The effect of specialization and level of competition on injury in elite male ice hockey players

Youth Sports Specialization and Its Effect on Professional, Elite, and Olympic Athlete Performance, Career Longevity, and Injury Rates: A Systematic Review

BACKGROUND

Limited data are available on the long-term consequences of early sports specialization in high-level athletes.

PURPOSE

To evaluate the existing literature on the effects of sports specialization among professional, Olympic, and other elite athletes.

STUDY DESIGN

Systematic review; Level of evidence, 3.

METHODS

We performed a systematic review of studies from 1990 to 2021 on youth sports specialization in professional, elite, and/or Olympic athletes following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. An elite athlete was defined as one who performed at the highest level of his or her sport, beyond college level. Data were summarized according to 6 objectives: (1) definitions of specialization, age at specialization, and participation in other sports; (2) motivation for specialization; (3) athlete perspectives on specialization; (4) performance data; (5) specialization and injury risk; and (6) career longevity.

RESULTS

From 8756 articles, 29 studies were included, of which 17 (58.6%) were survey-based studies. Of the 8 articles that commented on injury risk, all demonstrated reduction in injury risk in athletes who delayed specialization. Performance benefits were apparent with later specialization in 7 of 9 articles; the remaining 2 showed benefit with earlier specialization in marathon runners and soccer players. There were less definitive results on career longevity, with 5 of 9 articles finding no association between career longevity and sports specialization.

CONCLUSION

Although current data on sports specialization in elite, professional, and Olympic athletes are mostly retrospective and survey-based evidence, most sports demonstrate better performance after youth multisport engagement, and youth sports specialization was linked with increased injury risk in athletes at the highest levels of competition.

Revisiting Early Sport Specialization: What's the Problem?

Context:

The assumed risks of early specialization in sport are well known, with several international consensus statements advising against specialization in early athlete development. However, there have been recent calls for more focused research in this area.

Evidence Acquisition:

Research evidence from several scientific disciplines (eg, sport psychology, sports medicine, human development) were synthesized to develop a framework for practitioners working with adolescent athletes.

Study Design:

Narrative review.

Level of Evidence:

Level 4.

Results:

There appear to be risks associated with a highly specialized approach to athlete training, but the mechanisms driving these effects are largely unknown. Greater attention to understanding these mechanisms would help mitigate risk and develop stronger policy for athlete development. Recommendations for program modifications are provided.

Conclusion:

Early specialization remains an important topic for researchers and practitioners working with youth and adolescent athletes. However, more work needs to be done to provide truly evidence-based recommendations for youth athlete training.