medicine clinics versus uninjured athletes during a sports preparticipation exam. Those who met the definition of a highly specialized athlete had 2.25 greater odds of having sustained a serious overuse injury than an unspecialized young athlete, even when accounting for hours per week sports exposure and age. There was a clear continuum with the more specialized an athlete (per the 3 criteria in the above chart), the greater this risk of injury.1 A separate study of 546 high school athletes found a relationship between the development of patellofemoral pain syndrome and single-sport training in athletes in basketball, soccer, and volleyball.6
Alternatives to Early Sports Specialization
Many parents or coaches believe they are doing the child a favor by starting them in a year round sport at an early age. It will give the child a competitive edge and a better chance to play in college or go pro, right? Clearly, the research does not support this hypothesis.
So what are the alternatives to early sports specialization? The answer may seem obvious. Sports diversification has been shown to be extremely beneficial in preventing overuse injuries in young athletes. “The greater the number of activities that the athletes experienced and practiced in their developing years (ages 0-12 years), the less sports-specific practice was necessary to acquire expertise in their sport. This is the transfer of pattern recall skills from one sport to another, most pronounced during the early stages of involvement. Early diversification followed by specialization may lead to more enjoyment, fewer injuries, and longer participation, contributing to the chances of success”3
Many studies challenge the current trends toward early youth sport specialization, finding that the majority of professional athletes do not specialize as youth, and that those that do specialize do not do so until their teen years. One study of a total of 1673 professional baseball athletes completed the survey, representing 26 of the 30 Major League Baseball (MLB) organizations, found that less than half (44.5%) of professional athletes specialized in playing a single sport during their childhood/adolescence. Those who reported specializing in their youth did so at a mean age of 14 years old.7 This is just one example out of hundreds, if not thousands, of studies that do not support early sports specialization.
So, Instead of sport specialization at an early age, research suggests sport sampling and diversification is a better alternative. “Sport sampling involves children trying a variety of sports and physical activities and has been emphasized as critical for appropriate motor and social skill development, future athletic success, lifelong physical activity, and reduced injury risk.”8
References
1.Myer GD, Jayanthi N, Difiori JP, et al. Sport Specialization, Part I: Does Early Sports Specialization Increase Negative Outcomes and Reduce the Opportunity for Success in Young Athletes? Sports Health. 2015;7(5):437-442. doi:10.1177/1941738115598747
2. Jayanthi NA, LaBella CR, Fischer D, Pasulka J, Dugas LR. Sports-specialized intensive training and the risk of injury in young athletes: a clinical case-control study. Am J Sports Med. 2015;43:794-801
3. Jayanthi N, Pinkham C, Dugas L, Patrick B, Labella C. Sports specialization in young athletes: evidence-based recommendations. Sports Health. 2013 May;5(3):251-7. doi: 10.1177/1941738112464626. PMID: 24427397; PMCID: PMC3658407.
4. Brenner, J., et al. Intensive Training and Sports Specialization in Young Athletes. (2000). Pediatrics, 106(1), 154–157. https://doi.org/10.1542/peds.106.1.154
5. Malina RM. Early sport specialization: roots, effectiveness, risks. Curr Sports Med Rep. 2010 Nov-Dec;9(6):364-71. doi: 10.1249/JSR.0b013e3181fe3166. PMID: 21068571.
6. Hall R, Barber Foss K, Hewett TE, Myer GD. Sport specialization’s association with an increased risk of developing anterior knee pain in adolescent female athletes. J Sport Rehabil. 2015;24:31-35.
7. Buckley PS, Ciccotti MC, Bishop M, Kane P, Selverian S, Exume D, D'Angelo J, Emper W, Freedman KB, Hammoud S, Cohen SB, Ciccotti MG. Youth Single-Sport Specialization in Professional Baseball Players. Orthop J Sports Med. 2020 Mar 20;8(3):2325967120907875. doi: 10.1177/2325967120907875. PMID: 32232067; PMCID: PMC7092410.
8. DiStefano LJ, Beltz EM, Root HJ, et al. Sport Sampling Is Associated With Improved Landing Technique in Youth Athletes. Sports Health. 2018;10(2):160-168. doi:10.1177/1941738117736056
Dr. Samantha Benavides
PT, DPT
Co-Owner | The PATH Rehab & Performance
