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.
Fall Athletes: Prepare for Hot Weather
July 26, 2018
By Geoff Kimmerly
Second Half editor
As summer activities wind down with an eye toward the beginning of fall sports next month, the MHSAA advises that student-athletes need to prepare for training in the hot weather that traditionally accompanies the beginning of August and the first practices of the school year.
Each year, the MHSAA provides information to its member schools to help them prepare for hot weather practice and game conditions during the late summer and early fall. Football practice can begin at MHSAA schools August 6, followed by first practices for all other fall sports August 8.
The topic of heat-related injuries receives a lot of attention at this time of year, especially when deaths at the professional, collegiate and interscholastic levels of sport occur, and especially since they are preventable in most cases with the proper precautions.
“This month’s high temperatures across much of Michigan served as a reminder that we all must take a role in making sure our student-athletes are ready for hot weather as practices get underway,” said John E. “Jack” Roberts, executive director of the MHSAA. “At the start of every fall, we point out that with proper precautions and planning, heat illness is almost always preventable. It is imperative that we continue to emphasize this message and teach the best practices for staying safe both to our returning student-athletes and those taking part for the first time.”
Heat, hydration and acclimatization continue to be focuses of the MHSAA’s required preseason rules meetings for coaches and officials. The online presentations discuss the need for good hydration in sports, regardless of the activity or time of year, and informs both how to recognize the early signs of heat illness and the immediate steps to take to respond to those symptoms. The MHSAA requires all head varsity, varsity assistant and subvarsity coaches at the high school level to complete the rules and risk minimization meeting requirement.
The first days of formal practices in hot weather should be more for heat acclimatization than the conditioning of athletes, and practices in such conditions need planning to become longer and more strenuous over a gradual progression of time. Schools also must consider moving practices to different locations or different times of day, or change practice plans to include different activities depending on the conditions. Furthermore, football practice rules allow for only helmets to be worn during the first two days, only shoulder pads to be added on the third and fourth days, and full pads to not be worn until the fifth day of team practice.
Roberts also emphasized that student-athletes should make sure to hydrate all day long – beginning before practice, continuing during and also after practice is done. Water and properly-formulated sports drinks are the best choices for hydration, while energy drinks, high-carbohydrate fruit juices (greater than eight percent carb content), carbonated and caffeinated beverages are among those that should be avoided. The “Health & Safety” page of the MHSAA Website has a number of links to various publications and information including recommendations on proper hydration from the National Federation of State High School Associations (NFHS).
A number of member schools follow the MHSAA’s Model Policy for Managing Heat & Humidity, which while not mandated for member schools was adopted as a rule for MHSAA postseason competition in 2013. The plan directs schools to begin monitoring the heat index at the activity site once the air temperature reaches 80 degrees, and provides recommendations when the heat index reaches certain points, including ceasing activities when it rises above 104 degrees. (When the temperature is below 80 degrees, there is no combination of heat and humidity that will result in a need to curtail activity.)
The model heat & humidity policy is outlined in a number of places on the MHSAA Website, including as part of the publication Heat Ways, also available for download from the “Health & Safety” page.