By Dev Mishra MD, President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • A recent scientific article suggests that single sport specialization in young athletes increases injury risk, regardless of the number of hours played- this is a new and important finding
  • The risk of injury increases considerably if the young athlete plays a single sport for more than 8 months out of the year, or more than 16 hours per week
  • Some highly technical sport movements also increase the risk of injury, such as baseball pitching, the tennis kick serve, or technically repetitive sports such as gymnastics, dance, swimming, and diving
  • If a young athlete does choose single sport specialization it would be wise to limit participation to a maximum of 8 months out of the year and 16 hours per week

This week I’d like to point you to a recent publication of an interesting scientific article about Sport Specialization, published in the journal Sports Health. The most interesting finding from the study is in the first bullet point above: early sport specialization is in and of itself a risk for injury in the young athlete, regardless of the number of hours played per week or months played per year.6-17-09-7 XATHLETES

My take on this is that it’s interesting and also perplexing. Why would sport specialization lead to an increased injury risk even if the number of hours played per week or months played per year is a reasonable or modest amount? There is some speculation about the reasons but no clear answers yet. The younger the athlete the greater the risk due to the presence of open bone growth plates, and some highly specialized repetitive sport movements could also reasonably increase risk- I get that. But we need more research in this area, which is likely to come in the next several years. The study I reference above is a pooled retrospective clinical review, so it can be difficult to take absolute recommendations from this but we can at least be reasonable.

In the meantime each family needs to assess their own child’s goals, ambitions, and risks for themselves. The 16-hour per week maximum really shouldn’t be that hard to do but I think the harder part will be the maximum 8 months of dedicated sport participation per calendar year. There’s a lot of pressure now for single sport athletes to play year round and in fact that’s generally viewed as a badge of honor by most of the parents I talk to.

When kids come to see the orthopedic surgeon it means they’ve already had a problem so our perspective is a bit skewed. On the plus side the super-elite sports world is full of athletes that will tell you they played multiple sports until somewhere in their mid-teen years and that’s a formula that leads to success competitively as well as from a health standpoint. I’d strongly encourage you to employ sport diversification and participation limits in your own kids’ lives.