Sport specialization has been a hot topic among youth athletes as long as I can remember. For those who do not know what sport specialization is, it is simply participating competitively in one sport. Obviously this is common in collegiate and professional levels due to the elite level of play in each respective sport. However, the growing specialization in one sport at a young age is growing significantly. With that being said, the research on sport specialization is fairly new with high levels of evidence coming out in the past four years on its impact physiologically and psychologically.
In a systematic review and meta-analysis that came out this year looked at The Concept of Sport Sampling Versus Sport Specialization: Preventing Youth Athlete Injury (2). The review investigated six studies with a total of 5,736 patients with an average of 14.6 years of age: 2,451 were sport samplers (non-specialized), 1,628 were sport specializers, and 1,657 were placed in the others category (2). The criteria for sport specialization was determined through a series of questions and the responses to those questions: “have you quit another sport to focus on 1 sport?” “Do you consider your primary sport more important than your other sports?” “Do you train more than 8 months a year in your primary sport?” (2) A yes means 1 point. 0-1 points were sport samplers, 2 is the others, and 3 is a sport specializer (2).
Now that we got all the boring background information out of the way, the statistics indicated that those who specialized in sports (based on the criteria described above) had a significantly higher risk of injury compared to those who did not specialize in sports. More specifically, the relative risk of injury increased 37% for sport specializers compared to non-sport specializers (2).
Although that’s a relatively high percentage, do not freak out if you specialize in one sport. Sport Injuries can develop based on many different variables. The thing with youth sport specializers is they are exposed to a specific stimulus at a young age for a long period of time. Whereas youth that participate in a variety of sports are exposed to different kinds of stimuli on their body, which may help prevent overuse of a specific type of stimulus. A different systematic review with meta-analysis looked at sport specialization in individuals under the age of 18 and the associated risk of overuse injuries in their respective sport. The total sample was 5,617 individuals. The relative risk for overuse injuries in sport specializers was 81% more than athletes with low specialization (1). These are big time numbers.
Does youth sport specialization directly increase one’s risk for injury? I don’t think so. In some cases, injuries are just unpreventable; wrong place wrong time. With that being said, I think these numbers reveal that the year-round, consistent stimuli placed on the body through sport specialization enhances the variables that would increase the risk for injury. For example, a youth baseball pitcher decides to stop playing basketball and football, and focus solely on baseball outside of the normal season. The kid is a good player, but a phenomenal pitcher that throws hard. If he pitches in fall ball, winter ball, normal spring season, and then summer ball. How do you think that arm will be feeling? Participating in a variety of sports at a young age is vital for the growth and development of young athletes.
Burnout is a real thing. Anyone who has experienced it knows it is not fun, and usually leads to a significant decrease in performance for whatever you are doing. Another systematic review and meta-analysis investigated burnout in adolescent athletes based on if they sport specialized or sampled (3). The criteria they labeled as a sport specializer was athletic participation in one sport, and competing in that sport for greater than 8 months out of the year (3). There were a total of 1,429 athletes observed with an average age of 15.59 years, and 1,422 of them completed an Athlete Burnout Questionnaire that observed a sense of accomplishment, exhaustion, and sport devaluation (3). The data showed statistically significant differences between sport and non-sport specializers. More specifically the sport specializers displayed reduced sense of accomplishment, increased exhaustion, and exhibited sport devaluation in comparison to non-sport specializers (3). Wow.
This is definitely interesting data to interpret, but it does not surprise me in the slightest. We live in a society that thinks more of something is always better. If a kid loves soccer at the age of 10, that does not automatically mean that kid will still love it at age 15. Youth athletes need to be exposed to a wide range of opportunities to find what they like and don’t like. Not to mention all of the relationships, memories, and character that can be developed with different people in different sports. Even if you have a primary sport that you love, participating in other sports will develop traits such as grit, toughness, teamwork, discipline, etc that can directly translate to your primary sport. For example, being exposed to a 4th and 1 situation in football can help you in a similar situation in basketball where you may need 1 defensive stop to win the game. At higher levels, you need these controllable traits to be successful. Lebron James is arguably one of the greatest hoopers ever, and even he played a variety of sports in his youth. Am I saying that a kid should go out for a sport if they already know they do not enjoy it? No. I would have been mad at my parents if they made me go out for a sport that I did not enjoy and was not good at. Am I saying that sport specialization under all circumstances is bad? No. Focusing on a sport itself is not bad, the dosage of the sport is the problem. Many people (including me) do not have the knowledge or the resources to correctly monitor the dosage of youth sport specialization to reduce the risk of injury and burnout. In my opinion, the best way to do this is to simply play other sports.
(1) Bell DR, Post EG, Biese K, Bay C, Valovich McLeod T. Sport Specialization and Risk of Overuse Injuries: A Systematic Review With Meta-analysis. Pediatrics. 2018;142(3):e20180657. doi:10.1542/peds.2018-0657
(2) Carder SL, Giusti NE, Vopat LM, et al. The Concept of Sport Sampling Versus Sport Specialization: Preventing Youth Athlete Injury: A Systematic Review and Meta-analysis [published online ahead of print, 2020 Jan 21]. Am J Sports Med. 2020;363546519899380. doi:10.1177/0363546519899380
(3) Giusti NE, Carder SL, Vopat L, et al. Comparing Burnout in Sport-Specializing Versus Sport-Sampling Adolescent Athletes: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2020;8(3):2325967120907579. Published 2020 Mar 2. doi:10.1177/2325967120907579
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