Injury Rates in Early Sport Specialization Athletes

Athlete Development vs Sport Specialization

Baby - Injury Rates in Early Sport Specialization AthletesCurrent and emerging research regarding early sport specialization versus long-term athletic development continues to support the IYCA’s stance that the long-term athletic development model, or LTAD, provides the greatest benefit to a developing athlete, in both physical and psychological aspects, over time.

Most recently, researchers at the Loyola University Health System located outside Chicago, Illinois presented the results of their study, "The risks of sports specialization and rapid growth in young athletes," at the American Medical Society for Sports Medicine annual meeting in Salt Lake City, Utah.

Athlete DevelopmentThe results, while consistent with the IYCA’s message since inception, further illustrate the tangible risks young athletes are exposed to when their parents, caregivers, and/or coaches ascribe to the early specialization model.


Details About the Study

Athlete Development 1The study involved 154 participants (92 male, 62 female) with an average age of 13. All participants were scored using a six-point sport specialization score and other factors such as height and weight were recorded.

Athletes who had sustained injuries (85 athletes) completed another survey to further define their specific injury and their particular training habits. Results for injured athletes were compared to the uninjured control group (69 athletes).

The sport specialization score probed at several clues regarding the level of involvement a young athlete had in sports generally or in a specific sport. Questions included the following:

  • Whether athletes trained more than 75% of the time in one sport exclusively
  • Whether participation in other activities was discontinued in order to focus on one sport
  • Whether or not participation involved travel outside the state
  • Whether participation (practices, games, etc.) involved training for more than eight months in a given year
  • Whether the competition season exceeded six months per year in duration

Following data collection and analysis, researchers noted trends toward significance in two relationships:

  1. Injured athletes spent more hours per week playing sports (19.8 hours per week vs. 17 hours per week).
  2. Injured athletes spent more hours per week in organized sports (11 hours per week vs. 8.8 hours per week).

In addition, uninjured athletes average sport specialization score was 2.75. At the same time, injured athletes averaged a sport specialization score of 3.49.

Final Note

Note, the study, supported through funding from the American Medical Society for Sports Medicine, is considered preliminary. Researchers are currently recruiting additional participants in order to improve statistical power.

The IYCA applauds such efforts to further define the inherent risks associated with early specialization and looks forward to future efforts to better understand both the injury and performance implications associated with this practice.

Toby Brooks, PhD, ATC, CSCS, PES, YFS3

Source: Jayanthi NA, Pinkham C, Luke A. The risks of sports specialization and rapid growth in young athletes. Presented at the 2011 Annual Meeting of the American Medical Society for Sports Medicine. April 30-May 4. Salt Lake City, Utah.

About the Author: Toby Brooks

Athlete DevelopmentDr. Toby Brooks is currently an Assistant Professor in the Master of Athletic Training Program at the Texas Tech University Health Science Center in Lubbock. Dr. Brooks has worked with numerous youth, collegiate, and professional athletes and previously owned and operated a youth athletic development business. He is also Co-Founder and Creative Director of NiTROHype Creative in Lubbock.

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24 Responses

  1. Brad says:

    Great article on a topic I am “trying” to get across to folks… Questions I receive from some, (seriously)… What type of injuries are we speaking of? How long out of action? Which group were the better athletes? Are these injuries not simply the price we pay for striving to be the best?
    I am not joking here folks…

  2. Brad says:

    I am big into functional assessments and concussion baseline tests for all my athletes. You would be surprised by how many folks (including parents) think these are of no value!

  3. […] 1st, 2011 Injury Rates in Early Sport Specialization Athletesby Toby Brooks, PhD, ATC, CSCS, PES, […]

  4. Michael Whittley says:

    Something I have been advocating for years and essential for every young athelete who wants to ensure achieving the 10,000 hours target as required under the LTAD model Needs to be continuousously reinforced by all practitioners

  5. Michael Whittley says:

    Great article Something I have been advocating for years.Essential for all those who hope to achieve the target of 10,000 hours as recommended under the LTAD Model. Needs to be continuiously reinforced by all practitioners

  6. Peter Guare says:

    Disappointing to see that the study results are “trends towards significance.” This certainly sounds like “statistically insignificant.”

  7. Dave Gleason says:

    @Michael Whittley equating 10,000 hours with LTAD can be misleading. In fact, the 10,000 hour theory is misleading in itself and many times leads to over use due to ill-concieved goals for young children.

    I see this with club sports especially in my community.

  8. kevin says:

    I am not a proponent of athletes specializing until they are in college, but the data here doesn’t tell us anything.

    “First, injured athletes spent more hours per week playing sports (19.8 hours per week vs. 17 hours per week). Additionally, injured athletes spent more hours per week in organized sports (11 hours per week vs. 8.8 hours per week).”

    To me that reads, if you play more hours you’re more likely to get hurt, regardless of whether it’s in one sport or more.. The problem is the overwhelming majority of kids who just play their sport and do no structured strength and conditioning work to get stronger and work on their imbalances and weaknesses, effectively leaving them more prone to injury.

  9. P J says:

    Good piece of information. BUT, a little knowledge can be a dangerous thing. In this particular case I might equate this drawing too much on the conclusions of one article, and basing an opinion on thin foundations:

    Say for instance that one particular athlete forgoes only playing the sport they love, e.g. tennis or baseball. Instead they will now play both tennis and baseball with a bit of athletics thrown in for good mesure, doing shot-put and discus (becuase they are fun). An unbalanced use of the body exists in single-sport and multi-sport participation alike, so it is not the question of how many sports we are talking about that should be the concern. It is how the body is conditioned, how it is allowed to recover and regenerate. Suddenly we are talking about a LOT of knowledge to make informed decisions.

    Also, to hold up LTAD as an antidote to specialisation is in my opinion yet anohter example of an uninformed debate, when one paradigm in LTAD clearly caters for ‘Early Specialisation’ sports. Well informed LTAD/LTPD deals with multilateral development, load patterns, periods of accelerated trainability, etc, and not with one versus many sports.

    I wholeheartedly support the IYCA in making knowledge and opportunities for upskilling coaches and trainers available, but I fear that a lot of people will go for the abridged ‘simple version’ of ‘best practice’. I see it in coaches and trainers alike. They do a level 1 course, and possibly a level 2. Then they are experts – because they repeat the simple messages they’ve picked up from ‘expert’ experts.

    For the sake of the kids we need to do better, all of us. On your side of the Atlantic as well as on this side.

    Knowledge is power. Rant over. Thanks for your attention.

  10. Doug V. says:

    Thanks IYCA.
    99.99% of the kids we train will participate in sports through high school. 1% will play in college. .01% or fewer will play professionally. I am very supportive of the IYCA position regarding early sports specialization and will continue to advocate this position. However I would like to know if you believe a child could become the next Andre Agassi or Tiger Woods without the early specialization that they, and most others who have reached their level in their sport, had.
    Doug V

  11. David says:

    Dr. Brooks I have a question as this applies to my own children (11 and 8). I am having a tough time with wether my kids should be involved with other organized sports. The both love baseball, are quite good at it, and they don’t express a whole lot of interest in other sports. While they do play football, basketball, soccer (very little soccer) they do this mainly at home or with friends at school. There main focus for an organized sport is baseball. They both play from about February until November. Now that is not to say they are playing every weekend but again this is where they are focused. As an example, we are playing in 4 tournaments for the fall season at both ages and it goes from September until the beginning of November.
    My question is whether we need to be overly concerned about the committment to one sport, based on your research, when this is what they are really interested in and as long as they are not over doing it?
    Hope this makes sense and I appreciate your time.

  12. Mike says:

    This information reinforces studies done over 25 years ago.

    In two separate studies (Harre 1982 and Nagormi 1978) found the following similar
    results comparing early specialization to a multilateral program. This is what they found:
    Early Specialization:
    -quick performance improvement
    -Best performance achieved at 15-16 years
    -inconsistency of performance in competitions
    -by age 18 many athletes were burned out and quit the sport
    -prone to injuries because of forced adaptation.


  13. Glenn says:

    I think this is great article. What I will say though is are problems come from parents who are misinformed and pressured by coaches to play one sport year round to again the target of 10,000 hours. Once again misleading information. In our community we have coaches paying lip service to the multi-sport athlete but when push comes to shove they don’t want their top athletes playing any other sport.

    Jenkins elite Training
    Coach Glenn

  14. Casey Wheel says:

    What if the kid chooses to play the sport all year round with his friends competitive or not? That technically is early specialization but would any of you stop a kid who truly loves to play all the time?

    Seems to me the problem lies in two distinct areas of early specialization. 1) Playing for more than 1 season a year of competitive games before pubescent age. 2) Parents who want it more than the kids.

    Playing year round is not wrong but forcing a 7 year old to play in a competitive league with 3 games a weekend for 6 months probably will lead to burnout and injuries.

    We broadly throw out early specialization, when for some people it’s not a bad thing. You think you would have told Gretzky, Ted Williams, Messi, or Federer to stop playing so much on their own when they were kids because of there deep love of the game?

  15. Toby B. says:


    As I indicated, the findings are preliminary and the study is ongoing. This was taken from a publication of an abstract presented this summer from an ongoing project. It is customary to use verbiage such as “trends towards significance” at this point because frankly the data set is incomplete. It would be inappropriate to refer to the findings as “significant” just yet because the data set lacks statistical power (i.e. numbers of participants) that the researchers are in the process of collecting. It would be premature to refer to the findings as either statistically significant or insignificant at this point.

  16. Toby B. says:

    “We broadly throw out early specialization, when for some people it’s not a bad thing. You think you would have told Gretzky, Ted Williams, Messi, or Federer to stop playing so much on their own when they were kids because of there (sp.) deep love of the game?”

    I would say that for the overwhelming majority of people, it IS a bad thing. And you are spot on in your assumption that a fair amount of such behavior is parent-driven in vain attempts to live vicariously through their children. As to your examples, no doubt they were great. My point is simple…a foundation of motor fluency developed through a wide variety of movement exposures is beneficial all the time. Highly specialized training for “elite” athletes usually isn’t. This study isn’t tackling the philosophical issues we are debating, just attempting to establish facts.
    The IYCA often equates motor learning to language acquisition. I really wish I had been exposed to multiple languages as a child and had developed fluency early, because any effort now is difficult. Since all I got was English, I attained fluency in it alone. By the same token, if all I ever do with my son or daughter is have them hit fastballs, they will get better over time. But heaven forbid if they decide to play basketball or volleyball later in life, because their highly developed hitting patterns will be of little benefit in protecting their knees. It is an extreme example but it illustrates my point. I want my children to be fluent movers and decelerators, not just early bloomers in whatever sport might happen to be their favorite at the time because we all know that that is subject to change.

  17. Anon says:

    One thing, the early sport specialization kids were up around 20 hours a week, which I think is at least the amount of total activity one would want in kids (organized+ unorganized). Shouldn’t kids be doing some sort of athletic playing 3 hours a day on average ? So it seems like there are two points from this study, some kids are specializing too much and some aren’t doing enough activity in total.

  18. My name is Jeff Drock and I have been the strength and conditioning coach of elite level junior tennis players for more than a decade. Unfortunately, I cannot speak about this topic of sport specialization across all sports, but I can provide a bit of insight regarding junior tennis players. The tennis players I work with are generally between the ages of 11 and 17.

    Generally speaking, serious tennis players in the United States tend to specialize prior to turning 9 years old. At the age of 11 or 12, it is commonplace for these players to be home schooled. A normal sport training schedule for these players consists of three hours of morning training and three hours of afternoon training. That daily training is done Monday through Friday and the players also play tournaments on the weekends. Only the occasional Monday after a tournament is taken as a rest day. Although this may seem excessive, it is the schedule that every tennis academy or high level training center implements for its serious players. I guess that either the (6) hours of training, the sport specialization or a combination of the two causes the injury rate of tennis players to be ridiculously high. Of course, parents want me to improve their child’s speed and strength, but the main reason I am usually hired is to stop players from continually getting injured!

    At the conclusion of the actual study, Dr. Neeru Jayanthi, medical director of primary care sports medicine at Loyola and the study’s senior author explains that one should participate in a single sport only 11 hours a week. If I were to tell any high level coaches or parents that, I would most certainly be ostracized and laughed right out of the sport. I can say with confidence that there are absolutely no serious high level junior tennis players training 11 hours a week.

    I am curious to know what the operational definition of an injury was? How long did the particular injury keep them out of the sport?

    What can we conclude from the preliminary findings of the study?

    Perhaps those specializing in sport specific conditioning should be making certain to convey the importance of prehabilitation being incorporated into a specialized sport athlete training program?

    Perhaps the amount of hours a week for the sport specializing athlete needs to decrease a bit. Note: I force all players training with me to take at least 2 hours of tennis sport training off on days that they are doing physical conditioning with me.

    Perhaps we also need to look at the specific sport and the individual?

    For these sport specific athletes, is more intensive training taking place? In other words, is the multi-sport athlete a bit less intense or serious?

    There is definitely a huge gap betweeen researchers and practitioners in sport. I am glad to see the IYCA placing focus on this matter.

    Hopefully I did not tick too many people off. I must sarcastically say great timing Pat! (Joking) I already have my wife ticked off at me for letting our two year old watch spongebob. Last night a report came out about the ill effects of watching spongebob on an infant’s brain development. Heck, my daughter likes spongebob and even wears boy’s spongebob pijamas. Go figure!!! I digress…

  19. Most of the overzealous parents I would think have a stock portfolio. Your broker tells you to diversify. We should do the same thing with kids. Diversity builds the complete athlete. Then when they mature they can tackle anything and it will be THEIR idea.

  20. Dave Gleason says:

    FYI – Gretzky was quoted as saying the worst thing that has ever happened to the game is year round hockey….The fact is that EVERY great athlete you could name played multiple sports growing up.

    What I see in my facility on a daily basis is younger and younger athletes with soft tissue injuries and burnout. I also see athletes that specialized early, played year round and spent ridiculous amounts of money for club team participation…fast forward years of this and they did NOT make their high school team.

    No physical culture to fall back on, no foundation of skills to try engage in something else, no confidence.

  21. Toby B. says:


    I missed your question in the thread until just now. We are in much the same boat, as both my kids love stick and ball sports in general, especially baseball & softball. There are opportunities here to the point that they could play all year ’round, and one youth league in town has just launched a “select” league that is more competitive but intentionally scheduled such that kids can play both “select” and regular league CONCURRENTLY! I can tell you the Brooks kids will NOT be doing that! I think it is important for me to support them in their desires and likes, but it is also my responsibility to see to it that they are getting a good, well rounded physical education. I am collecting data this weekend for a project in which I will be analyzing movements and time spent performing various skills in youth softball. My guess is that we will be stunned at just how very little our kids do over the course of an hour and a half at the ballpark. More to come!

    Bottom line for us is let them play, don’t over-schedule them, and provide plenty of enrichment opportunities away from formal sports at home. We had a water gun fight as a family last night in a lawn furniture obstacle course I set up in about three minutes. We played and ran and evaded one another for at least 30-45 minutes. I GUARANTEE the kids got more out of that activity from a motor learning standpoint than a week worth of baseball/softball practice (my kids are 8 and 5), plus it was FUN for the whole family and builds more than just measurable/tangible biomotors or anthropometrics! Try it!

  22. Early specialisation does pose threat to acute to overuse injuries in many children. In India cricketers start quite early and very few reach First class and test cricket.
    In my experience, habit forming years are 8-15 years in both sexes, if they do not play any either one or more games, they will never develop stimulus for sports and games participation in future.
    Nevertheless, in early years they should play more games with a focus on particular game of interest and attention is paid on adequate recovery, early injury detection, management so that they do not feel monotonous.
    To become a champ one has to spend more than a decade.

  23. Brent says:

    From talking with some parents it seems as if some coaches want their players to play in different leagues year round of the same sport. It’s my thought process that if as an adult you don’t want to train the same way every day to avoid overtraining or injury. So what do we do? Cross train. Why would it be any different for kids? Let them play different sports and have fun. Kids are meant to have fun.

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