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.
43 Percent of Athletes are Multi-Sport
August 19, 2019
By Geoff Kimmerly
Second Half editor
Nearly 43 percent of athletes at MHSAA member high schools continued to participate in two or more sports in 2018-19, according to the Multi-Sport Participation Survey, reinforcing similar data collected for the first time two years ago and providing a foundation for work by the MHSAA’s Multi-Sport Task Force as it prepares to continue efforts this fall to promote the multi-sport high school experience.
Early and intense sport specialization has become one of the most serious issues related to health and safety at all levels of youth sports, as overuse injuries and burnout among athletes have been tied to chronic injuries and health-related problems later in life. In early 2016, the MHSAA appointed the Task Force on Multi-Sport Participation as part of a continued effort to promote and protect participant health and address the issues leading to early sport specialization.
The multi-sport participation survey was created in 2018 to provide data on the prevalence of sport specialization at MHSAA member high schools. This year’s survey received responses from 82.9 percent of member high schools and measured how multi-sport participation exists at schools. The collection of survey results annually is expected to show how schools are succeeding in promoting a multi-sport high school experience, providing another tool as schools work to guide students toward a well-rounded interscholastic sports career.
From schools that responded to this year’s survey, 42.9 percent of students participated in athletics in 2018-19 – 46.3 percent of boys and 39.5 percent of girls. The overall participation number was up nearly half a percent from 2017-18 (42.5), with the boys percentage holding steady and the girls increasing nearly a full percent from a year ago. Class D schools – those with the smallest enrollments – again enjoyed the highest percentage of athletes among the entire student body, at 57.1 percent, followed by Class C (50.7), Class B (45.8) and Class A (39.4).
Of those athletes counted by responding schools, 43 percent participated in more than one sport – including 45.1 percent of boys and 40.4 percent of girls – with all three of those percentages nearly identical to those derived from the first survey a year ago. Class D again enjoyed the highest percentage of multi-sport athletes, 61.8 percent, followed by Class C (56.7), Class B (48.7) and Class A (35.4).
Similar results for overall sport participation and multi-sport participation relative to enrollment size were seen by further breaking down Class A into schools of fewer than 1,000 students, 1,000-1,500 students, 1,501-2,000 students and more than 2,000 students. Similarly to 2017-18 for both sport participation as a whole and multi-sport participation specifically, the smallest Class A schools continued to enjoy the highest percentages, while percentages then decreased for every larger size group of schools.
Also of note, the percentage of two-sport athletes at every school measure around one-third of athletes – from 29.2 percent at Class A schools to 35.7 at Class B, 37.2 at Class C and 35.6 at Class D. However the number of athletes participating in three sports decreased substantially relative to the increase in school enrollment, with 22.5 percent of Class D athletes playing three sports, 18.2 in Class C, 12.4 in Class B and 6.0 percent in Class A.
The MHSAA Task Force on Multi-Sport Participation will be meeting this fall to discuss creating a program to measure multi-sport participation at MHSAA member schools and to recognize “achievers” – that is, schools that surpass the norm given their enrollment and other factors that affect school sports participation.
For 2018-19, in Class A, Marquette posted the highest percentage of multi-sport athletes with 85.9 percent, up 3.3 percent from its top-ranking Class A percentage from 2017-18. Grand Rapids Northview also topped 80 percent multi-sport participation, with 83.1 percent of its athletes playing two or more sports. Orchard Lake St. Mary’s, Detroit East English and Gibraltar Carlson all saw multi-sport participation from at least 70 percent of their athletes.
In Class B, four schools again achieved at least 80 percent multi-sport participation – Coloma (87.2 percent), Gladstone (86.7), Flat Rock (83.2) and Dundee (80.2), while 10 schools had 70 percent or more athletes playing at least two sports.
Six Class C schools reported more than 80 percent of its athletes taking part in more than one sport – Schoolcraft (87.1), Mayville (86.2), Manton (85.3), Houghton Lake (84.9), Cass City (84.7) and Decatur (83.5) – and 12 schools total with 75 percent or more athletes participating in multiple sports. There were 14 Class D schools with multi-sport participation at 80.9 percent or higher, with Gaylord St. Mary (93.2), Waterford Our Lady of the Lakes (91.5) and Watersmeet (90.3) topping the survey not just for Class D but among all schools that responded.
The full summary report on the Multi-Sport Participation Survey is available on the “Health & Safety” page of the MHSAA Website.