Sport Specialization at an Early Age Can Increase Injury Risk

From PT in Motion, the professional issues magazine of the American Physical Therapy Association

Parents and coaches need to be educated on the risks and signs of overuse injuries common in children who specialize in a single sport at a young age, say authors of a recent research review published in the American Journal of Sports Medicine. Surgery, they concur, should not be the first-line treatment for such injuries.

An increasing number of children are focusing on 1 sport early, often because parents and coaches are enticed by the possibility of scholarships and professional participation, “increasing emphasis on sports accomplishment,” and perceived value of elite competition, authors note. But the evidence, say authors, suggests that children who wait until age 12 or older to specialize in 1 sport or begin intense training reach higher levels of athletic achievement than those who specialize at a younger age.

In general, say authors, young athletes’ “underdeveloped musculature” and still-growing bones make them prone to overuse injuries such as rotator cuff tendinitis, shoulder instability, humeral epiphysiolysis, knee and elbow ligament injuries, hip impingement, and stress fractures, among others. The strain to a developing body also may increase their risk of injury as adults.

The authors write that more research needs to be done to determine early specialization risks and injury patterns for specific sports, and to identify long-term consequences. In the meantime, they urge, it is important to inform parents and coaches about general injury risk and signs of overuse injuries in children. In addition, say authors, while “operative treatment is occasionally indicated for these injuries [it] should not be taken lightly or considered the first treatment option for most overuse injuries.”