To Specialize or Not to Specialize

By Tim Koba, ATC

Undoubtedly, everyone has heard of the 10,000 rule that stipulates in order to reach expert status, 10 years or 10,000 hours of deliberate practice are required.  This study was initially looking at elite musicians and their non-elite counterparts. It was then transferred to other fields, including athletics.  This has, in part, contributed to the growth of single sport athletes and the clubs, coaches, centers and equipment suppliers that support the sport.  Unfortunately, early specialization does not guarantee long term athletic success, and may potentially limit it.

Whenever a new level of sport is undertaken, fewer athletes participate.  The large number of youth athletes fizzle out in high school, college and beyond.  For those who do move on, they tend to play more than one sport in high school with extra work put into their main sport.  They still require the deliberate practice required to excel, but not at the large commitment that has been suggested.  There is also concern that early sport specialization can lead to injury, burnout and other negative consequences, although sufficient data is still required to fully understand the relationship.

The information that we do have can help us to have honest conversations with athletes, coaches and parents when they ask our opinion on playing one sport or multiple sports.  One study looked at athletes who were in a single sport versus multiple sports and the injuries in the two groups.  The athletes who played a single sport, spending more hours per week in that sport, had greater risks for overuse injury.  This total volume of repetitive activity is related to injury risk across many sports.

Female athletes who play a single sport have increased incidence of anterior knee pain than those who play multiple sports.  A lot of research has gone into youth baseball players and elbow injuries. We know that the risk factors for developing elbow pain are throwing too many pitches in a day, throwing curve balls at a young age and throwing more months out of the year.  This understanding has helped lead to recommendations regarding pitch counts in youth baseball, although they may not be strictly adhered to.  Gymnasts are more likely to have wrist and lumbar overuse injuries, while specialized hockey and soccer players suffer from hip pain and the development of impingement.

These injuries are predictable based on the sport.  The understanding of when those injuries occur in relation to how often an athlete plays the sport is unknown.  Theoretically, participating in many sports or a neuromuscular training program can limit the repetitive motion of an individual sport and improve movement quality that can lead to fewer injuries.  The constant stress, physical and psychological, of intense sport training can lead some athletes to over-train or even burn out from their sport.  In order to adapt physiologically, the body needs time to adjust to a new stimulus.  Without adequate recovery periods built in, athletes may experience these, and other, negative outcomes of participation.

Right now, the best we can do is to discuss the risk of injury based on the sport and the importance of adaptation and volume control.  Sports are meant to be fun and youth athletes should be exposed to many sports for enjoyment.  Waiting longer to specialize may help delay an overuse injury, but nothing is guaranteed for playing at the next level.  The longer sports are fun, the more likely young athletes are to remain active throughout their life. That is the real victory


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