Monday, November 30, 2015

Sports Specialization: What is the right age?

Many sports medicine providers agree that intense training and practice is needed to achieve an 'elite' status in that sport. So the question remains, at what age should such training begin? Dr. Hong offers some evidence to help find an answer.

Sports Specialization: What is the right age?

At what age should such training begin? Dr. Eugene Hong offers some evidence to help find an answer. (istockphoto)
At what age should such training begin? Dr. Eugene Hong offers some evidence to help find an answer. (istockphoto)

In sports medicine circles, sports specialization is generally considered to be defined as intense year-round training in a single sport, with the exclusion of other sports. It is also generally accepted by sports medicine providers and the sports world at large that there is a need for practice and training to improve one’s skills and ability in any given sport—and certainly if that individual’s goal is to attain an “elite” status in that sport. 

What is a matter of debate and discussion, at least in sports medicine and the topic of this blog, is whether intense training in a single sport, to the exclusion of others, must begin at an early age and if so when. Some theory on this issue has been subverted from the area of music and music training—for example, the idea that 10,000 hours over 10 years are needed to achieve elite musical ability, and that music training must start at an early age and must be a full-time commitment to the exclusion of other pursuits.  Needless to say, while there may be some similarities in background between Yo Yo Ma and Peyton Manning, there are likely many differences in the training of a world class musician and a world class athlete.

This is not intended to be a commentary judging or lamenting the paradigm shift in youth sports in the US from child-focused recreational play (for the purpose of enjoyment) to adult driven, “structured, deliberate practice” (for the purpose of “sport- specific skill development”) (Jayanthi, Sports Health, May 2013). To be clear, one of the main goals of sports specialization at an early age is to improve performance in a particular sport.  It is not to improve enjoyment; in fact it may be that a specialized youth athlete has less satisfaction and enjoyment in their sport as they get older. So what are the risks and what are the rewards to early sports specialization in youth sports, as we best currently understand them to be?

Three main risks of early specialization in youth sports, as summarized by Dr. Jayanthi, include:

  • increased psychological stress on the athlete
  • potential increased rates of injury
  • possibly increased burnout and dropout rates
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There is some data, although not enough, to support these postulates. For example in one study of over 400 youth baseball pitchers, those that pitched more than 100 innings in a given year were 3.5 times more likely to be injured; another study demonstrated that pitching 8 months a year or more increased the risk of having shoulder or elbow surgery. This makes sense, as we know from other studies that increasing exposure (i.e. training, practice, competition) has a linear relationship with increasing injury risk. 

Interestingly, in another study examining burnout in competitive athletes, 20 percent of elite athletes cited injury as their reason for quitting their sport.  Depression in college student athletes is likely at least as prevalent in their non-athletic peers, further dispelling the notion that athletes, and especially elite athletes, are somehow protected from clinical depression by virtue of their athletic participation.

The rewards of specialization at any age may be achieving a high level in their sport. The rewards of early sports specialization are not as clear. It may depend on one’s chosen sport. In gymnastics and rhythmic gymnastics there is support for early specialization in childhood to achieve elite status. In other Olympic-type sports, studies support intense focused training starting in late adolescence.  In fact, there is evidence that for many athletes playing a variety of different sports while growing up may in fact be helpful.

One study of NCAA Division 1 female athletes found that most had played other sports, and only 17 percent had only exclusively played in their current sport. Diversity of sports, as opposed to specialization of sport, at a young age may provide the athlete with additional benefits in terms of healthy development both physical and mental, including self-motivation.

So the bottom line is that for most sports and most youth athletes, specialization should probably begin in late adolescence. Doing so may decrease the risk of injury and increased psychological stress. And while sport specialization is likely necessary to achieve an elite status, beginning the focus and intensity on a single sport in late adolescence may in fact be helpful for many athletes and help contribute to their own success in sports. As always, good communication and understanding between the youth athlete, their parents, and the coach—about goals, expectations, motivations, and the like—will optimize the outcomes for a healthy successful youth athlete. 


Read more Sports Doc for Sports Medicine and Fitness.

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About this blog
Tracey Romero Sports Medicine Editor,
J. Ryan Bair, PT, DPT, SCS Founder and Owner of FLASH Sports Physical Therapy, Board Certified in Sports Physical Therapy
Brian Cammarota, ATC, PT, DPT, CSCS Partner at Symetrix Sports Performance
Ellen Casey, MD Physician with Drexel University Sports Medicine
Desirea D. Caucci, PT, DPT, OCS Co-owner of Conshohocken Physical Therapy, Board Certified Orthopedic Clinical Specialist
Michael G. Ciccotti, M.D. Head Team Physician for Phillies & St. Joe's; Rothman Institute
Julie Coté, PT, MPT, OCS, COMT Magee Rehabilitation Hospital
Peter F. DeLuca, M.D. Head Team Physician for Eagles, Head Orthopedic Surgeon for Flyers; Rothman Institute
Joel H. Fish, Ph.D. Director of The Center For Sport Psychology; Sports Psychology Consultant for 76ers & Flyers
R. Robert Franks, D.O. Team Physician for USA Wrestling, Consultant for Phillies; Rothman Institute
Ashley B. Greenblatt, ACE-CPT Certified Personal Trainer, The Sporting Club at The Bellevue
Eugene Hong, MD, CAQSM, FAAFP Team Physician for Drexel, Philadelphia Univ., Saint Joe’s, & U.S. Lacrosse
Brian Maher, BS, CSCS Owner, Philly Personal Training
Julia Mayberry, M.D. Attending Hand & Upper Extremity Surgeon, Main Line Hand Surgery P.C.
Gavin McKay, NASM-CPT Founder/Franchisor, Unite Fitness
Heather Moore, PT, DPT, CKTP Owner of Total Performance Physical Therapy, North Wales and Hatfield, PA
Justin Shaginaw, MPT, ATC Athletic Trainer for US Soccer Federation; Aria 3B Orthopaedic Institute
Thomas Trojian MD, CAQSM, FACSM Chief of the Division of Sports Medicine at Drexel University
Robyn Weisman, ACE-CPT Certified Personal Trainer
Sarah Whitman, MD Sports Psychiatrist in Philadelphia
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