The benefits to kids from playing sports are numerous. Simply from a physical health standpoint, improvements in obesity and decreased risks of chronic medical conditions like diabetes and high blood pressure are invaluable. Playing sports as a child or adolescent is also thought to be associated with academic, social and emotional benefits. But is early youth sport specialization – playing just one sport year round – harmful for kids?
Risks of early youth sport specialization
When a child should transition from playing sports for fun to training for success in that sport has increasingly become a concern. Orthopedic surgeons and sports medicine physicians are concerned that early youth sport specialization – playing one sport only throughout the year – not only risks overuse musculoskeletal injuries but also increases the chance for burnout.
In an article recently published in the American Journal of Sports Medicine, Brian T. Feeley and others explore issues related to single-sport specialization at an early age for young athletes in popular youth sports – baseball, swimming, gymnastics and ice hockey.
There are far more scientific studies on overuse youth baseball injuries than in other sports. Factors such as a child pitching more than 100 innings per year, pitching in warm-weather climates (and thus pitching year-round) and pitching through pain have been shown to increase the risk for a shoulder or elbow injury.
Despite the risks of overuse injuries, many young kids subject their arms to considerable repetitive stress. A survey of 754 pitchers between the ages of 9 and 18 found that 45% of them participated with no pitch counts. 13% pitched more than the recommended eight months per year. Another survey found that 31% of youth baseball coaches, 28% of players, and 25% of parents don’t believe that pitch count is a risk factor for injury.
Elites swimming usually involves training year-round or almost all year, and thus it subjects the young swimmers to significant repetitive stress. In fact, some elite swimmers swim up to 9 miles a day.
It’s not surprising then that shoulder pain is common among elite swimmers. One survey found that 91% of elite swimmers between the ages of 13 and 25 had shoulder pain. 84% had shoulder impingement signs on physical exam, and 70% had MRIs consistent with supraspinatus tendinopathy. The volume of training correlated with shoulder pain.
Since gymnastics is performed indoors, young athletes participate year-round. Many believe that gymnastics is different from other sports and that peak performance occurs in younger ages instead of the 20s, like many sports. It’s possible, then, that early single-sport specialization might be necessary in order to reach elite levels.
Overuse injuries do occur in gymnastics, though. Injuries to the growth plate of the distal radius (one of the forearm bones at the wrist) are common as gymnasts use their arms for weight bearing. Spondylolysis and stress fractures of parts of the bones of the lumbar spine can occur due to forces commonly placed in that area from repetitive gymnastics maneuvers.
Hip and groin injuries are more common in ice hockey than in other sports. One recent study found high rates of femoroacetabular impingement and hip labral tears in young players. These problems increased in frequency with elite level players in older age groups. It is possible that these are overuse injuries that occur with participation in ice hockey at an elite level in childhood and adolescence.
Parents, coaches and young athletes need to consider the risks of musculoskeletal injuries into decisions to play sports an elite level at a young age. Training adjustments to allow kids’ bodies to rest is especially important. Plus, as orthopedic surgeons and sports medicine physicians, we need more data on the incidence of the early youth sport specialization in different sports, as well as long-term data on the effects of some of these overuse bone and joint injuries.
Feeley BT, Agel J, LaPrade RF. When Is It Too Early for Single Sport Specialization? Am J Sports Med. Published online March 30, 2015.
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