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.

MHSAA Survey Shows More Than 44 Percent of Athletes Play Multiple Sports

By Geoff Kimmerly
MHSAA.com senior editor

August 17, 2022

More than 44 percent of athletes at Michigan High School Athletic Association member high schools participated in more than one sport during the 2021-22 school year, according to the Multi-Sport Participation Survey conducted this spring, the fourth such survey conducted by the MHSAA over the last five years to monitor the rate of specialization in school sports.

Early and intense sport specialization has become one of the most serious issues related to health and safety at all levels of youth sports, as overuse injuries and burnout among athletes have been tied to chronic injuries and health-related problems later in life. In early 2016, the MHSAA appointed a Task Force on Multi-Sport Participation as part of a continued effort to promote and protect participant health and address the issues leading to early sport specialization. The annual Multi-Sport Participation Survey, first conducted for the 2017-18 school year, was among results of the task force’s work. (No survey was conducted for 2019-20 as spring sports were canceled due to COVID-19.)

The MHSAA 2021-22 Multi-Sport Participation Survey received responses from 85 percent of member high schools, the highest response rate of the four years the survey has been conducted. Survey results showed a slightly lower percentage of member high school students participating in athletics compared to the inaugural survey in 2017-18 – but a higher percentage of multi-sport athletes among those playing at least one sport.

For 2021-22, schools responding to the survey showed 40.4 percent of their students participated in athletics during the last school year – 43.5 percent of boys and 37 percent of girls. Class D schools enjoyed the highest percentage of athletes among the entire student body, at 51.8 percent, followed by Class C (47.8), Class B (41.3) and Class A (37.7).

Those percentages – total and by Class – all were slightly lower than what was produced by the 2017-18 survey, which saw 42.5 percent of students total participating in athletics. However, the percentage of athletes competing in multiple sports in 2021-22 was higher than in 2017-18, 44.3 percent to 42.8 percent.

For 2021-22, 46.5 percent of male athletes and 41.4 percent of female athletes played multiple sports. Class D again enjoyed the highest percentage of multi-sport athletes among this group, at 60.8 percent, followed by Class C (58.5), Class B (49.5) and Class A (36.7).

Similar results for overall sport participation and multi-sport participation relative to enrollment size were seen by further breaking down Class A into schools of fewer than 1,000 students, 1,000-1,500 students, 1,501-2,000 students and more than 2,000 students. For both sport participation as a whole and multi-sport participation specifically, the smallest Class A schools enjoyed the highest percentages, while percentages then decreased for every larger size group of schools. This has remained consistent over the last five years.

“The multi-sport participation survey again shows that student-athletes across the state continue to focus on participation in several sports and the benefits that come with that participation for their school teams. What the numbers don’t show is the behind-the-scenes benefits of multi-sport participation,” said MHSAA assistant director Cody Inglis, who has served as coordinator of the multi-sport task force. “So many student-athletes see great success on and off the field with their teams, teammates, friends and peers while also developing the lifelong lessons that sports done right provide. We continue to believe and know that student-athletes who are involved in multiple sports are more successful, benefit from the variety of sports and see huge long-term benefits.”

The MHSAA Task Force on Multi-Sport Participation also recommended measuring multi-sport participation in MHSAA member schools to recognize “achievers” – that is, schools that surpass the norm given their enrollment and other factors that affect school sports participation.

In Class A, Bay City Central (78.7) and Livonia Franklin (77.7) posted the highest percentages of multi-sport athletes in 2021-22, with Clinton Township Chippewa Valley (75.6) and Parma Western (75.4) also reaching 75 percent. In Class B, four schools achieved at least 80 percent multi-sport participation – Brooklyn Columbia Central (85.8), Detroit Southeastern (84.6), Warren Michigan Collegiate (84) and Durand (82.6).

Class C saw five schools with more than 80 percent of its athletes taking part in more than one sport: Brown City (95.7), Decatur (87.4), Niles Brandywine (85.6), Ishpeming Westwood (83.2) and Flint Beecher (80.4). Five Class D schools responded at higher than 90 percent multi-sport participation, with Coldwater Pansophia Academy and Kinross Maplewood Baptist both reporting 100 percent of their athletes played multiple sports. McBain Northern Michigan Christian (98.6), Ewen-Trout Creek (94.3) and Detroit Douglass (91.7) were the next highest on the Class D list.

A total of 10 schools have appeared among the top 10 percent in their respective classes for multi-sport participation three of the four years of the survey: Battle Creek Harper Creek, Detroit Cody, Gibraltar Carlson, Grand Rapids Northview, Hamtramck, New Baltimore Anchor Bay, Ovid-Elise, Warren Lincoln, Athens and Maplewood Baptist.

The full summary report on the Multi-Sport Participation Survey is available on the Multi-Sports Benefits page of the MHSAA Website.