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.
MHSAA Schools' National Participation Ranking Rises, Continues to Outpace Population
By
Geoff Kimmerly
MHSAA.com senior editor
September 12, 2024
Michigan’s national ranking for participation in high school athletics improved during the 2023-24 school year, overall and also for girls and boys sports separately, and while continuing to outpace its national ranking for high school-aged population, according to the annual national participation study conducted by the National Federation of State High School Associations (NFHS).
Michigan moved back into eighth for overall participation nationally, based on a total of 289,740 participants, after ranking ninth in 2022-23. The total counts students once for each sport played, meaning students who are multiple-sport athletes are counted more than once.
Michigan improved to seventh nationally for boys (169,533) and eighth for girls (120,207) participation separately, after ranking ninth for both the previous year and despite currently ranking 10th for both high school-aged boys and girls populations according to U.S. Census Bureau estimates.
Michigan’s national rankings in eight sports for which the MHSAA sponsors postseason tournaments improved from 2022-23, with only four sports moving down on their respective lists from the previous year.
Notably, Michigan led the nation in participation in a sport for the first time in at least 14 years – boys bowling with 4,292 athletes – and also moved up to third nationally for girls bowling, girls golf and girls tennis participation. Boys golf (fourth), wrestling (seventh – girls and boys combined), girls competitive cheer (eighth) and boys lacrosse (nine) also moved up on their respective lists.
Keeping with annual trends, participation in several more MHSAA sports also continued to outpace the state’s rankings for high school-aged population.
For girls, participation in volleyball (fifth), cross country (sixth), basketball (seventh), softball (seventh), swimming & diving (eighth), track & field (eighth) and soccer (ninth) all ranked higher than their population listing of 10th nationally. Among boys sports, ice hockey (fourth), tennis (fifth), track & field (sixth), basketball (seventh), cross country (seventh), football (seventh – 11 and 8-player combined), baseball (eighth), swimming & diving (eighth) and soccer (ninth) exceeded the boys ranking of 10th for population.
Only 11 states sponsor alpine skiing, but Michigan again ranked third on both the girls and boys lists for that sport. For wrestling, boys participation moved down one spot to eighth but girls participation moved up one spot to seventh – and their totals combined ranked seventh nationally overall, also up one spot from 2022-23.
Participation nationally exceeded 8,000,000 participants for the first time, with a total of 8,062,302 an increase of 2.7 percent from 2022-23. The total includes 4,638,785 boys and 3,423,517 girls – both record highs – according to figures obtained from the 51 NFHS member state associations, which includes the District of Columbia.
Eleven-player football remained the most popular boys sport and registered an increase for the second consecutive year from 1,028,761 to 1,031,508 athletes. There also was an increase in 8-player football participation from 23,812 to 26,420.
Next on the boys list were outdoor track & field, basketball, baseball, soccer, wrestling, cross country, tennis, golf, and swimming & diving, respectively.
For girls, outdoor track & field, volleyball and soccer all registered increases and remained the top three participatory sports. Track & field increased four percent to 506,015, followed by volleyball at 479,125 and soccer with 383,895 participants. Basketball ranked fourth, followed by softball, tennis, cross country, competitive spirit, swimming & diving and lacrosse, respectively.
Texas (859,301) and California (834,103) remained atop the list of state participation. New York (341,454) remained in third, followed by Pennsylvania (336,946), Ohio (323,117), Illinois (320,603), Florida (299,398), Michigan (289,740), New Jersey (280,798) and Minnesota (224,179).
The NFHS participation survey was started in 1971 and compiled in its current form through the 2018-19 school year, resuming annually with the 2021-22 survey.
The NFHS, based in Indianapolis, 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 writes playing rules for 17 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 19,800 high schools and 12 million participants in high school activity programs, including more than eight million in high school sports.
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.