Kids Specializing in One Sport More at Risk for Injury and Burnout, Experts Say

Specialization in a single sport at a young age can lead to lasting negative health outcomes for children, including injury and burnout, said expert panelists during a discussion hosted by the National Athletic Trainers' Association (NATA).

"Ensuring that young athletes have the skills, strength training, and confidence to enjoy healthy levels of physical activity is critical," said NATA President Kathy Dieringer, EdD, a licensed and certified athletic trainer. "Research shows that waiting to specialize and playing multiple sports during childhood is linked to higher achievement and lower injury risk across most sports."

"Establishing interdisciplinary and overarching guidelines by healthcare providers and governing organizations is vital," she added.

Michele LaBotz, MD, medical director of the athletic training program at the University of New England in Biddeford, Maine, noted that "before children develop those sport-specific skills -- before they become particularly a soccer player or a lacrosse player -- they should really kind of build this foundation of general athleticism."

"If they do that, the sport-specific skills are probably going to come more easily and they're likely to have greater success because they're going to have more tools in their movement toolbox," she said.

Mental health implications are another important reason to limit specialization in youth sports, the panelists stressed, particularly burnout. They pointed to research that showed that athletes ages 13 to 18 who spent more hours per week in sport than the number of their age -- for example, a 14-year-old spending over 14 hours per week on their sport -- reported that their participation felt excessive, although it was not associated with burnout or depression.

"Overall sport is an incredibly positive driver of positive mental health," Eric Post, PhD, a certified athletic trainer and manager of Sports Medicine Research Laboratory for the U.S. Olympic and Paralympic Committee, told MedPage Today. "The data, over and over again, show that specialization is linked with an increased risk of injury, overuse injuries in particular, and we know that when an athlete is removed from their sport environment -- especially for an extended period of time -- that has negative mental health consequences."

He noted these standards can be difficult to uphold due to a lack of awareness of specific recommendations around key participation restrictions intended to protect kids from dangerous sport regimens among healthcare professionals.

In fact, a study co-authored by Post found that healthcare professionals were not aware of recommendations crafted by other professions. He and his team surveyed members of several professional organizations including the National Association of Pediatric Nurse Practitioners. They found that just 17.9% of nurse practitioners were aware of recommendations for the maximum number of months per year a child should participate in a sport.

According to NATA, it is recommended that young athletes spend less than 8 months per year participating in a single sport.

Another study found that college basketball athletes who were considered to be moderate- to high-level specialists based on quantity of training in their sport reported higher levels of performance-related stress and a desire to quit sports more than athletes with lower levels of specialization.

"We are hoping to increase the awareness of healthcare professionals on the concept," LaBotz said of the risk of specialization in youth sports. "Not just ... [the] amount of activity but being aware of the role of quality of activity both in athletes and non-athletes alike."

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