Sidelined from Sports Specialization

Sports injury more likely in young athletes who specialize in one sport

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Competition among young athletes can be fierce—so fierce, in fact, that some athletes may play their sport more than they can handle. And that intense focus on one sport may put these growing athletes at risk of serious injury.

Results of a recent study showed that young athletes who specialized in one sport, and trained intensively for that sport, had an increased risk of serious overuse injuries such as stress fractures.

According to one of the study's authors, the findings suggest that young athletes should not play sports more hours per week than their age.

In other words, a 12-year-old tennis player should not spend more than 12 hours per week playing tennis.

These findings also suggest balancing time spent on organized sports with free play.

"Let your child get some free play."

Neeru Jayanthi, MD, a primary care sports physician at Loyola University Medical Center in Chicago, and colleagues conducted their study on 1,206 athletes between 8 and 18 years of age who went to Loyola and Lurie Children's Hospital of Chicago for a sports physical or to get treatment for an injury.

The researchers observed a total of 859 injuries. Of these, 564 were overuse injuries, including 139 serious injuries. These serious injuries included stress fractures in the back or limbs, injuries to elbow ligaments and injuries to cartilage and underlying bone.

Young athletes who played their sport for more hours per week than their age were 70 percent more likely to sustain a serious overuse injury than other injuries.

On average, athletes who sustained serious injuries had engaged in about 21 hours of physical activity per week. That physical activity included organized sports, gym play and unorganized free play. But 13 of the 21 hours were spent in organized sports.

Athletes who were not injured spent less time engaged in physical activity. On average, they spent 17.6 hours in total physical activity, 9.4 hours of which were spent in organized sports.

The researchers also found that the risk of injury increased among athletes who spent twice as much time playing organized sports as they did on free play like pick-up games of soccer.

In their study, the researchers used a six-point scale to measure the degree to which athletes specialized in a sport. An athlete received one point for each of the following statements that applied:

  • Trains more than 75 percent of the time in one sport
  • Trains to improve skill or misses time with friends
  • Has quit other sports to focus on one sport
  • Considers one sport more important than other sports
  • Regularly travels out of state
  • Trains more than eight months a year or competes more than six months per year

Results showed that uninjured athletes had a score of 2.7 on the specialization scale while injured athletes scored 3.3.

"We should be cautious about intense specialization in one sport before and during adolescence," Dr. Jayanthi said.

"Among the recommendations we can make, based on our findings, is that young athletes should not spend more hours per week in organized sports than their ages," he said.

Dr. Jayanthi also recommended that young athletes not spend more than twice as much time in organized sports as in unorganized play. Furthermore, he recommended that young athletes avoid specializing in one sport before their late teenage years, avoiding year-round competitive sports play and taking at least one day off per week from training.

Jim Crowell, owner and head trainer at Integrated Fitness in Pittsburgh, Pennsylvania, also recommends that young athletes engage in more than one sport.

"I have a powerful belief that kids should be involved in multiple sports as they grow older for three major reasons. One is that many kids burn out and lose interest in their main sport if they push too hard too early. Two is that they will learn a more well rounded set of athletic skills which will help them pick movements up faster at the higher reaches of their main sport. And three, their bodies are subjected to the massive wear and tear of the exact same muscles day in and day out," Crowell explained to dailyRx News. 

"It is my belief that over-training happens more from a volume perspective and less from an intensity perspective. What I mean by that is that it is the wear and tear on the joints that eventually breaks them down. Doing the same movement over and over again, especially if done with poor technique, will wear down kids' bodies and make them more susceptible for injury," he said.

This study, which was funded by the American Medical Society for Sports Medicine (AMSSM), was presented April 19 at the meeting of the American Medical Society for Sports Medicine. As such, the research has yet to be reviewed by a body of peers. All research should be considered preliminary before being published in a peer-reviewed journal.

Dr. Jayanthi is on the AMSSM committee that is working to develop guidelines on the prevention and treatment of overuse injuries in young athletes.

Reviewed by: 
Review Date: 
April 17, 2013
Last Updated:
August 14, 2013