Sports Specialization Tied to Higher Injury Risk

Sports overuse injuries in teens were likelier among older and more specialized athletes

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Kids grow — they become stronger, faster and taller. But for child athletes who grow with their sport and become more focused on that one sport, their chances of getting injured may go up.

A new study presented at a conference found that teenage athletes who spent more time in their sports were more likely to be injured than younger athletes. The younger athletes spent less time participating in organized play and were less specialized in their sports.

The findings showed that spending more than twice the amount of time in organized play than free play was linked to a higher risk for injuries.

The study also found that the rate that kids grew did not affect the number of injuries.

"Make sure your kid gets some free play on top of organized sports."

This study, which was led by Neeru Jayanthi, MD, from the Loyola Stritch School of Medicine in Maywood, Illinois, aimed to see if injuries among student athletes were affected by how much kids specialized in their sports.

The study, which involved 1,206 student athletes, also looked at how the amount of training performed each week and kids’ growth rates affected their number of injuries.

The athletes were recruited during their sports physical examinations at primary care clinics. They ranged from 8 to 18 years of age, and about half were male.

The researchers followed the athletes for up to three years between 2010 and 2012. The athletes reported their level and intensity of training every six months, and their height and weight were recorded.

Among the participants, 837 athletes were injured with almost 860 unique injuries.

The researchers found that injured athletes were typically older and spent more hours playing their sports than the non-injured athletes.

Injured athletes were 14 years of age on average and spent 11.3 hours per week in organized play.

Non-injured athletes were almost 13 years of age on average and spent 9.4 hours per week in organized play.

Looking at total physical activity and play, which encompassed time spent in the gym, in free play and in organized activity, injured athletes spent 19.7 hours a week in some sports activity. Non-injured athletes spent about two hours less doing overall physical activity and play than the injured athletes.

The researchers measured players’ level of sport specialization on a six-point scale. After adjusting the score to account for the athletes’ age and the number of hours spent in their sports each week, the researchers also found that injured athletes were typically more specialized in their sport. 

Injured athletes had a 3.3 rating on the sport specialization scale, compared to a 2.7 rating among the non-injured athletes.

Kids’ growth rate was not linked with an increased risk of injury.

The researchers also found that young athletes who spent more total hours in overall play than others their age were more likely to be injured. In addition, young athletes who spent more than twice the time in organized sports than in free play were also more likely to be injured than others their age.

“We found that kids on average play organized sports nearly twice as much as free play,” Dr. Jayanthi said in a press release. “Those kids who exceed that two-to-one ratio are more likely to be injured.”

According to Jim Crowell, owner and head trainer at Integrated Fitness in Pittsburgh, "There is a huge potential for overuse injury when kids specialize in their sport too early. I believe that kids need to play multiple sports when they are young and only after they have learned outstanding overall athleticism should they narrow down into one sport and try to master it.

"The problem that I see in many athletes in their early teen years is that there is no down time for that sport. They should have a month or two of down time after their sport season ends where they can play other sports for fun and let their body heal," Crowell told dailyRx News.

"If an athlete doesn't learn overall athleticism and then spends too much time stressing the exact same muscles they are skating a very dangerous line of injury. The only examples where this isn't as relevant would be in sports where an athlete would need to be world class at a very young age, think gymnastics or dance," said Crowell, who was not involved in this study.

The researchers’ next research goal is to see how providing specific guidelines and educating parents and kids about the time spent in sports versus free play affects overuse injuries among youth in sports, according to Cynthia LaBella, MD, FAAP, of Northwestern University and one of the study’s co-authors.

This study was presented October 28 at the American Academy of Pediatrics (AAP) National Conference and Exhibition in Orlando.

Review Date: 
October 28, 2013
Last Updated:
October 30, 2013