Early Sports Specialization: Is It Worth It?

Orthopaedic Surgeons Call Time Out, Speak to the Dangers of One Sport for Youth

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American Academy of Orthopaedic Surgeons

Nov 15, 2019, 09:01 ET

ROSEMONT, Ill., Nov. 15, 2019 /PRNewswire/ -- As sport specialization at the youth and high school levels becomes increasingly popular, parents, coaches and medical professionals are encouraged to understand and help prevent the risk of injury among young athletes. Orthopaedic surgeons are increasingly finding themselves on the front line of the competition, recognizing injury, psychological fatigue and burnout. In a new literature review published in the November issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), the authors take a deep dive into the impact of early sport specialization to explore the adverse health and social effects on today's youth.

"Sports are a great way for kids to exercise, have fun and learn about teamwork," said lead author and orthopaedic surgeon Charles A. Popkin, MD, with Columbia University Department of Orthopedic Surgery and New York-Presbyterian Hospital in New York. "However, the days of sandlot play and street pick-up games are waning and we're witnessing the professionalization of youth sport. Parents and coaches are increasingly focused on developing elite athletes and believe that if more focus is placed on deliberate practice and early specialization, young athletes will have a better chance at college-level play or even Olympic standings. That's not usually the case."

Early sport specialization (ESS) is defined as the intensive training or competition in organized sport by prepubescent children (under the age of 12) for more than eight months per year, with a focus on a single sport to the exclusion of other sport and free playⁱ. And while trends in ESS vary across individual and team sport and by sex, the article notes that the lack of diversified activity in youth leads to increased risk of injury and burnout. The authors note that ESS may not be necessary for elite athletic achievement, but rather early diversification of sports leads to superior results.

"The merits and timing of cross-training versus specialization are evident," said Dr. Popkin. "Not only are talented young athletes able to transfer cognitive and physical skills learned from one sport to another, but they demonstrate more enjoyment in sport and a lower frequency of dropout. In addition, there are fewer signs of chronic stress, higher levels of motivation and a gradual independence."

According to the American Academy of Orthopaedic Surgeons (AAOS), overuse injury in children can have a lifetime effect on their game and quality of life. The AAOS launched a public service campaign with the American Orthopaedic Sports Medicine Association (AOSSM) called OneSport™ to educate the parents, physicians, young athletes and coaches about the dangers of sport specialization which includes materials for physician offices and public education:

When a young child whose body is still growing and developing, and repeatedly participates in one type of athletic activity, their body does not have enough time to heal properly between resting and playing.
Intense and repetitive training can lead to pediatric trauma and may require surgery to young shoulders, knees, elbows and wrists.
Though most experts agree that some degree of sports specialization is necessary, there is much debate about how early intense training should begin.ⁱⁱ

While orthopaedic surgeons need to be prepared to identify an injury, treat it and help the patient get back in the game, the JAAOS review article highlights the importance of advocating on behalf of their health too. By guiding discussions about ESS and noting that there is no strong evidence that it is a requirement to achieve elite athletic status, they can help open dialogue about ways parents and coaches can promote enjoyable, lifelong physical activity without the psychological and social risks of ESS.

"The debate over the optimal age to start sport specialization will likely continue as parents, coaches and developing athletes look for a competitive edge. In a perfect world, however, specialization would be part of a natural progression driven by the athlete, and not their parents or coaches," added Dr. Popkin.

For more information about specific sport and overuse injury prevention, or for a guide to safety for young athletes, patients can visit OrthoInfo.org.

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ⁱ LaPrade RF, Agel J, Baker, et al: AOOSM early sport specialization consensus statement. Orthop J Sports Med 2016; 4:2325967116644241.
ⁱⁱ Jayanthi, N., Pinkham, C., Dugas, L., Patrick, B., & LaBella, C. (2013, 4 25). Sports Specialization in Young Athletes: Evidence-based Recommendations. Sports Health: A Multidisciplinary Approach, 5(3), p. 251. doi:10.1177/1941738112464626

SOURCE American Academy of Orthopaedic Surgeons