April 2017

Online counseling helps reduce injuries in highly specialized youth athletes

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Early single-sport specialization in youth athletes is associated with increased risk of reinjury in addition to primary injury, but online counseling can help to reduce those risks, according to two studies from Atlanta presented at the IOC World Conference on Prevention of Injury and Illness in Sport, held in Monaco in March.

Both sets of findings were presented by Neeru Jayanthi, MD, a sports medicine physician at the Emory School of Medicine, who was the first author of a 2015 study that made headlines with its conclusion that injury risk was twice as high for highly specialized youth athletes than in those who participated in multiple sports.

In Monaco, Jayanthi presented three-year follow-up results for the same population, including the finding that nearly 70% of the reported injuries were reinjuries (approximately half of which were in the same location as the previous injury). Risk of reinjury was more than three times higher in youth athletes who were highly specialized than in their more diversified counterparts. Injured athletes were more likely than uninjured athletes to be female, to have started specializing at an age younger than 12 years, and to train for more than eight months of the year.

“Young athletes were more likely to develop a reinjury at follow-up if they had a high degree of specialization,” Jayanthi said.

In a separate study, also presented by Jayanthi, the Emory researchers assessed the effectiveness of an online counseling program designed to educate youth athletes about associations between sport specialization and injury risk, as well as provide evidence-based recommendations to reduce that risk. Athletes between ages 8 and 17 years were randomized to a group that received online counseling or to a control group; both groups were monitored for one year.

Injured athletes accounted for similar percentages of each group at baseline. At six months, however, athletes in the intervention group had a significantly lower injury rate than those in the control group (27.7% vs 48%).

“We do think there’s opportunity to do serial online counseling, and we do think it can be as effective as smoking or weight loss counseling,” Jayanthi said.

Athletes were most compliant with the recommendations to take one day off from sports per week, and to keep the number of hours of sports participation per week to less than the athlete’s age. They were least compliant with the recommendation that the ratio of hours spent in organized sports versus free play should be less than 2:1.

“We can’t change people’s decisions,” Jayanthi said. “What we try to do is provide information.”


Jayanthi N. Sports specialized risks for reinjury in young athletes: A 2+ year clinical prospective evaluation. Br J Sports Med 2017;51(4):333.

Jayanthi N. The effects of serial sports training risk assessment and counseling in kids (TRACK). Br J Sports Med 2017;51(4):333-334.

Jayanthi NA, LaBella CR, Fischer D, et al. Sports-specialized intensive training and the risk of injury in young athletes: A clinical case-control study. Am J Sports Med 2015;43(4):794-801.

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