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.
On Call as Doctor, Director, Mom
By
Geoff Kimmerly
MHSAA.com senior editor
October 31, 2013
By Geoff Kimmerly
Second Half editor
Dr. Kiran Taylor is in her 10th year as a practicing psychiatrist and specializes in providing therapy to cancer patients and family members who care for them.
Taylor is the medical director of the Supportive Care Medicine Clinic at Spectrum Hospital’s Lemmen-Holton Cancer Pavilion in Grand Rapids. She's also the Chief of Psychiatry and Behavioral Medicine for the entire Spectrum Health System, which includes 11 hospitals and nearly 200 ambulatory and service sites all over the western Lower Peninsula.
And Thursday, she made sure to schedule a trip to her children’s school for the Halloween parade and costume parties.
Balancing is a daily requirement for Taylor (formerly Khanuja), an MHSAA Scholar-Athlete Award winner as an East Lansing senior in 1994. But the skills she learned as a tennis standout for the Trojans and at the University of Michigan are those she relies on still as a doctor, director and Mom.
“My high school athletic experience impacts all areas of my life,” Taylor said. “I think about the journey of those experiences and how those changed me.
“The discipline and time management skills you have to have as a scholar-athlete, to pay attention to school and pay attention to your sport, those are certainly skills I carry with me today.”
Taylor was one of 20 scholar-athletes recognized that winter by the MHSAA and 
Farm Bureau Insurance, which continues to sponsor the award program that has grown to 32 recipients. In advance of this March’s 25th celebration, Second Half is catching up with some of the hundreds who have been recognized.
Taylor advanced as far as the Lower Peninsula Class A No. 1 singles championship match during her high school tennis career, finishing runner-up at the top flight her junior season. She already had an interest at that point in health and an understanding of what went into playing at a high level, and was most interested in sports medicine and orthopedics when she began medical school, also at U-M.
But as she got a little deeper into her studies, Taylor discovered a path that seemed more in line with her personality.
‘Natural fit’
A video bio of Taylor on the Spectrum Health website includes her explaining that she chose psychiatry because it’s an area that allows her to empower patients to help themselves. In her line of work, she not only heals but aspires to help those in her care reach their potential.
“When they’re helping themselves, they’re helping others, they’re helping their communities,” Taylor said, “and the impact is endless.”
While at U-M, Taylor found a mentor in Dr. Michelle Riba, the director of the PsychOncology program at U-M’s Comprehensive Cancer Center. Her work, like Taylor’s at Spectrum, centers on treating patients in their dealing with the emotional issues that come with cancer diagnosis and treatment.
Taylor’s role as chief of psychiatry and behavioral medicine for the entire Spectrum system allows her to affect a patient’s entire care by making more accessible treatment for emotional and well as physical needs.
There are days she comes home after working with a patient facing especially somber circumstances, and through her medical training has learned how to keep those sad situations from affecting her personally.
But there also are days when she’s had to deal with a difficult managerial situation, and during those times she taps into the skills she learned while on the court.
"You manage adversity on a tennis court. It could be a tight match, or you're up 5-0 or down 5-0," Taylor said. "It's a microcosm of the world.
"If I have a challenging colleague or someone with a different opinion in a meeting, I tap into knowing how to deal with adversity."
Pass it on
Taylor, 37, remains tied to a few from her Scholar-Athlete Awards class. She has known Okemos winner Andy Dhaliwal since childhood and he is now a doctor too, having also graduated from U-M. Jackson winner Harland Holman is a family physician in Grand Rapids and also part of the Spectrum Health system, and knew Taylor's husband through wrestling.
Karin is married to Dr. Joe Taylor, quite a former scholar-athlete himself – he was a standout wrestler at Charlotte before graduating in 1995 and going on to study at U-M.
Thanks at least in part to their parents’ inclination toward sports, the Taylor kids are beginning to try some out. The oldest is 9, the same age as when Kiran first picked up a tennis racket.
For this, Taylor also is prepared thanks to her high school and college careers. Considered together, they give her a long perspective when it comes to kids and sports.
“(It’s about) letting them figure out what they’re interested in, letting them explore. They want to pay attention to things or don’t; watching them unfold was fun,” Taylor said. “It’s about understanding the road, and that’s what high school athletics did, and going on into college athletics. They helped me understand it’s a long road. You don’t have to start your kid at 4 and have the best at 7.”
And it's a road she advises this year's Scholar-Athletes to appreciate now as they pick up knowledge they'll use for a lifetime.
“The lessons they’re learning now, and how they conduct themselves – being a scholar-athlete, I think, is about the way you conduct yourself – those are the skills they will take with them no matter what they do at any point in life,” Taylor said. “That’s what being a scholar-athlete has done for me.”
Click to read the series' first installment:
25 Years Later, Scholar Athletes Shine On
PHOTO: (Top) Kiran Khanuja returns a volley during a tennis match while at East Lansing High School. (Bottom) The MHSAA Scholar-Athlete Award class of 1993-94 included Khanuja, seated fourth from left.
