‘Sports specialization’ in young athletes can do more harm than good

The University of Kentucky Public Relations and Strategic Communications Office provides a weekly health column available for use and reprint by news media. This week's column is by Ben Wilson, M.D., a pediatric orthopaedic surgeon with UK HealthCare.

LEXINGTON, Ky. (Oct. 2, 2023) —“Sports specialization” is a topic that's come to the forefront in recent years, meaning athletes that are playing one particular sport, especially year-round. This is at the exclusion of other activities that they would otherwise be doing, which can have negative effects on the athlete.

How does sports specialization affect young athletes?

Sports specialization can affect kids in a number of ways. I personally see the physical manifestations. Why this has come to the forefront in recent years is because we've started seeing an alarming number of injuries in our young athletes, and not just the typical run of the mill ankle sprains and fractures that we're used to seeing.

What we've seen is an increase in more adult type injuries that are happening in younger and younger ages, so think “Tommy John” surgeries, more formally known as ulnar collateral ligament reconstruction. These elbow surgeries used to just be done in major leaguers. Now we're seeing high school and even middle school aged pitchers getting things like Tommy John surgeries. The same thing occurs with tearing ACLs or dislocating kneecaps injuries to the cartilage, etc.

But almost more important is the mental or the psychologic aspects of sports specialization. We're seeing an alarming number of kids becoming burnt out on the activity that they're choosing. And instead of falling back on a different sport, they're dropping out of sports participation altogether, which is definitely something that we don't wish to continue.

How might young athletes fall into the trap of sports specialization?

What happens is the kids start playing a sport when they're younger because it interests them, and then it becomes a situation where they feel the need to continue signing up for leagues because everyone else is doing it or coaches are encouraging it. It really gets back to the concept of needing 10,000 hours to perfect a skill or an activity. The fallacy is that in youth sports, more time practicing that sport will equate to perfection or excellence, and that's not always the case.

What we see often is that athletes are going year-round, nonstop. When I was growing up, we would play baseball in the spring and summer, football in the fall, basketball in the winter. Now, take baseball for example: we've got spring leagues, summer travel leagues, fall ball, winter workouts, exhibitions and travel. It becomes a vicious cycle where the kids feel that if they stop, then they'll fall back and not be as skilled as their peers or fall behind.

How can parents determine whether their children are at risk for overuse injuries from sports specialization?

I like to tell my patients is that a young athlete shouldn't be participating in a single activity for more hours per week than their age in years. So your average 12-year-old shouldn't be playing three hours a day for seven days a week. That would put them over that limit. But it recognizes the fact that as they age and mature, that they can tolerate more and more.

But our youngest athletes should really just be playing one or two nights a week, and then as they get older and develop a little bit more, they can become more involved. Likewise, when we talk about sports specialization, they shouldn't be playing the same sport for more than eight months out of a year.

Certainly a sport like soccer that has a steady spring and fall season. They can do training in the summer, but they should really be thinking about doing another activity over the winter to give their bodies a break.

Another quick way to burn out and overuse injuries is to try to play multiple sports within the same season. I see a lot of kids that are playing both soccer and volleyball at the same time. And yes, they're playing multiple sports, but they're doing it at the same time, and that's almost as bad on their young bodies.