Early specialisation may not impact injury risk or sporting participation

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Early specialisation (ES), defined here as specialisation in a single sport before the age of 15 years, has been a contentious issue among sports medicine providers over the past decade. This edition of the FastFact highlights a study in the American Journal of Sports Medicine that has examined the impact of sport specialisation in a large cohort of former NCAA athletes. In particular it has investigated how specialisation impacted performance (scholarship attainment), injury risk, attrition, and burnout.1

The study involved a total of 1,550 NCAA athletes, 544 (35.1%) of whom were women. Participants attended college between 1960 to 2018. Participants completed a survey that included questions about their sport, decade of participation, scholarship status, whether they had sustained a 30-day time-loss injury while at college, whether they had orthopaedic surgery in college, career length and age of single-sport specialisation. Rates of early specialisation were calculated for each sport, sex, individual and team sports, and decade of participation. Rates of scholarship attainment, injury, and attrition were compared between groups.

Within the study cohort, only 18.1% of NCAA athletes reported specialising in a single sport early, which suggests that ES is not essential for sporting success. There is however evidence to suggest that this practice may be becoming more common with a significant trend toward increasing specialisation, with the highest rate of ES being seen among athletes graduating in the last 10 years. Almost one quarter (23.4%) of these athletes specialised before the age of 15 years. In this sample ES was more common among female athletes, individual sport athletes and among those playing football.

Whether specialising early is a problem is not known. It has been suggested that those who specialise early may be more prone to injury, may be more likely to burnout (and stop their sports perception) and may be less likely to succeed at a high level. This study has attempted to evaluate these factors. The results of this study suggest that ES is not associated with improved sporting performance, measured by the probability of obtaining a college scholarship. Based on this study’s findings, ES was also not associated with a shortened collegiate career or an increased rate of time-loss injury (while in college). Among those who did not complete their four years of college eligibility however, athletes in the ES group were more likely to identify burnout as their cause for attrition.

The results of this study suggest that ES may not have a significant impact, either negative or positive, on an athlete’s sporting career. There are a range of methodological considerations that should be considered. Firstly, the study is retrospective and as a result is likely prone to recall bias. It also only looks at those who participated in collegiate sport and may miss those who were unable to reach this level, potentially due to injury or burnout. Finally, the generalisability of the study’s results to football players is also not clear. The study involved athletes from a diverse range of sports, based in the United States. These athletes may be very different to those who are involved in elite football academies in other countries.

To learn more about youth sport complete the “Younger Athlete” module in the FIFA Diploma in Football Medicine.

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Dr. János Tóth jr.
19 March 2021 20:24
T Calligeris
T Calligeris
20 March 2021 4:55

It would be interesting to see the comparison with elite soccer academies.

Dr jo
21 March 2021 10:09

This is an interesting topic of study. Further research and wider viewpoint presumably should yield more information.

Kostis Sidiropoulos
21 March 2021 11:02

Still believe that ES is not the best choice for young athletes ( age < 13 )

Abdullah Jamal Aldin Elsamahy
22 March 2021 11:08