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Dangers of Early Specialization in Youth Sports

I love youth sports. I love the passion and dedication that young athletes have for the game.  I love to watch teammates bond and friendships grow, forged from countless hours of practice and competition. I love to see the timid athlete find her swagger as she scores her first goal, drains her first three, or runs her PR.

To provide a bit of background, I grew up in northern Minnesota and, upon graduation from college, spent the next 12 years in Aspen, Colorado. Much of that time was spent either skiing, playing hockey, or coaching hockey. After a five-year stint in Chicago, my family (wife and two young daughters) moved to southern California. Growing up in Minnesota, we played one sport in the fall, but due to an unholy amount of cold and snow, played another during the winter months. When the snow melted, it was back outdoors for spring and/or summer sports. Playing 2-3 different sports per year was not uncommon for many youth athletes. Since moving here, I’ve noticed a trend in youth sports that I haven’t seen much in the past: kids playing one sport year-round.

The weather is just too good here. Almost any sport with a season in southern California can be played non-stop. As a physical therapist working in an orthoepic out-patient setting, passionate about sports medicine and youth athletes, I’ve seen several youth athletes who specialize in one sport at an early age, pushed by either their coach, parents, or the misconception that in order to play in college they must specialize and play only one sport. I’ve even spoken with a young football player whose coach made him sign a contract NOT to play another sport in order to play on his team. The boy was 14 years old.

So, does a youth athlete need to specialize early to play college sports, or above? Researchers from the University of Wisconsin refute that notion with a study1 published in the journal Sports Health. They determined that of the 343 Division I athletes studied (228 male, 115 female) from 9 different sports, the majority were not highly specialized in high school. And while most athletes will eventually specialize in one sport, it is by no means a requirement to become a Division I athlete.

Sport specialization may not be a requirement to play in college, but are there any downsides to playing a sport year-round? Actually, yes. Major ones. The authors of the study cite “multiple adverse outcomes such as psychological burnout, altered movement patterns and injury.” Psychological burnout is when athletes no longer find joy in the sport they once loved, and often quit as a result of the increased stress or pressure to compete in one sport. Symptoms, which should not be minimized, include poor performance in school and sport, joint pain, and fatigue. Mental health issues stemming from sports burnout can be wide-ranging, affecting performance across the board, and can be addressed by professionals such as sports psychologists or social workers.

As a physical therapist, the idea of altered movement patterns and their contribution to injury is a serious concern and should be a red flag to a parent, coach, or athlete. In Pediatrics, the official journal of the Academy of Pediatrics, a 2007 study2 notes that about HALF of all pediatric sports injuries are related to overuse. This includes shoulder, hip, and knee injuries. In 2013, Dr. Timothy Hewett from Ohio State University found in one long-term study3 of 500+ females that those who only played one sport had a 50% increased risk of knee injury. When repetitive motions create altered movement patterns, injuries are imminent. Due to the demands of the sport, rotator cuff tears and shoulder impingement are common in swimmers, tennis or volleyball players, ACL injuries and ankle sprains are frequent in soccer players, and groin or hip injuries (including labral tears) are typical among hockey players.

Want a specific example?

When a baseball pitcher goes through his throwing motion, the elbow is stressed, especially the ulnar collateral ligament (UCL) that attaches the humerus (upper arm) to the ulna (forearm).  With overuse, including increased velocity, pitch count, fatigue, and implementation of breaking pitches, the UCL is subject to tearing. Tommy John surgery is a procedure to repair that ligament so the player can return to sport. In the MLB today, 1 in 4 pitchers has had this procedure, with a typical recovery time of 12+ months. A study co-authored by Dr. Anthony Romeo, an orthopedic surgeon and team physician for the Chicago White Sox, found that while Tommy John surgery was previously reserved for MLB players, today’s youth pitchers ages 15-19 make up over 60% of these procedures, with that number rising 9% annually4.  Recovery is not guaranteed and before you ask, this procedure should not be performed prophylactically as there is no evidence to suggest that velocity increases following repair.

Still not convinced? As a former youth hockey coach, I can unequivocally say that the best (most talented) hockey players I coached played multiple sports: football, soccer, lacrosse, or track. When evaluating kids, I didn’t want hockey players, I wanted athletes. How about more accomplished coaches? In 2014, of the 72 players recruited to play college football at Alabama, Ohio State, and Notre Dame, 61 (85%) were multi-sport athletes. By 2015, Urban Meyer (who by the way has won three college football national championships) had recruited 47 high school football players to play for the Buckeyes; 42 were multi-sport athletes. Does this trend translate to the pros?  Do you really need to ask? In the 2016 NFL Draft, 28 of the 31 first round picks played multiple sports in high school. In the 2017 and 2018 draft classes, that number ticked up to 29 of 32. That’s 90%!

 Some of your favorite athletes played multiple sports:

Wayne Gretzky (hockey) played lacrosse, baseball, soccer and track growing up.

Tom Brady (football) was drafted to play baseball, before he (arguably) became the GOAT.

Jim Brown (football) is in the Lacrosse Hall of Fame

Abby Wombach (soccer) attributes much of her success with heading the ball (before she retired, she was the best in the world) to learning how to rebound a basketball.

Jackie Robinson lettered in 4 sports at UCLA: baseball, football, basketball and track, before breaking the MLB color barrier.

Babe Didrickson, Bo Jackson, John Elway, Dave Winfield, Jim Thorpe, Dion Sanders… the list goes on and on.

Playing multiple sports in high school is a great way to improve strength, agility, proprioception, and flexibility while reducing your risk for overuse injury and burnout. It could even be a springboard to playing at the collegiate level and beyond. Make more friends, play in different environments, and have more fun. It’s what youth sports are all about.

Below are some guidelines from the American Academy of Pediatrics regarding sport and how to avoid overuse injuries and psychological burnout:

  • Encourage athletes to strive to have at least 1 to 2 days off per week from competitive athletics, sport-specific training, and competitive practice (scrimmage) to allow them to recover both physically and psychologically.
  • Advise athletes that the weekly training time, number of repetitions or total distance should not increase by more than 10% each week (eg, increase total running mileage by 2 miles if currently running a total of 20 miles per week).
  • Encourage the athlete to take at least 2 to 3 months away from a specific sport during the year.
  • Emphasize that the focus of sports participation should be on fun, skill acquisition, safety, and sportsmanship.
  • Encourage the athlete to participate on only 1 team during a season. If the athlete is also a member of a traveling or select team, then that participation time should be incorporated into the aforementioned guidelines.
  • If the athlete complains of nonspecific muscle or joint problems, fatigue, or poor academic performance, be alert for possible burnout. Questions pertaining to sport motivation may be appropriate.
  • Advocate for the development of a medical advisory board for weekend athletic tournaments to educate athletes about heat or cold illness, over participation, associated overuse injuries, and/or burnout.
  • Encourage the development of educational opportunities for athletes, parents, and coaches to provide information about appropriate nutrition and fluids, sport safety, and the avoidance of overtraining to achieve optimal performance and good health.
  • Convey a special caution to parents with younger athletes who participate in multigame tournaments in short periods of time.

Resources

1.      https://www.ncbi.nlm.nih.gov/pubmed?term=%22Sports+health%22[Jour]+AND+Post[author]&cmd=detailssearch

2.      http://nyshsi.org/wp-content/uploads/2012/08/AAP-Clincal-report-on-overuse-injuries-2007.pdf

3.      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247342/

4.   https://www.researchgate.net/profile/Benedict_Nwachukwu/publication/279512289_Trends_in_Medial_Ulnar_Collateral_Ligament_Reconstruction_in_the_United_States_A_Retrospective_Review_of_a_Large_Private-Payer_Database_From_2007_to_2011/links/5593e68908ae5af2b0eccf74/Trends-in-Medial-Ulnar-Collateral-Ligament-Reconstruction-in-the-United-States-A-Retrospective-Review-of-a-Large-Private-Payer-Database-From-2007-to-2011.pdf

About the Author - Luke Mathison

Luke Mathison received his bachelor’s degree in English Literature and Classical Studies from Concordia College in Moorhead, MN, and his doctorate in Physical Therapy from the University of Illinois – Chicago. Prior to earning his DPT, Luke spent 12 years in Aspen, Colorado, fueling his love of the outdoors and downhill skiing. As a lifelong athlete, playing hockey and college soccer, he understands the importance of maintaining a healthy and active lifestyle, and the pitfalls often associated with recovery.  As a manual therapist, Luke enjoys working with athletes of all ages and abilities by reducing their risk of injury and to help them achieve their peak performance goals. Luke is a Level IV certified coach with USA Hockey, and enjoys playing guitar, learning to surf, traveling, and spending time with his family.