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.
Rep Council Approves Phased-In Fall
July 29, 2020
By Geoff Kimmerly
Second Half editor
The Representative Council of the Michigan High School Athletic Association today approved the next steps in returning sports for member schools, adopting a plan to phase in competition for Fall sports in hopes of continuing to deter the spread of COVID-19.
The Council affirmed that lower-risk sports – cross country, Lower Peninsula girls golf, Lower Peninsula boys tennis and Upper Peninsula girls tennis, and Lower Peninsula girls swimming & diving – may begin practice on Aug. 12 and begin competition on their traditional start dates of Aug. 19 and 21.
However, moderate and high-risk sports – football, girls volleyball and boys soccer – may begin practice but not competition. Decisions about competition timelines for these three sports will be made by Aug. 20.
Practice for boys soccer and girls volleyball may begin on Aug. 12. Football will delay the start of practice with full player pads and equipment until Monday, Aug. 17. The week of Aug. 10 may include football practice sessions consisting of conditioning, physical training and skill work with no other player equipment except helmets. This week of acclimatization is similar to allowed summer football activities that have been ongoing for schools since June.
The Council – the MHSAA’s 19-member legislative body – also voted to cancel scrimmages in all Fall sports for this school year and approved limitations on numbers of teams that may compete together at regular-season tournaments, invitationals and other multi-team events. The Council believed eliminating scrimmages emphasized the importance of keeping teams from mixing before the first date of competition, and the regular-season limitations may lessen opportunities for viral spread while still allowing meets to be conducted.
As this remains a fluid situation, the MHSAA would release updated timelines for competition for football, girls volleyball and boys soccer by Aug. 20 dependent on how the spread of the virus is trending statewide. Plans remain reliant on sustained metrics measuring virus spread and/or progression by schools and regions across the state according to Governor Gretchen Whitmer’s MI Safe Start Plan. Currently two regions are in Phase 5, which allow for limited indoor activity, while the rest are in Phase 4 and unable to host indoor training, practice or competition.
The start of volleyball and swimming & diving practices are in part contingent on the reopening of indoor facilities. Those sports may begin their practices outdoors if not allowed to be indoors by Aug. 12.
“The Council, reflecting on the positive impact on their athletes this summer from taking part in offseason training, feels it’s of utmost importance to continue athletic activity moving forward,” MHSAA Executive Director Mark Uyl said. “If we take a month off, our students will find opportunities to compete through non-school entities that may not be as focused on safety. Our athletic directors and coaches can provide the safest-possible environment to return to sports, and this phased-in approach to competition will help schools continue building on progress already made.
“The Council chose to make these adjustments to help ensure our athletes have a safe regular season this fall. As we continue to solidify the regular season, we can then turn our attention to building a safe postseason for our athletes.”
The MHSAA also has posted sport-by-sport guidance documents outlining increased precautions designed to limit the viral spread, plus a four-page overview with precautions that apply generally for all sports and include coverage of the following topics:
- Protocol for reporting COVID-19 infections.
- Guidance on face coverings. Athletes participating on the field/court are not required to wear face coverings, but are allowed to do so. However, bench personnel must wear face coverings at all times.
- Transportation, use of locker rooms and facility cleaning.
Specific sport guidelines and the overview are available on the respective sport pages of the MHSAA Website. Recommendations on spectator attendance will follow before the start of competition; spectators will be limited in accordance with Governor Whitmer’s executive orders on large gatherings.
The Council on July 17 approved a return-to-activity plan for the 2020-21 school year retaining the traditional calendar of Fall, Winter and Spring sports, but allowing for the possibility that Fall sports forced to halt activity during the next four months may conclude later in the school year.
“The easy way out would be to postpone all activity to next spring, and we are not taking the easy way out. But we will make wise decisions based on medical guidance,” Uyl said. “We will make these difficult decisions quickly and appropriately. If we don’t play this fall, it won’t be because we didn’t make every effort to do so.”
The Representative Council is the legislative body of the MHSAA. All but five members are elected by member schools. Four members are appointed by the Council to facilitate representation of females and minorities, and the 19th position is occupied by the Superintendent of Public Instruction or designee.
The MHSAA is a private, not-for-profit corporation of voluntary membership by more than 1,500 public and private senior high schools and junior high/middle schools which exists to develop common rules for athletic eligibility and competition. No government funds or tax dollars support the MHSAA, which was the first such association nationally to not accept membership dues or tournament entry fees from schools. Member schools which enforce these rules are permitted to participate in MHSAA tournaments, which attract more than 1.4 million spectators each year.