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: Fall 2015
December 14, 2015
By Geoff Kimmerly
Second Half editor
Results of recent changes to health and safety policies and possibilities for future work to help keep school sports safe were main topics of discussion by the Representative Council of the Michigan High School Athletic Association during its annual Fall Meeting on Dec. 4 in East Lansing.
Generally, Council takes only a few actions during its Fall Meeting, with topics often introduced for additional consideration and actions during its meetings in winter and spring. The Council heard reports on a number of subjects, chiefly the “4 H’s” of health and safety – Health Histories, Heads, Heat and Hearts – and the MHSAA’s recent work on these topics.
Among data most noteworthy, it was reported that 747 of 750 member high schools complied with the first-time requirement this fall that all head coaches have a valid certification in CPR. Eighty percent of high schools arranged in-person CPR training for all of their high school varsity head coaches, and two-thirds of high schools included assistant and subvarsity coaches in school-arranged in-person training.
The Council reviewed the preliminary concussion care data released to the public Dec. 9, recent actions by U.S. Soccer to reduce heading in youth soccer, discussion in the girls lacrosse community regarding head protection and actions taken by other states and the National Federation of State High School Association regarding football practice policies and their similarities to changes adopted for MHSAA schools prior to the 2014 season. Council members also examined results from this fall’s Update Meeting opinion poll, including questions related to the possibility of using electronic forms to track students’ health histories and the possibility of practice limitations for all sports similar to those adopted for football.
As a result of the recent amendment of the MHSAA Constitution allowing for membership at the 6th-grade level, a number of potential changes to the MHSAA Handbook necessitated by the amendment were presented to the Council, as was a draft of an updated 2016-17 Membership Resolution. Both are expected to be voted on at the March meeting.
The Council also received reports on athletic-motivated and athletic-related transfers, reviewed an updated list of Approved International Student Programs for 2015-16 and discussed concerns regarding the exception to the Transfer Regulation for residential students of boarding schools.
Changes to out-of-season coaching rules were among the most significant efforts taken up by MHSAA staff over the last year, and Council members shared their observations of the impacts of changes including the rule change that allows a school coach to work with up to four athletes at one time instead of the previous three. The Council discussed if the MHSAA should consider a policy requiring in all sports athletes to participate in a minimum number of contests against school teams to be eligible for MHSAA tournaments, but declined to take action on the topic beyond policies already in place for skiing, ice hockey and soccer. Council members also were presented with examples of calendars for a balanced school year and possible movement of standardized testing dates, which both have the potential to affect the school sports calendar in the future.
The Council voted on one matter concerning MHSAA tournaments, approving a recommendation by the Girls Lacrosse Committee to not accept the new overtime rule of U.S. Women’s Lacrosse that grants in tournament play sudden victory to the first team that scores. The MHSAA will retain its current overtime procedure for tournament games, which calls for two full 3-minute halves of stop-clock overtime – and, if the game remains tied after those first two halves – additional 3-minute overtime periods with sudden victory.
The Fall Meeting also saw the addition of Courtney Hawkins, athletic director at Flint Beecher High School, to the 19-person Council. He was appointed to a two-year term and also serves as his school’s varsity football coach. He fills the position formerly held by Maureen Klocke, athletic director at Yale High School, whose term ended. Also, Cheri Meier, principal at Ionia Middle School, was re-appointed for a second two-year term.
The Council re-elected Scott Grimes, assistant superintendent of human services for Grand Haven Area Public Schools, as its president; Benton Harbor athletic director Fred Smith was re-elected vice president and Vic Michaels, director of physical education and athletics for the Archdiocese of Detroit, was re-elected secretary-treasurer.
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.