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.
Participation Again Outpaces Population
August 26, 2019
By Geoff Kimmerly
Second Half editor
For the third straight school year, Michigan in 2018-19 had the eighth-most participants in high school sports nationally according to statistics recently released by the National Federation of State High School Associations, again outpacing the state’s national ranking of 10th for total number of residents of high school age.
Michigan’s participation ranking was based on a number of 292,947, with 126,342 girls and 166,605 boys taking part in high school athletics, and included sports in which the Michigan High School Athletic Association does not conduct postseason tournaments. The totals count students once for each sport in which he or she participates, meaning students who are multiple-sport athletes are counted more than once.
The state’s girls participation ranked eighth nationally for the third straight year, while boys participation fell back to eighth, after moving up one spot to seventh during 2017-18. However, as with overall population, Michigan continued to rank 10th for both females and males ages 14-17 according to the latest U.S. Census Bureau estimates from 2018.
A total of 19 sports bested the state’s overall national participation ranking of eighth by placing seventh or higher on their respective lists. Four Michigan sports improved in national ranking during 2018-19, while the state fell in the rankings of five sports.
Perhaps the most notable improvement among Michigan sports came in boys bowling, where Michigan moved up one spot to second – its highest ranking in any of the 28 sports under MHSAA administration. Michigan previously ranked second nationally in boys bowling as recently as 2013-14 before falling to third for the last four years. Michigan’s boys tennis participation moved up one spot as well to fifth on its ranking list, while girls track & field moved up one spot to seventh and girls lacrosse moved up one spot to 13th after a one-year drop back in 2017-18.
Three of five sports that fell on participation lists still outpaced Michigan’s overall participation rank – girls volleyball fell one spot to fifth, while girls golf and girls competitive cheer both fell one spot to sixth on their respective rankings lists. Other Michigan sports that ranked eighth or higher in 2018-19 were baseball (eighth), girls basketball (sixth), boys basketball (seventh), girls bowling (fourth), girls and boys cross country (both seventh), 11 and 8-player football (sixth and seventh, respectively), boys golf (sixth), boys ice hockey (fourth), girls and boys skiing (both third), girls softball (seventh), girls tennis (third) and boys track & field (seventh).
Boys lacrosse, girls soccer and boys and girls swimming & diving participation all slotted ninth on their respective lists, holding to their 2017-18 rankings and placing still ahead of where Michigan slotted for high school-aged population. Michigan wrestling participation fell two spots to ninth nationally, but still outpaced population, and boys soccer fell one spot to 10th. Girls gymnastics participation ranked 11th nationally for the second straight year.
National participation in high school sports in 2018-19 declined for the first time in 30 years – but the total of 7,937,491 participants still ranked third highest all-time, consisting of 4,534,758 boys and 3,402,733 girls.
Girls volleyball saw the largest increase in participants nationally with 6,225 more this past year over 2017-18, followed by boys track & field (+5,257), girls soccer (+3,623) and girls lacrosse (+3,164).
Football, despite a 5.8-percent decrease from 2017-18, remained the most-played high school sport nationally with 1,006,013 participants. Boys track & field (605,354), boys basketball (540,769), girls track & field (488,267), baseball (482,740), boys soccer (459,077) and girls volleyball (452,808) all saw at least 400,000 participants, while girls basketball (399,067) and girls soccer (394,105) approached that total.
The top 10 states by participants remained the same in 2018-19. Texas and California topped the list again with 825,924 and 824,709 participants, respectively, followed by New York (369,266), Ohio (339,158), Illinois (333,838), Pennsylvania (316,429), Florida (308,173), Michigan (292,947), New Jersey (281,058) and Minnesota (240,487). Only Texas, California and Minnesota reported higher figures than the previous year.
The participation survey has been compiled in its current form by the NFHS since 1971 through numbers it receives from its 51 member state associations, including the District of Columbia. Click to see the complete 2018-19 High School Athletics Participation Survey.
The NFHS, based in Indianapolis, Indiana, is the national leadership organization for high school sports and performing arts activities. Since 1920, the NFHS has led the development of education-based interscholastic sports and performing arts activities that help students succeed in their lives. The NFHS sets direction for the future by building awareness and support, improving the participation experience, establishing consistent standards and rules for competition, and helping those who oversee high school sports and activities. The NFHS writes playing rules for 16 sports for boys and girls at the high school level. Through its 50 member state associations and the District of Columbia, the NFHS reaches more than 19,500 high schools and 12 million participants in high school activity programs, including almost 8 million in high school sports. As the recognized national authority on interscholastic activity programs, the NFHS conducts national meetings, sanctions interstate events, offers online publications and services for high school coaches and officials, sponsors professional organizations for high school coaches, officials, speech and debate coaches, and music adjudicators; serves as the national source for interscholastic coach training and serves as a national information resource of interscholastic athletics and activities.
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.