Nearly 60 million children and young teens participate in organized athletics each year with ever-increasing numbers of kids specializing in one sport before the age of 14 with hopes of a college scholarship or professional career on the line. However, researchers presenting their work at the American Orthopaedic Society for Sports Medicine/Arthroscopy Association of North America 2019 Specialty Day found that this early intense participation might come at the cost of increased injuries during their athletic careers.
“Our research indicated that athletes who specialized in their varsity sport before the age of 14 were more likely to report a history of injuries and multiple college injuries during the course of their athletic career,” said author, Brian M. Cash, MD from the Department of Orthopaedic Surgery at the University of California at Los Angeles in a press release.
Cash and his colleagues sent a voluntary survey to 652 athletes who participated in athletics at a single institution. Participants were asked about demographics, scholarship status, reasons for sports specialization, age of specialization, training volume, and injury/surgical history. A total of 202 surveys were available for analysis after some were excluded due to incomplete or incorrect survey completion. Injuries were defined as those that kept an athlete out of participation for more than one week. High training volume was defined as greater than 28 hours per week during pre-high school years.
86.9% of individuals who specialized early (vs. 74% who did not specialize early) reported a history of injury.
64.6% of those who specialized early (vs. 49.4% who did not) reported multiple injuries and these athletes were held out of sport participation an average of 15.2 vs. 7.0 weeks in those that did not specialize early.
However, early specializers were also more likely to receive a college scholarship (92.9 vs 83.1%).
Full-scholarship athletes were more likely to report multiple surgical injuries (11.7 vs 3.5%).
In addition, those who trained more than 28 hours per week in their varsity sport before high school were more likely to report multiple injuries (90.0 vs. 56.7%).
Individuals with a pre-high school training volume greater than 28 hours/week were not more likely to be recruited (90.0 vs. 89%) or receive a scholarship (80% vs. 74.5%).
“Sports participation is an excellent way for kids to maintain their health and possibly even receive a college scholarship. However, our research further highlights that avoiding sports specialization before the age of 14 and minimizing training time to less than 28 hours per week, may significantly minimize a child’s injury chances and promote long-term, athletic college or even elite success,” said Cash.
The authors concluded that NCAA Division I athletes who specialized in their varsity sport prior to age 14 were more likely to be recruited and receive an athletic scholarship. However, these individuals, as well as those with high training volume prior to high school, had increased rates of injury and injuries requiring surgery.
Overuse Injuries Reach Epidemic Level Among Youth Athletes
Youth overuse and repetitive motion injuries are at epidemic levels today, according to Robert A. Weil, DPM, a sports podiatrist, radio host of the “The Sports Doctor,” and author of the book, #HeySportsParents!
In the July 2018 issue of LER, he wrote on this topic, noting that overuse injuries cause a significant loss of time off the field, but more importantly, they threaten future sport participation which could inadvertently lead to increased obesity. This population is at increased risk because growing bones are less resilient to stress and children’s awareness of symptoms as signs of injury are limited.
The most common overuse injuries seen in young athletes today include:
- Irritation of the growth plate (apophysitis)
- Problems with tendons
- Stress fractures
- Patellofemoral (knee pain).
Weil encouraged parents, trainers, coaches, and clinicians to listen to young athletes and to evaluate pain, decreased performance, limping, and swelling as signs of possible overuse injuries.