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Jul29th 2013

The push to stay competitive has forced many young children into specializing in just one sport hoping to have a chance to gain an athletic scholarship in college. A recent study showed that young athletes who train intensively in 1 sport have a “significantly higher” risk of stress fractures and other overuse injuries, even when compared with other injured athletes. Neeru Jayanthi, MD, a sports medicine physician and the author of this recent study looked at 1206 athletes aged 8 to 18 who had come in for sports physicals or treatment from 2010 to 2013. He presented his research at the 2013 American Medical Society for Sports Medicine (AMSSM) meeting in San Diego. The study is titled “Risks of Specialized Training and Growth in Young Athletes: A Prospective Clinical Cohort Study.” Over a 3 year follow up 859 total injuries, including 564 overuse injuries occurred. Jayanthi found that young athletes who spent more hours per week than their age playing 1 sport- such as a 12 year old that plays tennis 13 or more hours a week- were 70% more likely to experience serious overuse injuries than other injuries.

Among the study’s other findings:

• Young athletes were more likely to be injured if they spent more than twice as much time playing organized sports as they spent in unorganized free play — for example, playing 11 hours of organized soccer each week, and only 5 hours of free play such as pick-up games.

• Athletes who suffered serious injuries spent an average of 21 hours per week in total physical activity (organized sports, gym and unorganized free play), including 13 hours in organized sports. By comparison, athletes who were not injured, participated in less activity – 17.6 hours per week in total physical activity, including only 9.4 hours in organized sports.

• Injured athletes scored 3.3 on researchers’ six-point sports-specialization scale. Uninjured athletes scored 2.7 on the specialization scale. (On the sports specialization scale, an athlete is given one point for each of the following: Trains more than 75 percent of the time in one sport; trains to improve skill or misses time with friends; has quit other sports to focus on one sport; considers one sport more important than other sports; regularly travels out of state; trains more than eight months a year or competes more than six months per year.

Jayanthi offers the following tips to reduce the risk of injuries in young adults:

• Do not spend more hours per week than your age playing sports. (Younger children are developmentally immature and may be less able to tolerate physical stress.)

• Do not spend more than twice as much time playing organized sports as you spend in gym and unorganized play.

• Do not specialize in one sport before late adolescence.

• Do not play sports competitively year round. Take a break from competition for one-to-three months each year (not necessarily consecutively).

• Take at least one day off per week from training in sports.

“We should be cautious about intense specialization in one sport before and during adolescence,” Jayanthi said. “Among the recommendations we can make, based on our findings, is that young athletes should not spend more hours per week in organized sports than their ages.”

These numbers are alarming but no surprising. The STOP Sports Injury Campaign has been advocating that kids play multiple sports to avoid burnout, learn

skill development in other areas, and take at least one season a year off from competition. If you are a parent or coach it is your job to advocate for what is best for your child and sometimes that means not signing a child up for 2 travel baseball teams in one season.

Some examples of sport specific recommendations we recommend include:

  • Pitch count Limits for both softball and baseball
  • Taking one season off from overhead throwing to preserve shoulder and elbow health-football, baseball, tennis, swimming
  • Ultilizing a dynamic warm up prior to practicing or playing in a game-all sports
  • PEP Program or Sportsmetric program participation for soccer, volleyball, and basketball players to lower the risk of ACL injuries.

Matt McFadden, PT, MSPT, OMPT

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