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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: Spring 2012

June 28, 2012

In addition to authorizing a vote of its membership to allow for waiver of its maximum age rule under certain circumstances, the Representative Council of the Michigan High School Athletic Association also approved a variety of regulations and sports activities policies during its annual Spring Meeting, May 6-7, in Gaylord.

 

The Spring meeting of the 19-member legislative body of the Association’s over 1,500 member schools is generally the busiest of its three sessions each year.  The Council considered 33 committee proposals and also dealt with a variety of eligibility rule, post-season tournament and operational issues.

 

A couple of the most visible changes will take place in ice hockey beginning with the 2012-13 school year, which will see longer games in the MHSAA post-season tournament and the addition of a regular-season contest. Tournament games will now have 17 minute periods, something which had been allowed by local adoption for regular season games previously.  The regular season game limit was also raised, as the Representative Council approved a Hockey Committee recommendation to reduce the number of scrimmages to one in exchange for the addition of a 25th contest.

Here is a summary of other actions taken at the Spring Representative Council Meeting which will take effect during the 2012-13 school year:

Handbook/Administrative Matters 

  • By prior mutual consent of competing teams, schools may agree to vary the color of game uniforms to commemorate events or causes important to those schools, provided all other uniform specifications are followed.  The wearing of pink and camouflage uniforms, for example, to show support for breast cancer awareness or members of our armed forces wounded in action, among others, have become popular; but previously required advanced approval from the MHSAA.
  • The Council approved a revision of the sections of the MHSAA Handbook addressing the sanctioning of meets conducted by non-school organizations or individuals and large interstate meets.  They now reflect the requirements of the National Federation of State High School Associations, as well as previously unstated policies and procedures of the MHSAA.
  • In junior high/middle school matters, the Council revised the Handbook so that schools may decide to allow student-athletes in the 7th and 8th grades to be members of an interscholastic team in more than one sport at the same time; and to allow a student who will exceed the maximum age limit as a 7th or 8th grader to apply for “Eligibility Advancement” while in 6th grade to begin a maximum of two years of junior high/middle school participation.

Sports Matters

  • Responding to situations where celebrations by student-athletes and spectators have resulted in property damage at MHSAA post-season tournaments, the Council approved the following language for inclusion in participating team and tournament managers materials addressing team and spectator conduct.
  • During contests, officials will penalize under applicable sportsmanship or playing rules those student-athletes or coaches who leave the field of play and contact or approach spectator areas for celebration.
  • Each tournament manager or the MHSAA Staff may determine an acceptable number of crowd supervisors necessary for each school, dependent on the situation, including inappropriate celebrations and other crowd control issues.
  • The cost for repair of replacement to facilities damaged as a result of participant and/or spectator conduct shall be paid by the school involved directly to the host facility within 30 days of the bill being submitted to the school.  MHSAA reimbursement or revenue sharing will be withheld until paid by the offending school.  Future tournament hosting privileges or school reimbursements to offending schools may be withheld if payment is not made.
  • In Golf, the Council approved a committee recommendation to allow coaching contact for one designated coach during MHSAA tournament competition on all areas of the course, except when players reach the green.  The school designated coach must be identified and approved by the school prior to the MHSAA tournament.  Coaching privileges may not be transferred to persons not approved and designated by school administration.    A committee recommendation to exempt one qualifying round of the Michigan Amateur Tournament from the limited team membership rule beginning in 2013, replacing the exemption approved in 2010 for the two U.S. Open qualifying stages, was adopted.
  • In Boys Lacrosse, a committee recommendation to limit entry in the MHSAA post-season tournament beginning in 2013 to those schools that play no fewer than 50 percent of their regular season schedule against other MHSAA member school teams was approved.
  • In Soccer, the Council did not adopt a National Federation rule adoption that eliminates a substitution for a player who receives a second yellow card.  This action affects the 2012-13 school year only during which the Soccer Committee will consider this rule change further and its impact on Michigan’s ten-minute sit-out rule following a yellow card. 
  • A second day of weigh-ins will take place at the MHSAA Team Wrestling Finals, which will be independent of the previous day’s weigh-in, and all competitors would be given a one-pound growth allowance for consecutive days of weigh-in.  The Council also approved a Wrestling Committee recommendation to permit wrestling practice to begin two Mondays before Thanksgiving.  The first day of competition does not change.

The Council also reviewed reports on membership, with 763 senior high schools and 768 junior high/middle schools in 2011-12; eligibility advancement applications, which totaled nine for the year; the use of Educational Transfer Forms, which was stable this year; school violations, which declined significantly; attendance at athletic director and coaches in-service workshops; officials’ registrations, topping the 12,000 mark again; rules meeting attendance; and officials reports submitted for the past three sports seasons.  The Association’s $9.8 million budget for the 2012-13 school year was also approved.

The Representative Council is the 19-member 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.