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.
Michigan Improves Ranking in 12 Sports as NFHS Participation Survey Returns
By
Geoff Kimmerly
MHSAA.com senior editor
January 4, 2023
Despite ranking 10th nationally in high school-aged population, Michigan ranked eighth nationally for participation in high school sports during the 2021-22 school year and moved up lists in 12 sports as the National Federation of State High School Associations (NFHS) conducted its national participation survey for the first time since 2018-19.
Michigan’s participation ranking was based on a number of 271,423, with 114,999 girls and 156,424 boys taking part in high school athletics, and included sports in which the Michigan High School Athletic Association does not conduct postseason tournaments. The totals count students once for each sport played, meaning students who are multiple-sport athletes are counted more than once.
Michigan previously also ranked both eighth overall in participation and 10th overall for high school-aged children from 2016-17 through 2018-19, the population rankings according to U.S. Census Bureau estimates from those years. The NFHS did not conduct its national participation survey during the 2019-20 and 2020-21 school years, although the MHSAA continued to collect participation data from member schools during that time.
A total of 18 sports bested the state’s overall national participation ranking of eighth in 2021-22 by placing seventh or higher on their respective lists. Twelve Michigan sports improved in national ranking from the last national survey in 2018-19, while the state fell in the rankings of five sports.
Michigan’s best showings were in boys bowling – where it continued to rank second nationally in participation – and also girls and boys alpine skiing, where Michigan also ranked second. Girls bowling participation moved up to third nationally from fourth in 2018-19, while boys ice hockey and girls tennis participation ranked fourth and boys tennis and girls and boys golf participation all ranked fifth nationally. Other Michigan sports ranking seventh or higher on the national participation lists were girls and boys basketball (both sixth), girls competitive cheer (sixth), girls (sixth) and boys cross country (seventh), football (sixth), boys track & field (sixth), girls volleyball (sixth) and wrestling (seventh).
Michigan’s participation in baseball (eighth), boys lacrosse (eighth), softball (eighth), girls track & field (eighth), girls soccer (ninth), girls and boys swimming & diving (both ninth) and boys soccer (10th) also met or exceeded the state’s national rank in high school-aged population.
Although the national total of 7,618,054 participants in 2021-22 was down four percent from the 2018-19 figure of 7,937,491, high school sports appear on the road back after schools in many states were unable to offer programs in normal fashion during portions of the 2019-20 and 2020-21 school years.
The 2021-22 total is composed of 4,376,582 boys and 3,241,472 girls, according to figures obtained from the 51 NFHS member state associations, including the District of Columbia.
Among the top 10 boys sports in participants nationally from 2018-19, golf was the only sport to register an increase during 2021-22 – up just under four percent with 148,585 participants and surpassing tennis as the eighth-most popular sport. Golf was one of the few sports to increase on both sides of the ledger as girls participation was up one percent to 80,829 participants.
Volleyball continued its rise in popularity among girls sports and was the only top-10 sport to register an increase from three years ago. With 454,153 participants, volleyball is only 2,500 participants behind track & field for the No. 1 participatory sport for girls nationally.
Texas topped the list of state participation with 846,161. Texas was one of 14 states that enjoyed a gain in participation since the 2018-19 survey. California retained the No. 2 position with 762,823 participants despite a drop of more than 60,000 from three years ago.
Other changes in the top 10 involved Ohio moving to No. 3 with 378,354 participants, followed by Pennsylvania (315,097), Illinois (314,839), New York (313,404), Florida (291,504), Michigan (271,423), New Jersey (264,139) and Massachusetts (215,848).
The participation survey has been compiled in its current form by the NFHS since 1971 through numbers it receives from its 51 member state associations, including the District of Columbia.
The NFHS, based in Indianapolis, Ind., is the national leadership organization for high school sports and performing arts activities. Since 1920, the NFHS has led the development of education-based interscholastic sports and performing arts activities that help students succeed in their lives. The NFHS sets direction for the future by building awareness and support, improving the participation experience, establishing consistent standards and rules for competition, and helping those who oversee high school sports and activities. The NFHS writes playing rules for 17 sports for boys and girls at the high school level. Through its 50 member state associations and the District of Columbia, the NFHS reaches more than 19,500 high schools and 12 million participants in high school activity programs, including more than 7.9 million in high school sports. As the recognized national authority on interscholastic activity programs, the NFHS conducts national meetings, sanctions interstate events, offers online publications and services for high school coaches and officials, sponsors professional organizations for high school coaches, officials, speech and debate coaches, and music adjudicators; offers online education courses for coaches, administrators, students, officials, performing arts educators, parents and others; and serves as a national information resource of interscholastic athletics and activities.
The MHSAA is a private, not-for-profit corporation of voluntary membership by more than 1,500 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 1.3 million spectators each year.