Going for the Gold?

Sport SpecializationI was going to write about a completely different topic for this week’s post, but I just saw an incredible presentation about sport specialization by UW’s own Alison Brooks, MD, MPH, and I can’t stop thinking about it. Dr. Brooks was presenting research about whether sport specialization – when an athlete focuses on one sport, usually throughout the year and at the exclusion of participation in other sports – is a healthy and effective way to help youth achieve their athletic goals. In other words, does someone who wants to play in the WNBA have to play in a year-round basketball league before high school (or even middle school)?

Spoiler alert: no, they don’t. And while background stories on the Williams sisters might lead us to believe that earlier sport specialization is better, there are some real risks to early and intensive specialization.

As background, let’s just say that participation in organized sports has exploded in recent decades. According to the National Council of Youth Sports 2008 Market Research Report, 44 million individual youth ages 6-18 participated in sports in 2008 compared to just under 33 million in 1997. The reports also noted that girls were participating in organized sports at younger ages compared to in 1997. Despite this uptick in participation, however, the recently released American Academy of Pediatrics Clinical Report on “Sports Specialization and Intensive Training in Young Athletes,” just published this month, notes that 70 percent of youth drop out of organized sports by age 13.

This clinical report looks at sport specialization and the research that we have so far, and asks a number of important questions. It’s definitely worth a read, but I’ll summarize some of their key points:

Does sport specialization work?

If someone is going to specialize, when should they do it?

The available studies show that the reasons that youth specialize in a particular sport are varied, but often include the hope of obtaining a college scholarship or being able to someday compete at an elite level, like participating in the Olympics or being a professional athlete. These are lofty dreams for many: only 1 percent of high school athletes receive full athletic scholarships to play in college. The NCAA has released numbers showing how many high school athletes go on to play in the NCAA, and it ranges from about 3 percent (men’s and women’s basketball) to about 11 percent (ice hockey) in the sports that they looked at.

In looking at athletes that are successful in moving on to play in college and the pros, early specialization does not seem to be a consistent contributor. The AAP clinical report cites studies that show that college athletes that play in Division I athletics are more likely to have played more than one high school sport. Additionally, what has been dubbed “late specialization with early diversification” (doing a variety of sports early and specializing in a sport later) has been shown as the path most likely to lead to participation at the elite level. So, while those pictures of Olympic athletes doing their eventual sport at age 3 or adorable, it does not mean that sport specialization early in life makes success more likely. In fact, the report also cites studies that show that athletes that started sport-specific training at younger ages had shorter overall athletic careers.

Based on the research available, the AAP report states that “current evidence suggests that delaying sport specialization for the majority of sports until after puberty (late adolescence, ~15 or 16 years of age) will minimize the risks and lead to a high likelihood of athletic success.”

Wait – risks? We haven’t talked about those yet! That leads to the next important topic:

The risks of sport specialization

Based on the research available, one thing that seems clear is that youth sport specialization is associated with increased rate of injury. A study done here at the University of Wisconsin and summarized in this New York Times article looking at high school athletes showed that 49 percent of specialized athletes had had an injury compared with 23 percent of athletes that did more than one sport. Specialized athletes had higher rates of injury even if they had taken steps to participate in fewer games, even when compared to multisport athletes that played more than 100 games per year. The AAP report reviews a number of other studies that come to the same conclusion. Some studies have looked at the intensity of training, and the following have been associated with higher rate of injury:

  • Training more hours than the youth’s age or training more than 16 hours per week
  • Training twice as much or more than amount of time spent in free play
  • Training more than 8-9 total months per year in a single sport

The report also states that burnout, anxiety, and depression are increased in youth that sport specialize early.

Conclusion

It’s important to remember a couple of things (here’s a nice visual summary of this stuff):

  • Sports are a great opportunity to learn about hard work, commitment, and sportsmanship, but they should overall be fun and teach youth how to have skills that will help them be physically active throughout their lives. Most of us won’t be pro athletes, but we will need activity to help us shape our mental and physical health for as long as we’re around.
  • Doing a lot of different sports early (early diversification) and, if appropriate, specializing later is most likely to lead to lifetime athletic participation and fitness as well as possible participation in elite sports (for a few).
  • We can and should help youth set healthy, realistic goals about the sports that they love. Part of this is also thinking about how sports and competition are valued and talked about. Helping youth consider the benefits of sports apart from winning – like that it’s a social activity, they enjoy the adrenaline, that it’s a chance to work hard at something – can set the stage for healthy relationships with sports.
  • Time off is important! Taking at least 1-2 days off per week and 3 months off per year, in 1-month increments, can help prevent injury and allow for mental recovery from the intensity of training for single-sport athletes. Help kids and teens think of other ways to be active during this time off from their organized or primary sport.

Build a Foundation of Athleticism

UW Health’s Sports Medicine’s Sports Performance program offers sessions for kids and teens. From the high-energy P.L.A.Y. program for 6-8 year olds, to Sports Foundations for 9-11 and developmental training for 12-14 year olds – find a program that can help your child learn the fundamental skills and develop a lifelong love of athletics. Learn about the programs