Sports Specialization & Injury Risk

February 7th, 2020

Injury Risk Associated With Sports Specialization and Activity Volume in Youth
SourceAJSM, first published September 18, 2019 (full text)
Clinical Question: To investigate the relative importance of specialization vs volume of activity in increasing risk of injury.
Points to Consider: Cohort study, level of evidence, 2. Prospective analysis of 10,138 youth with assessment via questionnaires. Outcomes included were incident stress fracture, tendinitis, chondromalacia patella, ACL tear or osteochondral injuries.  
Bottom Line:  Sports specialization was associated with a greater volume of physical activity in both sexes. Females engaged in sports specialization were at increased risk of injury (hazard ration 1.31), but risk VARIES BY SPORT (specialization in running, swimming, soccer, cheerleading and gymnastics were all predictive of higher risk of injury). Total hours per week of vigorous activity was predictive of developing injury; among females, even those engaging in 3 to 3.9 hours per week less than their age were at significantly increased risk. In males, there was no clear pattern of risk.

Check these out…
AOSSM Consensus Statement on Early Sports Specialization.… (page 14 includes statement on early sports specialization)
Here is a helpful handout for parents of athletes – when is the play too much or too often?

Sport Specialization, Part 1: Does Early Sports Specialization Increase Negative Outcomes and Reduce the Opportunity for Success in Young Athletes? 
Source: Sports Health, first published August 6, 2015
Clinical Question: Does early sports specialization (>8 mos per year) result in negative outcomes?
Points to Consider: Nonsystematic review article accessing both physical and psychological concerns related to participation in a single sport at a minimum of 8 months of the year.  
Bottom Line:  Specialized training in young athletes has risk of injury and burnout – the degree of specialization is positively correlated with increased SERIOUS overuse injury risk. Risk factors include: 12-mos per year training in a single sport, involvement in sports that require early development of technical skills (ex. tennis, gymnastics, dance, swimming/diving), and more time in competition rather than unstructured free play.

About the Author:
Catherine A. Logan, MD, MBA, MSPT is a sports medicine Orthopaedic Surgeon and writer. Based in Denver, CO, she is an attending at Colorado Sports Medicine & Orthopaedics at Rose Medical Center. Dr. Logan is the Head League Physician for Premier Lacrosse League (PLL) member of the team physician pool for the US Ski & Snowboard teams each year. Dr. Logan completed her Orthopaedic Surgery residency at the Harvard Combined Orthopaedic Residency Program and her Sports Medicine Fellowship training at the prestigious Steadman Philippon Research Institute/The Steadman Clinic in Vail, CO. Logan is also on the board of The Chill Foundation.