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Tuesday, June 11, 2024

Risk vs. Reward: Early specialization in youth athletics


Some children wait all year for the much-anticipated start of a sport’s season, while others find themselves playing year-round by way of school ball, travel ball, summer ball, etc. Early specialization in youth sports refers to having a child focus intensively on a single sport, even a single position, at a very young age, often to the exclusion of other sports or activities. A 2019 article published in the Journal of Athletic Training reported that the prevalence rate of early specialization in youth athletics is as high as 41%.

Several factors might compel one to encourage early specialization in our youth.

Most notably, athletes will fall behind their peers if they are not also participating in a single sport year-round, thereby missing out on critical playing experience and training. Another potential driving factor for early specialization is financial in nature. With the skyrocketing cost of higher education, one might feel that athletic scholarships are the only avenue to ensure access to college without a significant financial burden.

As tempting as early specialization might seem to advance our youth athletes to a more elite level, it is certainly not a risk-free endeavor. Aside from its physical toll, we must also consider other potential consequences. Socioeconomically, we are promoting an environment that reduces access to sports among youth who cannot afford the time or money required to participate in a single sport year-round. Additionally, the American Academy of Pediatrics has reported that 70% of youth athletes choose to discontinue participation in organized sports by age 13, which highlights psychological burnout.

As alluded to previously, the physical toll and stress on our youths’ bodies and development is potentially the most critical and compelling argument against early specialization. We often talk about acute musculoskeletal injuries such as ACL, rotator cuff and UCL (i.e., “Tommy John” injury). What is discussed less often are overuse injuries. The American Academy of Pediatrics defines this plainly as the result of cumulative microtrauma to bone, muscle and/or tendon as a function of repetitive stress with insufficient recovery. Common overuse injuries in young athletes include, but are not limited to, apophysitis (i.e., Sever’s disease and Osgood-Schlatter disease), stress fractures, tendinopathy and epiphysiolysis (i.e., little league shoulder). The physical demands of the sport heavily influence the joint, risking physical compromise. For example, a 2018 article published in the Journal of Orthopaedic and Sports Physical Therapy reported that 30-40% of baseball players ages 7-18 years old experience elbow and shoulder pain during baseball season. Even more startling, the same article reported that up to 46% of injured adolescents reported being encouraged to keep playing despite having arm pain.

Now that we have identified the risk versus reward of early specialization, let’s discuss preventative measures we can implement to maintain the health of our youth athletes. 1. Avoid overtraining: If training loads are in excess and are more significant than recovery periods, an athlete can experience overtraining, which can decrease performance. According to the American Academy of Pediatrics, this could manifest as excessive fatigue, sleep disturbances, mood changes and increased risk of illness and/or injury. It is recommended that young athletes participate in no more than one sport per day and ensure at least one day of rest per week from all organized sports. In addition, young athletes should also have two to three months off from each sport per year.

2. Encourage cross-training: There are numerous benefits to being a multisport athlete. By doing this, we can help prevent psychological burnout and balance the load we pose on the bodies of our youth athletes. There is also the added benefit of carryover from one sport to another, meaning the primary soccer player will likely become faster and more explosive by also participating in track and field.

3. Warm-up and cool-down: A warm-up should have multiple components, including a light aerobic portion like light jogging or stationary biking. It should also include dynamic stretching and mobility exercises such as lunges, high knees, butt kicks, etc. Finally, it should also incorporate a moderate to higher intensity component performed before competition/training, such as sprints. A cool-down should incorporate a lower-level activity, such as a casual to brisk walk following competition. The idea is that the youth athlete shouldn’t finish a sprint while competing in track and field and then immediately sit in the bleachers. Arguably, the most critical component of an effective warm-up and cool-down includes appropriate supervision and instruction from a trained individual to ensure proper form and performance.

Overall, as with most things in life, there are risks and rewards to youth specialization in sports. The most important thing we can do as parents and coaches is ensure that our youth are intentional with their training and recovery and look for signs of physical and psychological burnout to help them be the healthiest athletes they can be.

Reed McMurry PT, DPT, is an orthopedic physical therapy resident at the LSU Health Shreveport School of Allied Health Professions.


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