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.
New Rules, Reminders Promote Safety
August 6, 2015
By Geoff Kimmerly
Second Half editor
The first practices of the 2015-16 school year next week provide a valuable opportunity for reminders on the importance of athletes remaining refreshed during the hottest days of training – and also an opportunity to explain new Michigan High School Athletic Association rules in football aimed at further promoting safety during competition.
The first practices begin next week for approximately 110,000 student-athletes taking part in eight sports in which the MHSAA sponsors postseason tournaments. Football practice for more than 40,000 players can begin at MHSAA schools Monday, Aug. 10, followed by first practices for all other fall sports Aug. 12.
Each year, the MHSAA provides information to its member schools to help them prepare for hot weather practice and game conditions in the late summer and early fall. Those resources – including the MHSAA’s Model Policy for Managing Heat & Humidity– are available on the revamped MHSAA.com Health & Safety web page.
This also will be the second season for football practice changes made last fall to promote heat acclimatization and limit helmet-to-helmet contact. And earlier this week, 70 MHSAA high schools from across Michigan received training to take part in one of two sideline concussion testing pilot programs expected to benefit 20,000 student-athletes over multiple sports.
“There’s been a lot of attention focused on football regarding head safety, but the fact is all school sports need attention to the safety of student-athletes,” MHSAA Executive Director John E. “Jack” Roberts said. “We’re addressing all sports at all levels, practice and competition, to make sure our staff, who are interacting with the young people, know the best practices for safety in school sports. And we’re trying to communicate to the public that school sports really are safer than ever.”
The final weeks of July were another reminder of the importance of adjusting to hot weather as practices begin. The MHSAA Representative Council adopted in 2013 the Model Policy for Managing Heat & Humidity that, while not mandated for member schools, has been adopted by many at the local level. 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.
The model policy is outlined in a number of places, including the publication Heat Ways, which is available for download from the MHSAA Website. Roberts reminded that the first days of formal practices in hot weather should be more for heat acclimatization than the conditioning of athletes, and that practices in such conditions need planning to become longer and more strenuous over a gradual progression of time. He added schools also must consider moving practices to different times of day, different locations, or change practice plans to include different activities depending on the conditions.
To assist in acclimatization, the football practice rule changes of 2014 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.
Practice in football must begin on Aug. 10 for all schools wishing to begin regular-season games the weekend of Aug. 27-29. Schools must have 12 days of preseason practice at all levels before their first game, and those 12 days of practice may not occur before 16 calendar days.
Practice sessions for all other sports begin Wednesday (Aug.12). In golf and tennis, competition may commence no earlier than after three separate days of team practice, and not before seven calendar days. The first day competition may take place in golf and tennis is Aug. 19. In all other fall sports, contests can take place after seven days of practice for the team and not before nine calendar days. The first day competition may take place in cross country, tennis, soccer, swimming and diving, and volleyball is Aug. 21.
This fall, two football dates precede Labor Day, and a number of MHSAA schools will play their first varsity games on Thursday, Aug. 27. In Week 1, 123 varsity games will be played on Thursday, 176 contests will be played on Friday, and 14 games will be played on Saturday.
Continuing the focus on player safety, additional rules changes were made in football for 2015 that again focus on minimizing injury risk:
- The definition of unnecessary roughness was expanded to include excessive contact with an opponent, including a defenseless player, which incites roughness. A defenseless player can be considered one no longer involved in a play, a runner whose progress has been stopped, a player focused on receiving a kick or a receiver who has given up on an errant pass, or a player already on the ground. Unnecessary and excessive contact can include blindside blocks and players leaving their feet to contact an airborne receiver attempting to secure the ball.
- The grabbing of a quarterback’s facemask by a defensive player, if it does not including the twisting, pulling or turning of the facemask, will be ruled incidental and result in a five-yard penalty instead of a roughing-the-passer penalty and automatic first down.
- A 2014 rule change stated that the kicking team must have at least four players on each side of the kicker when ready-for-play is signaled; a change this season states four players must be lined up on each side of the kicker when the ball is kicked. That fourth player may shift after ready-for-play but before the kick to comply with this formation rule, but may not go in motion more than five yards behind the ball. If the shifting player travels more than five yards behind the ball, it is a dead-ball foul for encroachment.
A few notable changes will go into effect for other fall sports:
- In cross country, the loosening on what runners are allowed to wear during competition continued after a ban on jewelry was lifted in 2014. Runners also now may wear sunglasses, and previous restrictions have been eliminated for specific styles of head gear – ski bands, head bands, stocking caps and hoods attached to other clothing. Previously, those head gear had to meet criteria including color and size of brand logos displayed.
- In swimming and diving, the ban on wearing jewelry has been lifted. The National Federation of State High School Associations deemed the ban unnecessary because there is little risk of injury to the competitor or opponents.
The 2015 Fall campaign culminates with postseason tournaments beginning with the Upper Peninsula Girls Tennis Finals the week of Sept. 28, and wraps up with the 11-Player Football Playoff Finals on Nov. 27 and 28. Here is a complete list of fall tournament dates:
Cross Country:
U.P. Finals – Oct. 24
L.P. Regionals – Oct. 30 or 31
L.P. Finals – Nov. 7
11-Player Football:
Selection Sunday – Oct. 25
Pre-Districts – Oct. 30 or Oct. 31
District Finals – Nov. 6 or 7
Regional Finals – Nov. 13 or 14
Semifinals – Nov. 21
Finals – Nov. 27-28
8-Player Football:
Selection Sunday – Oct. 25
Regional Semifinals – Oct. 30 or Oct. 31
Regional Finals – Nov. 6 or 7
Semifinals – Nov. 14
Finals – Nov. 20 or 21
L.P. Girls Golf:
Regionals – Oct. 7 or 8 or 9 or 10
Finals – Oct. 16-17
Soccer:
Boys L.P. Districts – Oct. 19-24
Boys L.P. Regionals – Oct. 27-31
Boys L.P. Semifinals – Nov. 4
Boys L.P. Finals – Nov. 7
L.P. Girls Swimming & Diving:
Diving Regionals – Nov. 12
Swimming/Diving Finals – Nov. 20-21
Tennis:
U.P. Girls Finals – Sept. 30-Oct. 3
L.P. Boys Regionals – Oct. 8 or 9 or 10
L.P. Finals – Oct. 16-17
Girls Volleyball:
Districts – Nov. 2-4 & 5, 6 or 7
Regionals – Nov. 10 & 12
Quarterfinals – Nov. 17
Semifinals – Nov. 19-20
Finals – Nov. 21
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.