Background:
Sport specialization is associated with an increased risk of musculoskeletal lower extremity injuries (LEIs) in adolescent athletes presenting in clinical settings. However, sport ...specialization and the incidence of LEIs have not been investigated prospectively in a large population of adolescent athletes.
Purpose:
To determine if sport specialization was associated with an increased risk of LEIs in high school athletes.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Participants (interscholastic athletes in grades 9-12) were recruited from 29 Wisconsin high schools during the 2015-2016 school year. Participants completed a questionnaire identifying their sport participation and history of LEIs. Sport specialization of low, moderate, or high was determined using a previously published 3-point scale. Athletic trainers reported all LEIs that occurred during the school year. Analyses included group proportions, odds ratios (ORs) and 95% CIs, and days lost due to injury (median and interquartile range IQR). Multivariate Cox proportional hazard ratios (HRs) with 95% CIs were calculated to investigate the association between the incidence of LEIs and sport specialization level.
Results:
A total of 1544 participants (50.5% female; mean age, 16.1 ± 1.1 years) enrolled in the study, competed in 2843 athletic seasons, and participated in 167,349 athlete-exposures. Sport specialization was classified as low (59.5%), moderate (27.1%), or high (13.4%). Two hundred thirty-five participants (15.2%) sustained a total of 276 LEIs that caused them to miss a median of 7.0 days (IQR, 2.0-22.8). Injuries occurred most often to the ankle (34.4%), knee (25.0%), and upper leg (12.7%) and included ligament sprains (40.9%), muscle/tendon strains (25.4%), and tendinitis/tenosynovitis (19.6%). The incidence of LEIs for moderate participants was higher than for low participants (HR, 1.51 95% CI, 1.04-2.20; P = .03). The incidence of LEIs for high participants was higher than for low participants (HR, 1.85 95% CI, 1.12-3.06; P = .02).
Conclusion:
Athletes with moderate or high sport specialization were more likely to sustain an LEI than athletes with low specialization. Sports medicine providers need to educate coaches, parents, and interscholastic athletes regarding the increased risk of LEIs for athletes who specialize in a single sport.
Biological maturation is associated with significant change to a number of physiological and structural processes throughout childhood and, in particular, adolescence. Mismatched rapid growth in the ...long bones relative to muscular lengthening may disrupt structure, neuromuscular function, and physical performance. Practitioners who work with school-age youth should be aware of the age-related changes that typically take place during a child's development to ensure that their strength and conditioning programming is as safe and effective as possible for enhancing performance and reducing injury risk. Although there are several methods available to assess biological maturation, practitioners who work with youth can benefit from assessment methods that are available and feasible, and that provide utility in the quantification of the degree and stages of biological maturation that affect motor performance in children and adolescents. This article synthesizes the relevant assessment methods and provides a rationale for understanding usable biological maturation assessment tools that can aid in the development of training program design for youth.
The impact of early single sport participation among young people has received much attention, with both sport leaders and pediatricians advocating multi-sport participation at least until early ...adolescence. In this study we explored the association between family socioeconomic status and level of Irish youth specialization in sport. We relied on data from the Children’s Sport Participation and Physical Activity (CSPPA) study, involving a representative sample of 3499 Irish children and adolescents aged 10–15 years. We analyzed data from questions related to the number of sports played, the number of days per week the youth were engaged in sport, and family affluence (as a proxy measure for socioeconomic status). Youth sport specialization before 12 years of age (males 5.7%; females 4.2%) and even between 13–15 years of age (males, 7.8%; females, 5.8%) was uncommon. However, lower levels of specialization were associated with higher socioeconomic status in that more children with high family affluence participated in multiple sports. Careful consideration should be given to whether low socioeconomic status may act as a barrier to participation in multiple sports.
Several sports demand an early start into long-term athlete development (LTAD) because peak performances are achieved at a relatively young age (e.g., gymnastics). However, the challenging ...combination of high training volumes and academic demands may impede youth athletes' cognitive and academic performances. Thus, the aims of this study were to examine the effects of a 1-year sport-specific training and/or physical education on physical fitness, body composition, cognitive and academic performances in youth athletes and their non-athletic peers.
Overall, 45 prepubertal fourth graders from a German elite sport school were enrolled in this study. Participating children were either youth athletes from an elite sports class (
= 20, age 9.5 ± 0.5 years) or age-matched peers from a regular class (
= 25, age 9.6 ± 0.6 years). Over the 1-year intervention period, the elite sports class conducted physical education and sport-specific training (i.e., gymnastics, swimming, soccer, bicycle motocross BMX) during school time while the regular class attended physical education only. Of note, BMX is a specialized form of cycling that is performed on motocross tracks and affords high technical skills. Before and after intervention, tests were performed for the assessment of physical fitness (speed 20-m sprint, agility star agility run, muscle power standing long jump, flexibility stand-and-reach, endurance 6-min-run, balance single-leg stance), body composition (e.g., muscle mass), cognitive (d2-test) and academic performance (reading ELFE 1-6, writing HSP 4-5, calculating DEMAT 4). In addition, grades in German, English, Mathematics, and physical education were documented.
At baseline, youth athletes showed better physical fitness performances (
< 0.05;
= 0.70-2.16), less relative body fat mass, more relative skeletal muscle mass (
< 0.01;
= 1.62-1.84), and similar cognitive and academic achievements compared to their non-athletic peers. Athletes' training volume amounted to 620 min/week over the 1-year period while their peers performed 155 min/week. After the intervention, significant differences were found in 6 out of 7 physical fitness tests (
< 0.05;
= 0.75-1.40) and in the physical education grades (
< 0.01;
= 2.36) in favor of the elite sports class. No significant between-group differences were found after the intervention in measures of body composition (
> 0.05;
= 0.66-0.67), cognition and academics (
> 0.05;
= 0.40-0.64). Our findings revealed no significant between-group differences in growth rate (deltas of pre-post-changes in body height and leg length).
Our results revealed that a school-based 1-year sport-specific training in combination with physical education improved physical fitness but did not negatively affect cognitive and academic performances of youth athletes compared to their non-athletic peers. It is concluded that sport-specific training in combination with physical education promotes youth athletes' physical fitness development during LTAD and does not impede their cognitive and academic development.
To determine if sleep quality, fatigue, anxiety, depressive symptoms, or perceptions of sport participation differ between high-, moderate-, and low-specialized high school athletes with or without ...prior injuries.
During pre-participation physical examinations (PPE), high school athletes completed questionnaires on sport specialization level, history of time-loss orthopedic injury, perceptions of sport participation, as well as sleep quality (Pittsburgh Sleep Quality Index (PSQI)), fatigue, anxiety, and depressive symptoms (Patient-Reported Outcomes Measurement Information System (PROMIS®)). Athletes were grouped according to sport specialization level and history of prior time-loss orthopedic injury.
A total of 186 athletes completed the study: 49% (n = 92; mean age = 15.3 ± 2.0 yrs; 50% female) were low specialized, 34% (n = 64; mean age = 15.3 ± 1.3 yrs; 47% female) were moderately specialized, and 16% (n = 30; mean age = 15.7 ± 1.1 yrs; 57% female) were highly specialized. Groups were similar for demographics, training volume, and injury history. Compared to the moderate-specialization group, highly specialized athletes reported higher levels of fatigue (3.1 ± 3.7 vs. 1.5 ± 2.2; p = 0.02), anxiety (3.6 ± 4.1 vs. 1.8 ± 2.6; p = 0.02), and depressive symptoms (2.4 ± 4.0 vs. 0.8 ± 2.0; p = 0.02). No differences in psychometric ratings, sleep quality, or perceptions of sport participation were observed between the low/moderate- or low/high-specialization groups. We did not observe any significant differences between groups who did and did not report a history of prior time-loss orthopedic injury.
Highly specialized high school athletes report higher levels of fatigue, more anxiety symptoms, and more depressive symptoms than their moderately specialized peers, despite no differences in training volume or injury history. Low specialized athletes did not differ from moderately specialized or highly specialized athletes in the aforementioned domains, and there were no differences in sleep quality across specialization groups. These findings add to the current body of literature on early sport specialization by illustrating the distinctive psychosocial implications of sport specialization and demonstrating the need for further prospective research.
Background:
The rate of early sport specialization in professional baseball players is unknown.
Purpose:
To report the incidence and age of sport specialization in current professional baseball ...players and the impact of early specialization on the frequency of serious injuries sustained during the players’ careers. We also queried participants about when serious injuries occurred, the players’ current position on the field, and their opinions regarding the need for young athletes to specialize early to play at the professional level.
Study Design:
Descriptive epidemiological study.
Methods:
A total of 102 current professional baseball players anonymously completed a 7-question written survey. Early sport specialization was defined as “single-sport participation prior to high school.” Injury was defined as “a serious injury or surgery that required the player to refrain from sports (baseball) for an entire year.” Chi-square tests were used to investigate the risk of injury in those who specialized early in baseball versus those who did not. Independent-sample t tests were used to compare injury rates based on current player position.
Results:
Fifty (48%) baseball players specialized early. The mean age at initiation of sport specialization was 8.91 years (SD, 3.7 years). Those who specialized early reported more serious injuries (mean, 0.54; SD, 0.838) during their professional baseball career than those who did not (mean, 0.23; SD, 0.425) (P = .044). Finally, 63.4% of the queried players believed that early sport specialization was not required to play professional baseball.
Conclusion:
Our study demonstrated a statistically significant higher rate of serious injury during a baseball player’s professional career in those players who specialized early. Most current professional baseball players surveyed believed that sport specialization was not required prior to high school to master the skills needed to play at the professional level. Our findings demonstrate an increased incidence of serious injuries in professional baseball players who specialized in baseball prior to high school. Youth baseball athletes should be encouraged not to participate in a single sport given the potential for an increased incidence of serious injuries later in their careers. No data are available to suggest that early specialization is needed to reach the professional level.
Objective: Gymnastics is a popular sport with high injury rates, especially at the collegiate level. There is limited evidence, however, regarding the risks of early specialization in this sport, the ...rate of concussions in gymnasts, and the long-term effects of disordered eating in gymnasts. We sought to describe health-related outcomes of former collegiate gymnasts and the association with early sport specialization, concussion history, and disordered eating.
Methods: We distributed an online survey through social media outlets. A total of 473 former female collegiate gymnasts completed the survey and were grouped according to early (<14 years) specialization, presence or absence of concussion history, and history of disordered eating. We determined the number of participants who had time-loss injuries, injuries requiring surgery, and injuries resulting in retirement. We also evaluated menstrual history, reasons for sport retirement, functional outcome measures, and mental health.
Results: The median age of gymnastics specialization was 8 years interquartile range = 6-11 years. The proportion of injuries sustained during college did not significantly differ by specialization age. A significantly greater proportion of early specializers required surgery for college sports-related injuries (60% vs. 44%; p = 0.02). Forty-two percent of the respondents reported concussion history, and a greater proportion of those with concussion history reported seeking mental health treatment during college (32% vs. 23%; p = 0.03), and anxiety disorder diagnosis (16% vs. 9%; p = 0.01). Disordered eating history was reported by 34% of the respondents, and this group had a higher proportion of time-loss injury (78% vs 65%; p = 0.004), and osteoporosis (4% vs 0%; p = 0.003) during college, and worse current pain (11.5 vs 10.2; p = 0.007) and physical function (12.2 vs 11.0; p = 0.01) than those without disordered eating.
Conclusion: Athletes and clinicians should be aware of the long-term effects of early specialization, concussions, and disordered eating in gymnastics as these issues are common in female collegiate gymnasts.
Objective
To track youth sports participation and injury occurrence accurately and longitudinally.
Results
An online survey tool that captures sports participation, frequency, level of competition, ...and tracks injury occurrence has been developed. The survey allows for longitudinal tracking of sports participation to evaluate the change from recreational to highly specialized sports participation. To maximize the utility of this research tool we identified swimmer plots which allow for clear visualization of the data as the best method for graphical representation.
Implication
Longitudinal measurement of sports participation to evaluate the impact of early sports specialization on injury is feasible with this tool and enhanced by the swimmer plots for visualization.
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