Study: Single-Sport Athletes Injured More
November 3, 2016
A study conducted by the University of Wisconsin School of Medicine and Public Health and funded by the National Federation of State High School Associations (NFHS) Foundation revealed that high school athletes who specialize in a single sport sustain lower-extremity injuries at significantly higher rates than athletes who do not specialize in one sport.
The study was conducted throughout the 2015-16 school year at 29 high schools in Wisconsin involving more than 1,500 student-athletes equally divided between male and female participants. The schools involved in the study represented a mixture of rural (14), suburban (12) and urban (3) areas, and enrollments were equally diverse with 10 small schools (less than 500 students), 10 medium schools (501-1,000 students) and nine large schools (more than 1,000 students).
Athletes who specialized in one sport were twice as likely to report previously sustaining a lower-extremity injury while participating in sports (46%) than athletes who did not specialize (24%). In addition, specialized athletes sustained 60 percent more new lower-extremity injuries during the study than athletes who did not specialize. Lower-extremity injuries were defined as any acute, gradual, recurrent or repetitive-use injury to the lower musculoskeletal system.
“While we have long believed that sport specialization by high school athletes leads to an increased risk of overuse injury, this study confirms those beliefs about the potential risks of sport specialization,” said Bob Gardner, NFHS executive director. “Coaches, parents and student-athletes need to be aware of the injury risks involved with an overemphasis in a single sport.”
Among those who reported previously sustaining a lower-extremity injury, the areas of the body injured most often were the ankle (43%) and knee (23%). The most common types of previous injuries were ligament sprains (51%) and muscle/tendon strains (20%).
New injuries during the year-long study occurred most often to the ankle (34%), knee (25%) and upper leg (13%), with the most common injuries being ligament sprains (41%), muscle/tendon strains (25%) and tendonitis (20%).
In addition, specialized athletes were twice as likely to sustain a gradual onset/repetitive-use injury than athletes who did not specialize, and those who specialized were more likely to sustain an injury even when controlling for gender, grade, previous injury status and sport.
Thirty-four (34) percent of the student-athletes involved in the Wisconsin study specialized in one sport, with females (41%) more likely to specialize than males (28%). Soccer had the highest level of specialization for both males (45%) and females (49%). After soccer, the rate of specialization for females was highest for softball (45%), volleyball (43%) and basketball (37%). The top specialization sports for males after soccer were basketball (37%), tennis (33%) and wrestling (29%).
The study, which was directed by Timothy McGuine, Ph.D., ATC, of the University of Wisconsin, also documented the effects of concurrent sport participation (participating in an interscholastic sport while simultaneously participating in an out-of-school club sport), which indicated further risk of athletes sustaining lower-extremity injuries.
Almost 50 percent of the student-athletes involved in the survey indicated they participated on a club team outside the school setting, and 15 percent of those individuals did so while simultaneously competing in a different sport within the school. Seventeen (17) percent of the student-athletes indicated that they took part in 60 or more primary sport competitions (school and club) in a single year. Among those student-athletes in this group who sustained new lower-extremity injuries during the year, 27 percent were athletes who specialized in one sport.
The student-athletes involved in the study were deemed “specialized” if they answered “yes” to at least four of the following six questions: 1) Do you train more than 75 percent of the time in your primary sport?; 2) Do you train to improve skill and miss time with friends as a result?; 3) Have you quit another sport to focus on one sport?; 4) Do you consider your primary sport more important than your other sports?; 5) Do you regularly travel out of state for your primary sport?; 6) Do you train more than eight months a year in your primary sport?
Although some sports (field hockey, lacrosse) are not offered in Wisconsin and were not included in the study, the study concluded that since specialization increased the risk of lower-extremity injuries in sports involved in the survey it would also likely increase the risk of injuries in sports that were not a part of the study.
From the Director: Back to School
August 7, 2020
By Mark Uyl
MHSAA Executive Director
Since March 12, our world has been anything but normal. These times have tested most everything in life, and as summer turns toward fall, we find ourselves still with far more questions than answers. It has been said that an abnormal reaction to an abnormal situation is normal behavior.
Let me start with these abnormal times. I’ve had many conversations with administrators over the past month about the start of school and school sports. The one constant theme is these are anything but normal times. Many of these conversations have moved to the issue of schools starting the academic year virtually while considering whether or not to offer school sports opportunities this fall. Let me share the things that have been part of almost all conversations on this topic.
The loudest message I hear is kids are going to be playing sports this fall someplace. Period. If we believe that kids are going to take the fall off if school sports aren’t offered, we haven’t been paying much attention since May. Since that time, athletic activity has taken place in the club, travel, AAU and non-school space nearly every day. From first-hand experience, many of these events have implemented ZERO of the safety standards and protocols that businesses and schools have adopted for their plans of return. The non-school world generally has plowed ahead this summer with few-to-no rules, regulations, enforcement, oversight and accountability to anyone. If kids are going to be playing sports, our member schools are telling us that activity needs to be in the safest environment possible – which is with professional educators and trained coaches in our school sports world.
Schools are quick to point out that kids have been conditioning and training with school coaches in school-sponsored workouts most of the summer. We believe that the absence of virus outbreaks among our 749 high schools’ summer activities, involving thousands of kids, has been because schools have been following the return-to-activity plans. Districts have told us they can continue doing what they’ve been doing safely since June by following all COVID guidance and regulations we have put in place with government’s leadership and partnership.
Schools starting the year virtually are telling us they will use the lessons learned from the start of sports for when students return to campus later in the fall. School administrators have shared this view privately as this has become a highly-charged topic among various groups within our school communities. Sports allow schools to bring students back to campus in small, consistent and defined groups with the same adults working with those students each day. In school sports, there is little mixing of students from one sport with those students in another – making it much easier to monitor, track and trace kids when needed than if all students were in the buildings, hallways and classrooms all day. We hear from administrators that valuable lessons can be learned with athletics in August and September for a successful school start-up with students back on campus in October.
All of us share the fundamental belief that we must protect the health and safety of individuals first. This doesn’t include only COVID prevention measures, but also the mental health of teenage students and adults as well. In districts that are starting the school year online, they see athletics being the one shred of normalcy students, and staff members who choose to coach, will have during the fall. It’s a chance to safely interact with peers and get needed physical activity that hasn’t been happening for some kids since March. Health and safety has to include all facets of the individual, and more research is being shared each day about how mental health is becoming a critical issue. For many at-risk kids, sports is the one motivating factor to keep them in school and progressing toward graduation. Given the challenges of all online education for these at-risk kids, sports and the daily routine they bring perhaps would be more important for this group of students than ever before.
With no school sports, the affluent communities and families can navigate online learning during the day and then afford the non-school athletic opportunities that kids and families in less-affluent areas simply cannot. In many communities, school sports can provide opportunities and open doors that would not appear if kids become priced-out from participating and competing.
The past five months have been the most abnormal in a century. School sports being the one pathway back to school for students in our state – the one norm for this fall – run by professional educators who put kids first, would be an incredible boost to the physical and mental health of all of us. We believe that school sports can be done safely and smartly, and the MHSAA has developed plans that do just that. While the optics of sports taking place while waiting for in-person education is not what any of us prefer, we believe we must react to these abnormal times by thinking differently and looking at these unique times through a unique lens.
Trying to find one normal for our kids in these abnormal school days might just be the best thing we can do.