Early sport specialisation and high training loads may increase the risk of injury

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Early sport specialisation (ESS) is often considered to be a risk factor for injury, despite a lack of good evidence to support this relationship. This FastFact highlights a paper that attempts to determine whether ESS is indeed associated with an increased risk of injury by evaluating a group of American Collegiate athletes1.

It has been demonstrated that school-aged athletes are increasingly opting to focus on a single sport at a relatively young age. This has become known as ‘early specialisation’. There is concern among many coaches and clinicians that this ESS may have negative effects on athletes. Athletes that specialise in a single sport early have been shown to have an increased risk of burnout, be more likely to retire from sport early and to be less likely to reach the elite level. The evidence relating to injury risk is less well established. The primary aim of this study was to evaluate whether NCAA athletes who reported specialising early were more likely to be injured (than those who did not).

A cross sectional study involving a total of 232 athletes, with a mean age of 20.1 years, was completed. The athletes were asked to complete a short survey detailing demographics, scholarship status, reasons for sport specialisation, age of specialisation, training volume, and injury/surgical history. The age at which an athlete ‘specialised’ was defined as being the age when they began to train greater than 8 months out of the year for their primary sport.

The study had several interesting findings. Firstly there was an association between both early specialisation (before the age of 14 years) and high training loads with an increased risk of injury and of having had surgery. The association was greatest for participants that trained for more than 28 hours per week in their eventual sport before they started high school. Participants with a history of ESS were more likely to be recruited or receive a scholarship that those who did not, which may indicate that they were better athletes.

A clear limitation of this study is recall bias. Participants were asked to estimate their training and injury history based on their recall. A prospective study design would have been more robust. The inclusion of athletes from multiple sports also makes it hard to generalise the study’s findings to other athlete groups, for example elite academy football players. Another consideration is that the study sample does not include athletes who did not reach the collegiate level, potentially due to injury or burnout.

While this study does have some clear limitations, it does support the impression that athletes who specialise in a single sport may be more likely to be injured.

To learn more about injuries among adolescents, and youth specialisation in general, please complete the ‘Younger Athlete’ module in the FIFA Diploma in Football Medicine.

Reference
1. Ahlquist S, Cash BM, Hame SL. Associations of Early Sport Specialization and High Training Volume With Injury Rates in National Collegiate Athletic Association Division I Athletes. Orthop J Sports Med. 2020 Mar; 8(3): 2325967120906825.

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Raul Ramirez Cortes
03 April 2020 2:33

A que edad es conveniente que se especialice un joven a un deporte.?
Por lo visto es recomendable que el joven realice varias actividades o en su caso varios deportes.

Gokalp
Gokalp
18 April 2020 20:52

Hasta los 12 o 13 hay que enseñar diferentes actividades y dar oportunidades de otros deportes. El atletismo se mejora hasta la pubertad.

Ahmed Shakyb
04 April 2020 0:46

Thank you very much for the impotent and very useful information .

Mohamed
08 April 2020 15:52

Traces of specialization in one sport early

Ihsan123
08 April 2020 21:14

Good information

Mohamed Amine Joundoub
09 April 2020 3:01

Perfect information

Comfort
10 April 2020 7:35

Thank you very much for the information so what will be the recommendation for starting specialization in football will 15 years be ideal to prepare our footballers for under 18 World Cup

Dr Shahram Mohaghegh
25 April 2020 11:07
Reply to  Comfort

This is my question too. But I think lt differs between boys and girls as girls become mature sooner than boys so maybe can have Sport specialization more sooner than boys

Ivan andres
11 April 2020 16:52

Buena información, sería bueno que los jóvenes tuvieran la experiencia en varios Deportes y que la especializacion no se diera en tan temprana edad.

Juan Miguel Sibaja Arias
11 April 2020 23:59

La especialización deportiva a temprana edad a nivel competitivo no está recomendado, ya que desde temprana edad llevas a un estrés al atleta que al pasar de los años años cuando llegue la edad de volverse profesional o dar un salto a la élite deportiva, éste joven termina harto o prendiéndole el amor/gusto al deporte.
Por lo cual lo recomendado es llevar un desarrollo kinestésico general, llevar una variabilidad deportiva y de actividades físicas para no provocar estrés prematuro ni volver al atleta susceptible a lesiones físicas futuras.

DARIO NIEVA RODRIGUEZ
12 April 2020 4:06

excelente

Giuseppe Iuvaro
13 April 2020 12:04

Tanks for this interesting article!

Geetha
16 April 2020 13:12

Thank you for the blog on Early Sport Specialization and its effects on children. Every child loves to play some kinds of sport in their childhood times. However, there is a time in their lives, when they have to choose the specialized sport to continue as a career.

Marco Giovannelli
16 April 2020 16:12

Very interesting! thanks

AFEEF PANGAT RAYIL
16 April 2020 20:24

Good information
Thank you 👍

John
20 April 2020 16:32

Core strength is critical to injury attenuation- I see many Pars Defects and stress reactions in young athletes. Load management and exercise volume need very careful analysis and progression

bangoura
bangoura
22 April 2020 20:05

AVEC LA FLORAISON DES CENTRES DE FORMATION LE CHOIX DES FORMATEURS DOIT ETRE DE RIGUEUR.UNE MISE PLACE D UNE TRES BONNE POLITIQUE DE FORMATION DES JEUNES QUI SERONT L ELITE DE DEMAIN. AVEC LE RESPECT SANS EQUIVOQUE DE LA BIOMECANIQUE ET DU CARTILAGE DE CROISSANCE. DANS LA PHASE D ORIENTATION OU DE SPECIALISATION LES FORMATEURS DOIVENT INSISTER SUR LES APTITUDES DES JEUNES. C EST A DIRE CEUX QUI SONT PREDISPOSES AUX SPORTS INDIVIDUELS ET COLLECTIFS. LE SUIVI MEDICAL DOIT ETRE DE RIGUEUR CAR C EST A CETTE PERIODE DE LIMITATION DES CHARGES QU ON PEUT REDUIRE LES EVENTUELLES LESIONS AU… Read more »

Keith Kucharnik
20 May 2020 4:13

If an athlete decides to specialize early on , I believe a properly formulated training program can attempt To replicate the various joint movements of a multi sport athlete.

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