Sport Specialization in Youth

Approximately 60 million children and adolescents between the ages of 6 and 18 years participate in some form of organized athletics in the United States (Fig 1).1 Single sport specialization is a growing topic of discussion in youth athletics. The American Medical Society for Sports Medicine (AMSSM) characterizes sport specialization as year round intense training in only one sport at the exclusion of other sports.2 Recent reports found that within a group of 1200 youth athletes, approximately one third participated in a single sport year-round.3,4 

Figure 1. Youth sports participation in the US. Adapted from the National Council of Youth Sports.1

Sports specialization, high intensity training, and participating in competitive events outside of the regular season are byproducts of an increasingly competitive nature of youth sports fueled even further by big business ventures from personal coaches, showcase events, etc.2 For several decades, it has been well documented that developing bones, specifically during puberty or growth, are more prone to injury from tensile, shear, and compressive forces.5-7 Bones more prone to injury, combined with the high intensities or frequencies of training that potentially accompany specialization, may contribute to a possible increase in risk of overuse injuries, albeit not directly.2 Studies have suggested that exceeding 16 hours of intense training per week8-10 (Fig 2)11 may increase injury rates. Year-round participation in sports, defined as playing sports over 4 seasons, may also increase risk of overuse injury among high school athletes.12 Although young athletes can often tolerate stress, there is a limit to the stress a youth athlete should experience and therefore proper time off and rest from sport activity is recommended to reduce risk of injury while maintaining long-term healthy athletic performance.2

Figure 2. Relationship of injury to exposure hours in high school athletes. Adapted from Jayanthi et al.11

Future research in this area should focus on what frequencies and intensities of training may correlate with overuse injuries or risk of injury with sport specialization.2 Such information could allow athletes to follow training programs that minimize injuries and maximize performance. Additionally, long-term studies comparing the effects of sport specialization with participation in multiple sports could prove worthwhile.2 These may allow insight on developmental differences and long-term implications resulting from participation variation.Minimal scientific evidence supporting the notion that earlier single-sport training is beneficial for success currently exists and further research is warranted.13 However, based on research that does exist, sport specialization may have some benefits. There is a general agreement in the sports medicine field that the number of purposeful hours spent in either training or practice is correlated with success.11 Some debate exists as to when intense training or practice should begin.11 It is also recognized that some degree of specialization is necessary to attain elite-level skills.14-18 This becomes more applicable as athletes age for most sports. Peak performance in some individual sports, such as diving or figure skating, may occur before the body matures, making specialization at preadolescent ages common (Figure 3).13 However, it is recommended that intense training in one single sport be delayed until late adolescence if possible in order to optimize success and reduce risk for injury and psychological stress.19-26

Figure 3. Recommendations for stage of specialization and sport. Adapted from Myer et al.13

As mentioned, there may be risks associated with specializing including the potential for increased psychological stress and overuse injuries. Although specialization may be appropriate for some athletes, the type of sport and age of the athlete should be considered. Regardless of whether youth choose to specialize or not, it is important to foster an environment that encourages athleticism and builds positive athletic experiences. Athleticism may be built through a variety of sports and training programs which cater to each child’s needs and interests.  The notion of playing multiple sports should not be the sole focus for injury prevention and performance enhancement considerations, the concept of athleticism and physical literacy are factors that should be strongly encouraged.  Individuals need to be provided various avenues for development and some may partake in a single sport, but need to supplement with cross sport sampling or less intense multi-sport  choices (e.g., playing high level baseball but playing recreational or social basketball) while others may choose to play two high level sports. Most importantly, children should enjoy sports and participating in an activity that builds positive healthy individuals who can grow physically and mentally.

Post Credit: Michael Lantz, Dan Clifton, Dr. James Onate


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