Let's start the year with a controversial topic shall we?! There is an on going out cry among many in the sports medicine community to stop young athletes from specializing in just one sport. We are a country of bigger is better--when it comes to a Samsung TV I can't really argue. When it comes to training for Little League there is some room for debate.
Using baseball for example, we are seeing some disturbing trends over the last decade. More Ulnar Collateral Ligament tears (Tommy John) are occurring in youth throwers. Figure #1 shows the percentage growth of UCL tears in youth and high school throwers according to the American Sports Medicine Institute. Not only are there more tears we are seeing these in younger and younger players. So why the trend?
Intuitively, one would think that we are seeing more injuries because children are spending more hours playing a sport. A very interesting paper was just released in The American Journal of Sports Medicine in 2015 stating that the specialization of sport may in itself be harmful. The title Sports-Specialized Intensive Training and the Risk of Injury in Young Athletes by Jaynathi, et al. was a case controlled study using youths age 7-18. 1
The children filled out surveys and were placed into groups depending on their level of specialization. Low, moderate, and high specialization were determined by answering 3 questions: "Can you pick a main sport?" "Did you quit other sports to focus on a main sport?" "Do you train > than 8 months a year?" The athletes medical records were than analyzed for minor and major injuries, including overuse verses acute injuries. 1
Results showed as we would somewhat expect that injured athletes were older and spent more time in organized sports. However, they also had higher specialization scores. Also, youths with the serious overuse injuries were almost 2 times (1.90) more likely to be highly specialized compared with non-serious overuse injuries. An interesting point from the study was that specialized athletes were not at more risk of getting acute injuries like ACL tears. These are the accidents that just happen to our kids, the slips and falls. However, the specialized kids are much more likely to experience the chronic severe stress fractures, spine injuries, and yes the UCL tear.
Me, my senior year of college. After having surgery on my own chronic shoulder injury.
One final thought on overuse in the specialized athlete comes from the authors Jayanthi and his counterparts at Loyola. "There is an increased risk of serious overuse injury for athletes who spend numerically more hours per week participating in sports versus their age in years."1
Great resources exist for how to limit the impact of intensive sport on young athletes.
Multisport
Softball
Soccer
Baseball
Sources:
1. Jayanthi N, LaBella C, Fischer D, Pasulka J, Dugas L. Sports-Specialized Intensive Training and the Risk of Injury in Young Athletes: A Clinical Case-Control Study. The American Journal of Sports Medicine. 2015;43(4):794-801. doi:10.1177/0363546514567298.
2. http://www.asmi.org/research.php?page=research§ion=UCL
The information on this blog is intended for informational and educational purposes only. It is not intended to be used in place of medical advice. If you have orthopedic issues that need to be addressed please contact your physician.