Kids Who Focus on One Sport, Often Driven by Parents, Get More Injuries

By Megan Brooks

March 14, 2018

NEW YORK (Reuters Health) – Many parents encourage their children to focus on a single sport year round, but this could be associated with a higher risk of injury, according to new studies presented at the American Academy of Orthopaedic Surgeons (AAOS) annual meeting.

“Culturally, we have found that parents have unrealistic expectations for their children to play collegiately or professionally and as a result, they invest in private lessons, trainers or personal coaches to help their kids,” Dr. Charles A. Popkin of Columbia University Medical Center notes in a statement. “When you’re investing this amount of time and resources, there can be unwritten, indirect pressure from parents to specialize.”

To gauge parental influence placed on young athletes to specialize, Dr. Popkin and colleagues surveyed 201 parents of pediatric patients in his New York practice.

One-third of parents reported that their children played one sport only, 53% had children who played multiple sports, but had a favorite sport, and 13% had children who balanced their multiple sports equally, the researchers found.

More than half of parents said they hoped their children would play collegiately or professionally and encouraged their children to specialize in a single sport.

“Parents of highly specialized and moderately specialized athletes were more likely to report directly influencing their child’s specialization and to expect their children to play collegiately or professionally,” the authors report in their meeting abstract.

They further found that children who had already suffered an injury were far more likely to receive elite regional or professional coaching than children without an injury history. Parents who hired personal trainers for their children were more likely to believe their children held collegiate or professional aspirations.

A separate study presented at the AAOS meeting suggests that specializing in certain sports is associated with an elevated risk of injury.

Dr. Mininder Kocher of Boston Children’s Hospital and colleagues analyzed data collected from 1997 to 2001, as well as 2004 data on sports injuries, for nearly 12,000 children aged 9 to 14 participating in the Growing Up Today Study. Sports specialization was defined as participating in only one sport during the fall, winter and spring seasons.

In age-adjusted analyses, specialization in baseball (hazard ratio, 2.02) and cheerleading/gymnastics (HR, 2.63) predicted a significantly increased risk of injury among the boys.

Among the girls, specialization in running (HR, 1.33), swimming (HR, 1.32), soccer (HR, 1.34) and cheerleading/gymnastics (HR, 1.43) were also significant predictors of suffering an injury.

Among both girls and boys, total hours per week of vigorous activity was predictive of developing injury.

“Kids are not little adults. And youth athletes are not little professional athletes. They need time to rest and recover,” Dr. Kocher told Reuters Health by email. “A common-sense rule of thumb is number of hours per week should not be more than their age. For example a 12 year old should not participate in more than 12 hours of organized sports activity per week.”

“Youth sports injuries are increasing dramatically,” said Dr. Kocher. For example, a prior study found a fivefold increase in ACL injuries in children and adolescents from 2004 to 2014, she noted. Other studies have found similar trends for acute injuries such as ACL and also repetitive overuse injuries such as stress fractures, patellofemoral pain and cartilage injury.

There are likely many reasons for this, she said, including participating in organized sports at a younger age, increased competitive level, less free play, and specialization in a single sport at a young age.

“Early youth sports specialization is very common now. Kids in late grade school and certainly by middle school have specialized in a single sport year round at the exclusion of other sports,” said Dr. Kocher. “It’s an arms race and parents are afraid that if their kids don’t specialize early and do ‘elite’ club teams they will not be able to keep up. This despite a lack of evidence that early specialization increases the likelihood of becoming a college or pro athlete – in fact the data suggest that multisport athletes are more likely to succeed.”

A number of organizations have come out with position statements advising against early sports specialization, including the American Orthopaedic Society of Sports Medicine (AOSSM) and the American College of Sports Medicine (ACSM), Dr. Kocher noted.

“I don’t want studies like these to be negative about youth sports,” she emphasized in email. “There are tremendous benefits of youth sports; medically (better health) and psychosocially (friends, self-confidence, lower rates of drug use, career success, etc.) In addition, we still have an epidemic of youth obesity. So the goal is to find the sweet spot in youth sports of kids participating in a positive way without injury.”


American Academy of Orthopaedic Surgeons 2018.