Sports Specialization and Overuse Injuries

As a pediatric sports medicine surgeon, I treat a lot of young athletes with hopes and dreams of eventually making it to the pros. Whether it’s a young pitcher who wants to throw curveballs like Cole Hamels or the running back who wants to break tackles like LeSean McCoy, a lot of youth athletes and their parents are banking on the very slim chance that they may someday become a professional athlete.

But one thing most kids and parents don’t realize is that the numbers and odds are stacked against them. Let’s look at the numbers. When looking solely at active player rosters, there are approximately 1,700 players in the NFL, 450 in the NBA, 750 in MLB, and 700 in the NHL. These numbers make it a bit more apparent as to how unlikely it will be for a youth athlete to go all the way to the pros.

Despite this, it is very common to see families devoting a tremendous of time, energy, and resources towards trying to achieve this goal for a child. This has led to an increase in popularity for year-round play and super-specialization for youth athletes.

In the 80s and 90s, most sports were played in a particular season. Soccer and football were in the fall, basketball and wrestling were in the winter, and baseball/softball were played in the spring.

Presently, with increased technology and facilities such as indoor bubble practice fields, kids are able to play the same sport 12 months out of the year. This may seem like a good idea on paper—if I practice and play the same position in the same sport 12 months out of the year, then I’m increasing my odds at eventually becoming a standout at the high school and college level, which in effect will increase my chances at becoming a pro.

Although it’s not readily apparent, there is one major flaw with this kind of mindset. Children and adolescents are not small adults. Their bodies are made of fragile growth plates that are quite susceptible to injury with overuse. By pushing the physical limits of their bodies, the risk of sustaining an injury far outweighs the potential benefit of excessive practice.

This is most evident in youth baseball pitchers. At the youth level, the big, strong pitchers with a “good arm” are identified very early and get recruited to play for teams in multiple leagues. This may seem good for their experience, training, self-esteem, and future potential; but recent research has shown that excessive pitching on multiple teams without appropriate rest increases the likelihood of elbow pain and serious injury.

Here are my recommendations for parents of elite athletes:

  • The motivation behind sports participation should be for exercise, socialization, and the enjoyment of the child.
  • The athlete should have at least four months in a calendar year off from participating in any given sport.
  • The athlete should have at least 2-3 days a week off for rest and unstructured activity.
  • If it’s necessary for the athlete to play sports 12 months out of the year, then they should play different sports (i.e. football  x 3months, baseball x6 months, basketball x3 months) so they are utilizing different body parts and muscle groups.

-By Alfred Atanda, Jr., M.D.