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 Wrap-Up: Winter 2016
March 31, 2016
By Geoff Kimmerly
Second Half editor
An increased effort to ensure student-athletes and their parents or guardians receive concussion education information was among topics that generated the most attention from the Representative Council of the Michigan High School Athletic Association during its annual Winter Meeting on March 24 in East Lansing.
Most of the Council’s discussion pointed toward possible actions at its Spring Meeting in May, with possible additions to the MHSAA Physical Exam/Clearance/Consent forms among those that may be voted upon when the Council reconvenes. The Council did take a first step, approving a requirement at its Winter Meeting mandating all students and their parent/guardian to sign a post-concussion consent form signifying they have received information on potential risks prior to returning to activity following a concussion.
Continuing its emphasis on the importance of collecting in-depth student-athlete health histories, the Council approved PRIVIT on a two-year trial basis as an electronic-based health history record-keeping tool to serve as an alternative to written communications and forms that accompany pre-participation physical examination of athletes.
The Council also discussed for possible action in May standardizing MHSAA rules/risk management meeting content for assistant and subvarsity coaches and increasing the frequency of in-depth concussion information within those meetings while still giving adequate attention to a variety of other important health and safety topics, including heat illness, sudden cardiac arrest and overuse injuries.
In other ongoing business, the Council reviewed necessary modifications to the MHSAA Membership Resolution and Handbook in advance of a change to the MHSAA Constitution that will permit schools to join the MHSAA at the 6th-grade level beginning in 2016-17. The amendment will allow schools which join the MHSAA at the 6th-grade level to let 6th-graders participate with MHSAA services and support and with and against 7th- and 8th-graders without MHSAA Executive Committee approval. It allows all districts, but requires no districts, to provide athletic opportunities for 6th-graders under the auspices of the MHSAA, either on separate teams or with 7th-and 8th-graders.
The Council considered one sport matter, in track & field, voting to begin this 2016 season to eliminate one preliminary round of the boys 110-meter hurdles, girls 100-meter hurdles and boys and girls 100 and 200-meter dashes at all Lower Peninsula Regionals that use fully automatic time (FAT) to determine race results. The Council also voted to require all Lower Peninsula Regional sites to use FAT beginning in 2017. Both actions were recommended by the MHSAA Cross Country/Track & Field Committee.
The Council also approved an Officials Review Committee recommendation to require all new officials to complete the National Federation of State High School Associations (NFHS) online course “Interscholastic Officiating” in addition to current requirements to complete the MHSAA Officials Guidebook exam and mechanics exams for new officials seeking to work football and basketball games.
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 1,400 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.