Studies: Sports specialization at young age increases risk of career-threatening injury

A series of studies in the Journal of Athletic Training about the effects of being a specialized athlete at a young age left researchers with a distinct takeaway:

Focusing on one sport at too early an age increases the risk of major, career-threatening injury later in life.

“The theory here is that repetitive activity, performing these repetitive sport-specific tasks over and over again, will stress the tissue … and then eventually lead to a breakdown in that tissue overtime,” Dr. David Bell, a professor at the University of Wisconsin who led one of the studies, said in a press conference.

This week, the National Athletic Trainers’ Association is holding its Youth Sports Specialization Awareness Week to raise awareness of the impact of focusing too heavily on one sport and one group of muscles while the body is still developing.

In girls basketball, soccer and volleyball, specialization increased the risk of hip- and knee-joint injuries, according to a study led by Christopher A. DiCesare. In baseball, pitchers who specialized early had a higher risk of elbow and shoulder injuries, according to a study led by Amanda J. Arnold.

“From a developmental standpoint, you need to build the athlete, you need to build overall athleticism, and get kids moving well. This concept of physical literacy – getting them to move well before you’re getting them to move more and at higher intensities,” said Dr. Michele LaBotz, a professor at Tufts University who led one of the studies, said in the press conference with Bell.

“Because if you don’t have that foundation, when you start to build those very specific skills, they’re not going to be able to adapt and they’re going to break down a lot quicker.”

A study also warned that there’s little evidence suggesting sports specialization leads to full-ride college scholarships or professional opportunities. There are outliers, including some who go on to be all-time greats, such as tennis star Roger Federer, but “no data supports” specialization leading to a higher likelihood of doing either, according to a paper in the journal written by NCAA Chief Medical Officer Brian Hainline.

NATA president Tory Lindley, who moderated the press conference with Bell and LaBotz, said a question he frequently hears from college coaches, in fact, is if the athlete of interest played multiple sports in high school.

In a Q&A with parents, Bell acknowledged that youth sports culture makes it tough to get adequate time in multiple sports. Whether it’s a select league like travel baseball or AAU basketball, or coaches’ summer leagues that varsity players often need to play in to prepare for that season, there are other components at play.

“When we talk to young athletes and we survey them, they say, they perceive a lot of benefit from specialization,” Bell said.

Bell recommended playing the sport for eight months a year and taking three to four months off throughout the year. The child should should be active, but taking time off from the specific sport will allow those body parts to relax and recover.

Researchers also recommended playing multiple sports to build different muscles while learning abilities that could apply to the main sport, too.

Jamie Reed, the senior director of medical operations for MLB’s Texas Rangers, was part of the Q&A. He has spent 38 years in baseball athletic departments focusing on elbow, shoulder and spine injuries.

He said the Rangers annually get medical risk assessments of about 575 to 600 draft targets. In 2014, 41 of the players they looked at had a Tommy John surgery in their history. That number rose each year, hitting 109 in 2018, before spiking all the way to 308 in 2019.

Reed said the focus on travel baseball and sports specialization is a cause of this, comparing those body parts to “literally tread on a tire” wearing out the more athletes use them without resting.

“When we’re talking about 5-, 7-, 12-year-olds, it’s gotta be fun first,” Reed said. “Wait until talent is needed before really specializing in anything.”


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