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Wilk KE, Thomas ZM, Mangine RE, Fuller P, Davies GJ. Neurocognitive and Reactive Return to Play Testing Protocol in Overhead Athletes Following Upper Extremity Injury. Int J Sports Phys Ther 2023; 18:1364-1375. [PMID: 38050554 PMCID: PMC10693490 DOI: 10.26603/001c.89926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/07/2023] [Indexed: 12/06/2023] Open
Abstract
The incidence of upper extremity (UE) injuries in sport, particularly with the shoulder and elbow in baseball/softball players, appears to be increasing yearly, especially in younger age athletes. Improving the objective criteria and testing methods used to determine return to play (RTP) readiness following non-operative or post-operative management of UE injuries is one aspect of the rehabilitation process that may significantly help in reducing reinjury rates. Currently, the majority of clinicians are still using post operative time frame and/or strength/range of motion as their main criteria for clearance to RTP following UE injury. This demonstrates an inadequate reflection of the actual unpredictable, dynamic environment athletes are returning to participate in. In our clinical experiences, objective testing to allow for clearance to sport participation should incorporate neurocognitive and reactive testing to promote improvements in the athlete's ability to dual task and focus/concentrate on the multi-dimensional tasks at hand. We know that neuroplastic changes occur following UE injury resulting in decreased proprioception and increased motor activation with simple UE tasks. Currently the research on UE return to play testing is limited. The purpose of this clinical commentary was to describe the utilization and provide reference values for a series of reactive neurocognitive UE tests, to assist with RTP, in high school and collegiate overhead athletes (baseball and softball) utilizing the Blaze Pod light system. The use of a more dynamic reactive testing battery may decrease the reinjury rates when an athlete is cleared for participation by measuring readiness in chaotic circumstances that are more reflective of the sporting environment the athlete is working to return to resulting in a greater sense of confidence, performance and prevention of reinjuries.
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Affiliation(s)
- Kevin E Wilk
- Champion Sports Medicine
- American Sports Medicine Institute
| | | | | | | | - George J Davies
- Georgia Southern University
- Coastal Therapy & Sports Rehab
- Gundersen Health System Sports Medicine
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2
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Garland WJ, Smith KL, Dixon JC, Horton S. Developmental activities of elite junior hockey players: an analysis of early sport specialization. Front Sports Act Living 2023; 5:1253007. [PMID: 38022788 PMCID: PMC10644152 DOI: 10.3389/fspor.2023.1253007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Early sport specialization is a popular and contentious topic in the scientific literature and popular media. The lure of extrinsic rewards has led to increasing rates of specialization among young athletes, while expert recommendations promote multisport participation. The purpose of this study was to describe and analyze developmental activities of a group of elite junior hockey players in Canada. Within this context, elements of specialization were investigated in accordance with existing theoretical frameworks and long-term athlete development models to enhance the literature. Fifteen participants from the Ontario Hockey League completed quantitative retrospective interviews, detailing past sport and recreational activities. Thirty-one developmental milestones were assessed. Accumulated hours of activity were categorized in accordance with Côté's (1999) Developmental Model of Sports Participation, along with the number and types of sports in which they participated during childhood. Jayanthi et al.'s (2015) continuum was utilized to determine the age at which the athletes became moderately and highly specialized. Accrued hours of deliberate practice reported by participants increased from ages 6 to 16 years, as did competition in organized hockey games. Reported hours of deliberate play peaked at 9 years of age and decreased thereafter. Participants played a combined 16 sports other than hockey, ranging from an average of 2.0 at age 6, to a maximum average of 5.6 at 12 years old, and decreasing each year to 2.3 by age 15. The greatest number of hours in other sports was accumulated at 12 years of age. Using a three-point scale, participants considered themselves "highly specialized" at 14 years old; however, other quantitative indicators suggested this may have occurred at 12 years of age. Relative to previous research on early sport specialization, participants in this study spent more time practicing hockey, while ceasing hockey-specific play and other sports at younger ages. Despite a diverse sport history, hockey competition was initiated earlier than recommended, showing high levels of sport commitment as young as 9 years old. The early specialization path remains a popular trajectory among coaches, parents, and athletes in Canadian ice hockey.
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Affiliation(s)
| | - K. L. Smith
- Department of Kinesiology, University of Windsor, Windsor, ON, Canada
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Larson HK, Young BW, McHugh TLF, Rodgers WM. Visual representations of single- and multi-sport participation in a youth swimming sample: Implications for definitions and discussions of early specialization. PLoS One 2023; 18:e0292038. [PMID: 37756317 PMCID: PMC10530013 DOI: 10.1371/journal.pone.0292038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/19/2023] [Indexed: 09/29/2023] Open
Abstract
Academic literature and sport policy documents have cited concerns about an increasing prevalence of early sport specialization, with associated burnout, dropout, and injury. However, evidence to support such statements is limited. Definitions of early specialization vary, but a common criterion is continued participation in a single sport, prior to adolescence. We explored the prevalence of single-sport participation and other patterns of sport involvement from ages 6-12 in a Canadian swimming sample using retrospective longitudinal methods. Parents of 236 competitive swimmers (ages 12-17) completed surveys on their children's sport backgrounds, including the number of sports participated in annually from age 6-12. A cluster heat map elucidated single- and multi-sport patterns over time. Mixed analyses of variance tested for differences by gender and club type. Fourteen percent of our sample showed stable participation in either one sport or multiple sports per year over time, 25% decreased their annual number of sports, and 60% increased. This trend of increasing, rather than decreasing the number of sports in their annual activity roster when approaching age 12 was particularly pronounced for girls. Only 10 participants (4% of the sample) consistently engaged in a single sport each year from age 6-12. Summer (seasonal) swimmers consistently did more sports than year-round swimmers. Overall, our findings showed highly idiosyncratic longitudinal patterns of sport participation that did not easily conform to current sport activity guidelines. We also found similar idiosyncrasy in an ad-hoc analysis of participants who had dropped out of swimming a year later. If single-sport participation is considered a key criterion for defining early specialization, our findings suggest the prevailing narrative around early specialization may be overstated in relation to the number of single-sport athletes. Alternatively, other components of early specialization may be more prevalent and deserving of attention due to possible associations with harmful outcomes.
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Affiliation(s)
- Heather K. Larson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Bradley W. Young
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Tara-Leigh F. McHugh
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Wendy M. Rodgers
- Faculty of Human and Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
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Ferraro SL, Batty M, Heyworth BE, Cook DL, Miller PE, Novais EN. Acute Pelvic and Hip Apophyseal Avulsion Fractures in Adolescents: A Summary of 719 Cases. J Pediatr Orthop 2023; 43:204-210. [PMID: 36727766 DOI: 10.1097/bpo.0000000000002355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Apophyseal avulsion fractures of the pelvis and hip are common injuries in adolescent athletes. However, high volume comparative studies elucidating the spectrum of injuries are largely absent from the literature. The current study provides a comprehensive analysis of demographic, anatomic, pathophysiological, clinical, and athletic-related variables associated with such injuries in an extensive population of affected adolescents. METHODS A retrospective review was performed of records of patients presenting to a single tertiary care pediatric hospital between January 1, 2005, and July 31, 2020, collecting variables including patient sex, age, body mass index, fracture location, injury mechanism, sport at the time of injury, and duration of prodromal symptoms. RESULTS Seven hundred nineteen fractures were identified in 709 patients. The average patient age was 14.6, and 78% of the fractures occurred in male patients. The anterior inferior iliac spine (33.4%), anterior superior iliac spine (30.5%), and ischial tuberosity (19.4%) were the most common fracture sites. The most common injury mechanisms were running (27.8%), kicking (26.7%), and falls (8.8%). The most common sports at the time of injury were soccer (38.1%), football (11.2%), and baseball (10.5%). Fracture site was significantly associated with patient sex, age, body mass index, laterality, mechanism, sport, time from injury, and presence of prodromal symptoms. The annual volume of pelvic avulsion fractures treated at the institution increased significantly from n=17 in 2005 to n=75 in 2019. CONCLUSIONS Adolescent pelvic and hip avulsion fractures occur during a narrow window of age and skeletal maturation and are frequently sustained during sporting activities. Each fracture location is associated with certain demographic, mechanistic, and patient-specific characteristics. The associations between fracture site and patient-specific or injury-specific variables offer insights into the pathophysiology and possible underlying biomechanical risk factors that contribute to these injuries. LEVEL OF EVIDENCE This is a level III retrospective study.
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Affiliation(s)
- Samantha L Ferraro
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA
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Nagano Y, Oyama T. Early Sport Specialization Trends and Injuries in Former High School Athletes Specialized in Sports. Open Access J Sports Med 2023; 14:1-7. [PMID: 36785718 PMCID: PMC9922066 DOI: 10.2147/oajsm.s385554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 01/05/2023] [Indexed: 02/08/2023] Open
Abstract
Purpose Determining the effects of early specialization in a specific sport is difficult. Therefore, it is necessary to investigate its effects based on the type of sports. The purpose of this study was to investigate the proportion of participants who had been participating in a single sport, in individual or team sports from an early age and to compared the prevalence of acute and overuse injuries among these participants. Methods A total of 1377 adult participants (team sports = 700, individual sports = 637) retrospectively completed a questionnaire assessing sports participation from elementary school to high school and injury history (acute and overuse) at high school age. The proportions of the specialized / nonspecialized groups per sport type were compared, and differences in acute or overuse injury prevalence were examined. Results The proportion of the specialized group participants who continued to play the same single sport from elementary school age to high school age was greater in team sports (33.6%) than that in individual sports (19.2%) (p < 0.01). The specialized group participating in team sports had a greater prevalence of overuse injury at high school age than the nonspecialized group (p < 0.05) who previously participated in several sports. However, the prevalence of overuse injury at high school did not significantly differ between the specialized and nonspecialized groups participating in individual sports. Conclusion More children who continued to play only one sport from elementary school age to high school age played in team sports in Japan. They also had a higher prevalence of overuse injuries when they were at high school age. It is necessary to consider the environment to play multi sports before high school age, especially in team sports.
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Affiliation(s)
- Yasuharu Nagano
- Department of Sports and Health Science, Japan Women’s College of Physical Education, Tokyo, Japan,Correspondence: Yasuharu Nagano, Department of Sports and Health Science, Japan Women’s College of Physical Education, 8-19-1, Kitakarasuyama, Setagaya, Tokyo, 157-8565, Japan, Tel/Fax +81-3-3300-5437, Email
| | - Takashi Oyama
- Faculty of Economics, Teikyo University, Tokyo, Japan
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Rockwood T, Edwards NM, Nelson B, Agel J. Evaluating the Impact of Youth Early Sport Specialization on Injury: An Evolution in Measurement. Health Serv Res Manag Epidemiol 2023; 10:23333928231176207. [PMID: 37251699 PMCID: PMC10209588 DOI: 10.1177/23333928231176207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/11/2023] [Accepted: 04/28/2023] [Indexed: 05/31/2023] Open
Abstract
Objective To track youth sports participation and injury occurrence accurately and longitudinally. Results An online survey tool that captures sports participation, frequency, level of competition, and tracks injury occurrence has been developed. The survey allows for longitudinal tracking of sports participation to evaluate the change from recreational to highly specialized sports participation. To maximize the utility of this research tool we identified swimmer plots which allow for clear visualization of the data as the best method for graphical representation. Implication Longitudinal measurement of sports participation to evaluate the impact of early sports specialization on injury is feasible with this tool and enhanced by the swimmer plots for visualization.
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Affiliation(s)
- Todd Rockwood
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | | | - Bradley Nelson
- Department of Orthopedics, University of Minnesota, Minneapolis, MN, USA
| | - Julie Agel
- Department of Orthopedics, University of Minnesota, Minneapolis, MN, USA
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7
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McLellan M, Allahabadi S, Pandya NK. Youth Sports Specialization and Its Effect on Professional, Elite, and Olympic Athlete Performance, Career Longevity, and Injury Rates: A Systematic Review. Orthop J Sports Med 2022; 10:23259671221129594. [PMID: 36353394 PMCID: PMC9638532 DOI: 10.1177/23259671221129594] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/07/2022] [Indexed: 08/08/2023] Open
Abstract
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.
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Affiliation(s)
- Maddison McLellan
- School of Medicine, University of California, Irvine, Irvine,
California, USA
| | - Sachin Allahabadi
- Department of Orthopaedic Surgery, University of California, San
Francisco, San Francisco, California, USA
| | - Nirav K. Pandya
- Department of Orthopaedic Surgery, University of California, San
Francisco, San Francisco, California, USA
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8
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Okoruwa ET, Abbott A, Stamm M, Mulcahey MK. Sport Specialization Classification and Injury Risk in Female Athletes. Sports Health 2022; 14:797-804. [PMID: 36203320 PMCID: PMC9631047 DOI: 10.1177/19417381221123532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Description of possible detrimental effects of sport specialization specific to adolescent female athletes is limited in current literature with no consensus on sport specialization classification. HYPOTHESIS Specialized female athletes will have higher rates of injury, body image issues, and menstrual dysfunction, regardless of the specialization classification utilized. STUDY DESIGN Cross-sectional. LEVEL OF EVIDENCE Level 3. METHODS Retrospective data was obtained from questionnaires from female athletes in local high schools (n = 229; 13-18 years of age). The 3-point specialization scale was used to analyze differences in injury rates, body image issues, and menstrual dysfunction within low, moderate, and highly specialized athletes. When comparing accuracy of specialization scales in identifying high risk athletes, three peer-reviewed specialization classification scales were utilized-a 3-point scale, a 6-point scale, and a binary self-selection scale. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for studied variables (a priori p ≤ 0.05). RESULTS Of 229 athletes surveyed, 219 (95.6%) completed the 3-point specialization classification questions and were included in the study. 91 athletes (41.6%) were categorized as low specialization (LS), 59 (26.9%) were moderately specialized (ModS), and 69 (31.5%) were highly specialized (HS). ModS athletes were more likely to have a history of stress fractures (SFx) compared to LS athletes (p = 0.02; OR 3.62; 95% CI 1.27-10.26). Compared to LS athletes, HS athletes were more likely to have injury history (p = 0.01; OR 2.93; 95% CI 1.38-6.24) and a history of concussion (p < 0.01; OR 5.00; 95% CI 1.86-13.42). CONCLUSION Among female high school athletes, higher levels of specialization are associated with greater risk of injuries overall, and greater risk of concussions and SFx. This study did not demonstrate significant associations between specialization and body image issues or menstrual dysfunction. CLINICAL RELEVANCE This study further strengthens the association between injury and sport specialization and suggests that combining specialization scales better improves risk stratification which overall aids in preventing athlete injury.
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Affiliation(s)
| | | | - Michaela Stamm
- Tulane University School of Medicine,
New Orleans, Louisiana
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9
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Peters CM, Hendry DT, Hodges NJ. A scoping review on developmental activities of girls' and women's sports. Front Sports Act Living 2022; 4:903886. [PMID: 36213454 PMCID: PMC9538116 DOI: 10.3389/fspor.2022.903886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/24/2022] [Indexed: 11/22/2022] Open
Abstract
We provide a scoping review of research on athlete development in girls' and women's sports. Our emphasis is on pathways to expertise in the context of deliberate practice theory and associated models, such as the Developmental Model of Sport Participation (DMSP). Despite rationale for sex and gender differences in sport development, there are relatively few studies where the developmental pathways of female elite athletes have been evaluated. We sought to map the scope of the literature on this population over the last 30 years, focusing on measures of practice types and amounts. Following an extensive search of the literature, 32 studies were identified that included all female participants or presented sex/gender disaggregated data. Retrospective methods were commonly used to quantify practice, play and specialization. National-level athletes were the most represented, although there was considerable heterogeneity in sport and expertise-level, making general or comparative judgements challenging. We identified some groups that had accumulated high volumes of practice at a young age, particularly in soccer and gymnastics. Across sports and studies, early majority hours of engagement in the primary sport was the norm. Athletes deviated from predictions in the specialization pathway detailed in the DMSP, by continuing to participate in other sports throughout childhood and adolescence. In addition to highlighting the relative paucity of data pertaining to athlete development pathways in female athletes, we show that the data from these groups deviate from predictions detailed in current models of athlete development.
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Affiliation(s)
- Carrie M. Peters
- Motor Skills Lab, School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - David T. Hendry
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Nicola J. Hodges
- Motor Skills Lab, School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
- *Correspondence: Nicola J. Hodges
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Emmet D, Roberts J, Yao KV. Update on Preventing Overuse Injuries in Youth Athletes. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022. [DOI: 10.1007/s40141-022-00362-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Hamer TJ, Rosen AB, Wilkins SJ, Nicholson KF, Bullock GS, Knarr BA. A Comparison of Pitching Biomechanics and Sport Specialization in High School Pitchers. Int J Sports Phys Ther 2022; 17:870-878. [PMID: 35949379 PMCID: PMC9340844 DOI: 10.26603/001c.37259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 05/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background The prevalence of sport specialization in high school athletes continues to rise, particularly among baseball players. Previous research has focused on the incidence of injury among specialized and non-specialized athletes but has yet to examine the level of sport specialization and pitching biomechanics. Hypotheses/Purpose The purpose of this study was to investigate differences in pitching volume and biomechanics between low-, moderate-, and high-level specialized baseball pitchers. It was hypothesized that high-level specialized pitchers would have the most pitching volume within the current and previous years while low-level specialized pitchers would exhibit the least amount. The second hypothesis states that kinematics and kinetics commonly associated with performance and injury risk would differ between low-, moderate-, and high-level specialized pitchers. Study Design Case-Control Study. Methods Thirty-six high school baseball pitchers completed a custom sport specialization questionnaire before participating in a three-dimensional pitching motion analysis. Sport specialization was based off current guidelines and categorized as low-, moderate-, and high-level specialized based upon self-reported outcomes. Pitchers then threw ≈10 fastballs from a mound engineered to professional specifications. Data averaged across fastballs was used for biomechanics variables. Key pitching biomechanical and pitching volume variables were compared between low-, moderate-, and high-level specialized pitchers. Results High-level specialized pitchers were older (p = 0.003), had larger body mass (p = 0.05) and BMI (p = 0.045), and threw faster (p = 0.01) compared to low-level specialized pitchers. Pitching volume and pitching biomechanics were similar across groups. Conclusions Pitching biomechanics were similar across groups, although high-level specialized pitchers threw with significantly higher throwing velocity compared to low-level pitchers. The low amount of pitching volume throughout the season may be responsible for the lack of additional observed differences. Further research should examine the relationship between pitching biomechanics, upper extremity strength and flexibility, and sport specialization. Level of Evidence Level III.
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Affiliation(s)
- Tyler J Hamer
- Department of Biomechanics, University of Nebraska Omaha
| | - Adam B Rosen
- School of Health and Kinesiology, University of Nebraska Omaha
| | | | | | | | - Brian A Knarr
- Department of Biomechanics, University of Nebraska Omaha
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Allahabadi S, Gatto AP, Kopardekar A, Davies MR, Pandya NK. National Football League (NFL) quarterbacks who were multisport high school athletes have better in-season performance statistics and career success. PHYSICIAN SPORTSMED 2022:1-5. [PMID: 35531708 DOI: 10.1080/00913847.2022.2075244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To determine (1) the proportion of National Football League (NFL) quarterbacks (QBs) who were multisport high school athletes (2) whether performance metrics in NFL QBs differed by playing multiple high school sports versus the single sport of football. METHODS A comprehensive online search identified NFL QBs from 1995 to 2020, classifying them as single or multisport high school athletes. Performance data were collected for regular season and playoffs when applicable and were calculated as rates. Regular season comparisons were limited to players playing at least eight games. Accolades (Pro Bowls, MVP awards, and Super Bowl victories) were also recorded. Mann-Whitney U was utilized to compare performance metrics between multisport and single sport athletes. RESULTS 403 QBs (223, 55.3% multisport) were included. In the regular season, multisport QBs played in more games (median 6.8, IQR 4-10.6 vs median 5, IQR 2.5-8.3; p = 0.0001), and had higher touchdowns/game (median 0.87, IQR 0.5-1.25 vs median 0.67, IQR 0.42-1; p = 0.0063), pass yards/game (median 159.4, IQR 103.9-206.7 vs median 139.4, IQR 96.3-179.6; p = 0.0392), and QB rating (median 78.5, IQR 69.4-85.2 vs median 74.4, IQR 66.7-81.2; p = 0.0063). There were no differences in pass completion %, interceptions/game, or rush yards/game. Multisport QBs played in more playoff games (median 0.5, IQR 0.22-0.81 vs median 0.33, IQR 0.2-0.62; p = 0.027), and had more Pro Bowl appearances, MVP awards, and Super Bowl victories per athlete (p < 0.05). CONCLUSION Over half of NFL QBs played multiple high school sports. Multisport involvement is associated with benefits in regular season including a higher proportion of games played, and more touchdowns/game, pass yards/game, and QB rating. Playing multiple sports was also associated with playing more playoff games and having more Pro Bowl appearances, MVP awards, and Super Bowl victories. This data supports the benefits of youth multisport training.
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Affiliation(s)
- Sachin Allahabadi
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Andrew P Gatto
- College of Osteopathic Medicine, Touro University California, Vallejo, California, USA
| | - Abhay Kopardekar
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Michael R Davies
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Nirav K Pandya
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
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13
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Kon K, Nagano Y, Oyama T. Association of Sports Participation and Training Frequency with Injury in Japanese Students Majoring in Physical Education: A Retrospective Analysis. EXERCISE MEDICINE 2022. [DOI: 10.26644/em.2022.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: This study evaluated prior sports participation and training frequency during elementary to high school and their association with acute and overuse injuries in Japanese college students currently majoring in physical education.Methods: This retrospective study included 292 students who completed questionnaires that assessed their type of sport participation (single sport or multiple sports), training frequency (number of days per week), and injury history (acute and overuse) during the elementary, junior high, and high school periods.Results: In total, 47.9% (95% confidence interval [CI]: 38.2–57.7) of elementary school-aged athletes played multiple sports; this decreased to 22.3% (95% CI: 14.1–30.4) in junior high school and 5.5% (95% CI: 1.0–9.9) in high school. There was a significant difference in the training frequency between those who had overuse injuries and not in elementary (p < 0.05), and junior high school (p < 0.05).Conclusions: The results of this study suggest that participating in multiple sports through junior high school may lead to improved sports levels (i.e., participation in higher levels of competition). In addition, appropriate management of training frequency may help reduce the incidence of overuse injuries.
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Proportions of Early Specializers Varies According to Methods and Skill Level. Sports (Basel) 2022; 10:sports10030034. [PMID: 35324644 PMCID: PMC8954525 DOI: 10.3390/sports10030034] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/15/2022] [Accepted: 02/24/2022] [Indexed: 12/03/2022] Open
Abstract
Sport researchers have warned about the lack of a clear and consistent definition of early specialization, while others have raised concerns around the validity of methods used to classify athletes as ‘specializers’. The current investigation includes two studies examining the implications of varying classification methods for exploring both specialization and early specialization in sport. Study 1 examined whether different approaches to defining and measuring specialization affected the classification of athletes throughout development and provided a ‘profile’ of the sample in terms of developmental milestones related to specialization. Results indicated the proportion of athletes classified as specializers varied depending on the method used and athletes generally met specialization milestones after the age of 12. Study 2 examined the proportions of athletes who achieved ‘elite’, ‘pre-elite’, and ‘non-elite’ status in adulthood who were early specializers as determined by different methods. Results showed the method used changed the proportion of athletes classified as specializers at each level and there was no clear advantage or disadvantage to being a specializer. Combined, these studies provide intriguing data regarding the implications of different measures for assessing specialization in young athletes.
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15
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Biese KM, Winans M, Fenton AN, Hernandez M, Schaefer DA, Bell DR. High School Sport Specialization and Injury in Collegiate Club-Sport Athletes. J Athl Train 2021; 56:1271-1277. [PMID: 34911075 PMCID: PMC8675310 DOI: 10.4085/1062-6050-0021.21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Sport specialization during adolescence may affect future injury risk. This association has been demonstrated in some professional sport athletes. OBJECTIVE To determine the association between adolescent sport specialization levels in high school and injuries sustained during collegiate club sports. DESIGN Cross-sectional study. SETTING Paper and online surveys. PATIENTS OR OTHER PARTICIPANTS Collegiate club-sport athletes. MAIN OUTCOME MEASURES(S) An anonymous survey was administered from September 2019 to May 2020. The survey included sport specialization classification via a commonly used 3-point scale (low, moderate, high) for each high school year (9th-12th), high school sports participation, and collegiate club-sport injury history. The number of years (0-4) an individual was highly specialized in high school was calculated. Individuals who participated in the same sport in high school and college were compared with individuals who played a different sport in college than in high school. An injury related to sport club activities was classified as arising from a contact, noncontact, or overuse mechanism required and the individual to seek medical treatment or diagnosis. Injuries were classified into overuse and acute mechanisms for the upper extremity, lower extremity (LE), and head/neck. RESULTS Single-sport participation and the number of years highly specialized in high school sport were not associated with college club-sport injuries (P > .1). Individuals who played a different collegiate club sport than their high school sport were more likely to report an LE or head/neck acute injury compared with athletes who played the same collegiate and high school sport (LE = 20% versus 8%, χ2 = 7.4, P = .006; head/neck = 16% versus 3%, χ2 = 19.4, P < .001). CONCLUSIONS Adolescent sport specialization was not associated with reported injuries in collegiate club-sport athletes. Collegiate club-sport athletic trainers should be aware that incoming students exploring a new sport may be at risk for LE and head/neck acute injuries.
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16
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Sugimoto D, Lambrinakos-Raymond K, Kobelski GP, Geminiani ET, Stracciolini A, Meehan WP. Sport specialization of female figure skaters: cumulative effects on low back injuries. PHYSICIAN SPORTSMED 2021; 49:463-468. [PMID: 33337938 DOI: 10.1080/00913847.2020.1855483] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: 1) to determine the proportion of sport specialization among female figure skaters, 2) to compare proportion of low back injuries between specialized female figure skaters and non-specialized female figure skaters, and 3) to identify an independent risk factor(s) for low back injuries in female figure skaters.Methods: A cross-sectional questionnaire study was used. Young female figure skaters were asked questions related to sport specialization and any history of low back injuries. The primary outcome variables were status of sport specialization, weekly training hours, and low back injury. Descriptive statistics, t-test, chi-square analyses, and binary logistic regressions were used.Results: Responses from 132 female figure skaters (mean age: 16.3 ± 2.7 years, age range: 8-22 years) were analyzed. Sixty-two percent (82/132) of figure skaters were specialized. Specialized female figure skaters spent more time in training (11.3 ± 6.5 hours/week) than non-specialized skaters (7.6 ± 4.9 hours/week, p = 0.001). No statistical differences were found in proportion of low back injury history between specialized (25.6%) and non-specialized female figure skaters (24.0%, p = 0.836). Chronological age was also identified as an independent risk factor for low back injuries in female figure skaters (aOR: 1.24, 95%CI: 1.00, 1.54, p = 0.048).Conclusions: The majority of female figure skaters in this cohort were specialized. An association between chronological age and low back injuries, found in the current study, may be a result of cumulative effects of participating in figure skating over time.
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Affiliation(s)
- Dai Sugimoto
- School of Sport Sciences, Waseda University, Tokyo, Japan.,The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
| | | | - Greggory P Kobelski
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA
| | - Ellen T Geminiani
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
| | - Andrea Stracciolini
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
| | - William P Meehan
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
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17
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Sweeney E, Howell DR, Seehusen CN, Tilley D, Casey E. Health outcomes among former female collegiate gymnasts: the influence of sport specialization, concussion, and disordered eating. PHYSICIAN SPORTSMED 2021; 49:438-444. [PMID: 33186080 DOI: 10.1080/00913847.2020.1850150] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Objective: Gymnastics is a popular sport with high injury rates, especially at the collegiate level. There is limited evidence, however, regarding the risks of early specialization in this sport, the rate of concussions in gymnasts, and the long-term effects of disordered eating in gymnasts. We sought to describe health-related outcomes of former collegiate gymnasts and the association with early sport specialization, concussion history, and disordered eating.Methods: We distributed an online survey through social media outlets. A total of 473 former female collegiate gymnasts completed the survey and were grouped according to early (<14 years) specialization, presence or absence of concussion history, and history of disordered eating. We determined the number of participants who had time-loss injuries, injuries requiring surgery, and injuries resulting in retirement. We also evaluated menstrual history, reasons for sport retirement, functional outcome measures, and mental health.Results: The median age of gymnastics specialization was 8 years [interquartile range = 6-11 years]. The proportion of injuries sustained during college did not significantly differ by specialization age. A significantly greater proportion of early specializers required surgery for college sports-related injuries (60% vs. 44%; p = 0.02). Forty-two percent of the respondents reported concussion history, and a greater proportion of those with concussion history reported seeking mental health treatment during college (32% vs. 23%; p = 0.03), and anxiety disorder diagnosis (16% vs. 9%; p = 0.01). Disordered eating history was reported by 34% of the respondents, and this group had a higher proportion of time-loss injury (78% vs 65%; p = 0.004), and osteoporosis (4% vs 0%; p = 0.003) during college, and worse current pain (11.5 vs 10.2; p = 0.007) and physical function (12.2 vs 11.0; p = 0.01) than those without disordered eating.Conclusion: Athletes and clinicians should be aware of the long-term effects of early specialization, concussions, and disordered eating in gymnastics as these issues are common in female collegiate gymnasts.
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Affiliation(s)
- Emily Sweeney
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA.,Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA
| | - David R Howell
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA.,Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA
| | | | - David Tilley
- Champion Physical Therapy and Performance, Waltham, MA, USA
| | - Ellen Casey
- Department of Physiatry, Hospital for Special Surgery, New York, NY, USA
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18
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Abstract
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.
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Affiliation(s)
| | - Kevin Till
- Leeds Beckett University, Leeds, England, UK
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19
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Ferber A, Howell DR, Seehusen CN, Tilley D, Casey E, Sweeney EA. Intersection of surgical injuries and pain interference among former female collegiate gymnasts. PM R 2021; 14:569-574. [PMID: 34498793 DOI: 10.1002/pmrj.12703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/22/2021] [Accepted: 09/01/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Gymnastics is a competitive sport with numerous health benefits. However, few data exist that examine the lasting effects of injuries in retired gymnasts. OBJECTIVE To examine pain interference among former collegiate gymnasts. Specifically, we focused on the relationship between gymnastics-related injuries sustained during middle/high school or college that required surgery and former collegiate gymnasts' current pain. We hypothesized that injuries requiring surgery would be associated with increased pain and reduced function after retirement. DESIGN Cross-sectional survey. SETTING An online questionnaire was distributed to former female collegiate gymnasts via social media. PARTICIPANTS A total of 447 former female collegiate gymnasts completed the survey and were grouped according to whether they indicated an injury during their middle/high school or collegiate gymnastics career that required surgery. MAIN OUTCOME MEASURES The association between current pain interference (Patient-Reported Outcomes Measurement Information System [PROMIS] scale) and injuries in middle/high school or college that resulted in surgery. Pain interference elements included current enjoyment of life, ability to concentrate, participation in day-to-day activities, enjoyment of recreational activities, ability to perform errands, and ability to socialize with others. RESULTS Those who reported an injury that resulted in surgery (n = 260; mean current age ± SD = 32.8 ± 9.5 years) were younger than those who did not at the time of survey completion (n = 187; current age: 37.0 ± 11.0 years) and reported beginning gymnastics at an earlier age (4.4 ± 2.0 years vs. 5.1 ± 2.5 years; p = .001). There were no statistically significant differences between the groups on any PROMIS questions. In secondary analyses, we found a small but significant association between beginning gymnastics at an earlier age and the odds of requiring surgery (odds ratio = 1.11, 95% confidence interval [CI] = 1.02-1.21; p = .02). CONCLUSIONS Most retired gymnasts reported a gymnastics-related injury that required surgery. Gymnasts who start gymnastics at a younger age were more likely to sustain an injury that required surgery, but surgery was not associated with higher levels of pain interference.
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Affiliation(s)
- Ally Ferber
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - David R Howell
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA.,Sports Medicine Center, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Corrine N Seehusen
- Sports Medicine Center, Children's Hospital Colorado, Aurora, Colorado, USA
| | - David Tilley
- Champion Physical Therapy and Performance, Waltham, Massachusetts, USA
| | - Ellen Casey
- Department of Physiatry, Hospital for Special Surgery, New York, New York, USA
| | - Emily A Sweeney
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA.,Sports Medicine Center, Children's Hospital Colorado, Aurora, Colorado, USA
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20
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Bartholomew J, Gilligan C, Spence A. Contemporary Variables that Impact Sleep and Development in Female Adolescent Swimmers and Gymnasts. SPORTS MEDICINE - OPEN 2021; 7:57. [PMID: 34373962 PMCID: PMC8353044 DOI: 10.1186/s40798-021-00331-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 05/24/2021] [Indexed: 11/10/2022]
Abstract
The effects of sleep on elite athletes in late adolescence and early adulthood have been well documented in a myriad of sports. However, there is underrepresentation of pre-pubertal and young female adolescent athlete research between the ages of 11-17, and specifically female gymnast and swimmers. Neglecting to understand how high energy demand at a young age relates to sleep and restoration may lead to developmental ramifications for this group, as they display physiological dysfunctions like delayed puberty, amenorrhea and are at risk for the female athlete triad or components of the triad. This review aims to summarize the contemporary variables of blue light emitting screens, social media, and caffeine on quality and quantity of sleep in young athletes while identifying gaps in the literature on how these factors impact the target group of young female swimmers and gymnasts. The implications of this work include sleep hygiene recommendations for increasing duration and quality of sleep, as well as future research with respect to electronic device usage, social media participation, caffeine consumption, and sport engagement in female early adolescent athletes.
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Affiliation(s)
- Janine Bartholomew
- Department of Biology, Portage Learning, 2521 Darlington Road, Beaver Falls, PA, 15010, USA
| | - Carrie Gilligan
- Carlow University, 3333 Fifth Ave, Pittsburgh, PA, 15237, USA
| | - Ann Spence
- Department of Nursing, Carlow University, 3333 Fifth Ave, Pittsburgh, PA, 15237, USA.
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21
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Puzzitiello RN, Rizzo CF, Garvey KD, Matzkin EG, Salzler MJ. Early sports specialisation and the incidence of lower extremity injuries in youth athletes: current concepts. J ISAKOS 2021; 6:339-343. [PMID: 34230066 DOI: 10.1136/jisakos-2019-000288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 05/15/2021] [Indexed: 11/04/2022]
Abstract
Year-round intensive, single-sport training beginning at an young age is an increasingly common trend in the youth athlete population. Early sport specialisation may be ineffective for long-term athletic success and contribute to an increased risk of physical injury and burn-out. The medical community has noted that repetitive movement patterns may occur in non-diversified activity and this may contribute to overuse injury in young athletes. Studies have begun to identify an association between early sport specialisation and lower extremity injuries in the youth athlete population that is independent of training volume. Recent literature has suggested that sport diversification, not specialisation, is a better path for athletic success and minimised lower extremity injury risk.
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Affiliation(s)
| | - Coleen F Rizzo
- Orthopedics, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Kirsten D Garvey
- Orthopedics, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Elizabeth G Matzkin
- Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Matthew J Salzler
- Orthopedics, Tufts University School of Medicine, Boston, Massachusetts, USA
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22
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Heath MR, Janosky JJ, Pegno A, Schachne JM, Fabricant PD. Age Is More Predictive of Safe Movement Patterns Than Are Physical Activity or Sports Specialization: A Prospective Motion Analysis Study of Young Athletes. Am J Sports Med 2021; 49:1904-1911. [PMID: 33914649 DOI: 10.1177/03635465211008562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Movement quality and neuromuscular balance are noted predictors of acute injury. Early sports specialization and extremely high activity levels have been linked to elevated risk of injury. PURPOSE To investigate for any relationships among quality of physical movement, quantity of physical activity, and degree of sports specialization in a healthy cohort of active children and adolescents. STUDY DESIGN Cross-sectional study with prospectively collected data. METHODS Healthy children between the ages of 10 and 18 years were recruited and completed the Hospital for Special Surgery Pediatric Functional Activity Brief Scale to assess quantity of physical activity and the Jayanthi scale to assess degree of sports specialization (high, score of 2 or 3; low, score of 0 or 1). Movement quality was assessed using motion analysis sensors during 5 repetitions of 4 different jumping and squatting motions, with a maximum score of 100 per participant. Independent-samples t tests were used to compare participants with high versus low specialization on physical activity and movement quality. A Spearman correlation was used to determine the relationship between quantity of physical activity and movement quality, and linear regression was used to assess for the effect of participant age on relevant covariables. RESULTS Final analyses included 147 participants (72% male) with a mean ± SD age of 13.4 ± 2.2 years. Participants who were highly specialized displayed better movement quality than did participants with low sports specialization (27.6 ± 14.0 vs 19.8 ± 10.1; P < .01). Participants who were highly specialized had significantly higher activity levels (24.6 ± 5.9 vs 18.1 ± 6.9; P < .001). Movement quality was moderately correlated with physical activity level (r = 0.335; P < .001). Physical activity; hours of organized sports activity; hours of free, unorganized physical activity; and specialization level were not significant predictors of movement quality when controlling for age. Age alone predicted 24.2% of the variance in the overall movement quality score (R2 = 0.242; B = 3.0; P < .001). CONCLUSION This study found that sports specialization and physical activity levels were not associated with movement quality when controlling for age, which was the most important variable predicting athletic movement quality. Although all participants displayed movement patterns that were associated with high risk for injury, overall movement quality improved with advancing chronological age. CLINICAL RELEVANCE All young athletes should ensure that neuromuscular training accompanies sport-specific training to reduce risk of injury.
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Affiliation(s)
| | | | - Angelo Pegno
- Hospital for Special Surgery, New York, New York, USA
| | - Jonathan M Schachne
- Hospital for Special Surgery, New York, New York, USA.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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23
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Kliethermes SA, Marshall SW, LaBella CR, Watson AM, Brenner JS, Nagle KB, Jayanthi N, Brooks MA, Tenforde AS, Herman DC, DiFiori JP, Beutler AI. Defining a research agenda for youth sport specialisation in the USA: the AMSSM Youth Early Sport Specialization Summit. Br J Sports Med 2021; 55:135-143. [PMID: 33462103 DOI: 10.1136/bjsports-2020-102699] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2020] [Indexed: 01/03/2023]
Abstract
Sport specialisation is becoming increasingly common among youth and adolescent athletes in the USA and many have raised concern about this trend. Although research on sport specialisation has grown significantly, numerous pressing questions remain pertaining to short-term and long-term effects of specialisation on the health and well-being of youth, including the increased risk of overuse injury and burnout. Many current elite athletes did not specialise at an early age. Methodological and study design limitations impact the quality of current literature, and researchers need to prioritise pressing research questions to promote safe and healthy youth sport participation. The American Medical Society for Sports Medicine hosted a Youth Early Sport Specialization Summit in April 2019 with the goal of synthesising and reviewing current scientific knowledge and developing a research agenda to guide future research in the field based on the identified gaps in knowledge. This statement provides a broad summary of the existing literature, gaps and limitations in current evidence and identifies key research priorities to help guide researchers conducting research on youth sport specialisation. Our goals are to help improve the quality and relevance of research on youth sport specialisation and to ultimately assure that opportunities for healthy and safe sport participation continue for all youth.
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Affiliation(s)
- Stephanie A Kliethermes
- Department of Orthopedics and Rehabilitation, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Stephen W Marshall
- Injury Prevention Research Center and Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Cynthia R LaBella
- Department of Pediatrics, Northwestern University's Feinberg School of Medicine, Chicago, IL, USA.,Division of Orthopedics and Sports Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Andrew M Watson
- Department of Orthopedics and Rehabilitation, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Joel S Brenner
- Sports Medicine Program, Children's Hospital of The King's Daughters, Norfolk, Virginia, USA.,Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia, USA.,Sports Medicine Division, Children's Specialty Group, PLLC, Norfolk, Virginia, USA
| | - Kyle B Nagle
- Department of Pediatrics and Orthopedics and Rehabilitation, University of Washington School of Medicine; Seattle Children's Hospital, Seattle, Washington, USA
| | - Neeru Jayanthi
- Departments of Orthopaedics and Family Medicine, Emory Sports Medicine Center; Emory University School of Medicine, Atlanta, Georgia, USA
| | - M Alison Brooks
- Department of Orthopedics and Rehabilitation, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Adam S Tenforde
- Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | - Daniel C Herman
- Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA.,Hospital for Special Surgery, New York, New York, USA
| | | | - Anthony I Beutler
- Musculoskeletal Clinical Program, Intermountain Health Care Inc, Salt Lake City, Utah, USA.,Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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24
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Sugimoto D, Slick NR, Mendel DL, Stein CJ, Pluhar E, Fraser JL, Meehan WP, Corrado GD. Meditation Monologue can Reduce Clinical Injection-Related Anxiety: Randomized Controlled Trial. J Evid Based Integr Med 2021; 26:2515690X211006031. [PMID: 33904781 PMCID: PMC8082977 DOI: 10.1177/2515690x211006031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background. Strategies to reduce anxiety prior to injection procedures are not well understood. The purpose is to determine the effect of a meditation monologue intervention delivered via phone/mobile application on pre-injection anxiety levels among patients undergoing a clinical injection. The following hypothesis was tested: patients who listened to a meditation monologue via phone/mobile application prior to clinical injection would experience less anxiety compared to those who did not. Methods. A prospective, randomized controlled trial was performed at an orthopedics and sports medicine clinic of a tertiary level medical center in the New England region, USA. Thirty patients scheduled for intra- or peri-articular injections were randomly allocated to intervention (meditation monologue) or placebo (nature sounds) group. Main outcome variables were state and trait anxiety inventory (STAI) scores and blood pressure (BP), heart rate, and respiratory rate. Results. There were 16 participants who were allocated to intervention (meditation monologue) while 14 participants were assigned to placebo (nature sounds). There was no interaction effect. However, a main time effect was found. Both state anxiety (STAI-S) and trait anxiety (STAI-T) scores were significantly reduced post-intervention compared to pre-intervention (STAI-S: p = 0.04, STAI-T: p = 0.04). Also, a statistically significant main group effect was detected. The pre- and post- STAI-S score reduction was greater in the intervention group (p = 0.028). Also, a significant diastolic BP increase between pre- and post-intervention was recorded in the intervention group (p = 0.028), but not in the placebo group (p = 0.999). Conclusion. Listening to a meditation monologue via phone/mobile application prior to clinical injection can reduce anxiety in adult patients receiving intra- and peri-articular injections. Registration:ClinicalTrials.gov NCT02690194
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Affiliation(s)
- Dai Sugimoto
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Faculty of Sport Sciences, Waseda University, Tokyo, Japan
| | - Nathalie R Slick
- Division of Sports Medicine, Department of Orthopaedics, 1862Boston Children's Hospital, Boston, MA, USA
| | - David L Mendel
- Division of Sports Medicine, Department of Orthopaedics, 1862Boston Children's Hospital, Boston, MA, USA
| | - Cynthia J Stein
- Division of Sports Medicine, Department of Orthopaedics, 1862Boston Children's Hospital, Boston, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
| | - Emily Pluhar
- Division of Sports Medicine, Department of Orthopaedics, 1862Boston Children's Hospital, Boston, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
| | - Joana L Fraser
- Division of Sports Medicine, Department of Orthopaedics, 1862Boston Children's Hospital, Boston, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
| | - William P Meehan
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopaedics, 1862Boston Children's Hospital, Boston, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
| | - Gianmichel D Corrado
- Division of Sports Medicine, Department of Orthopaedics, 1862Boston Children's Hospital, Boston, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
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25
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Abstract
Dual-fellowship-trained surgeons specializing in both pediatric and sport medicine are treating an increasing number of pediatric orthopedic injuries, making pediatric orthopedic sports medicine a potential new emerging subspecialty. With fellowship training now being the norm rather than the exception across orthopedics, it is possible that dual-fellowship training may become a prerequisite for treatment of pediatric sports medicine patients. This may impact the practices of surgeons trained in either pediatric or sports medicine alone. As the trend toward dual-fellowship training is likely to continue, future studies are needed to characterize the impact it has on patient care and training patterns.
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Affiliation(s)
- Maksim A Shlykov
- Department of Orthopaedic Surgery, Washington University School of Medicine/Barnes-Jewish Hospital, 660 South Euclid Avenue Campus Box 8233, St Louis, MO 63110, USA
| | - Pooya Hosseinzadeh
- Pediatric Adolescent Orthopaedic Surgery, Department of Orthopaedic Surgery, Washington University School of Medicine, 4S60, Suite 1B, One Children's Place, St Louis, MO 63110, USA.
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26
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Bell DR, Snedden T, Biese K, Nelson E, Watson A, McGuine T, Brooks MA, Brown R, Kliethermes SA. Consensus Definition of Sport Specialization in Youth Athletes Using a Delphi Approach. J Athl Train 2021; 56:1239-1251. [PMID: 33787895 DOI: 10.4085/1062-6050-0725.20] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT A single, widely accepted definition of sport specialization does not exist. A consensus definition is necessary to guide youth sport stakeholders on issues associated with sport specialization. OBJECTIVE The aim of this study was to develop a consensus definition of youth sport specialization and to identify elements that support the construct of specialization. DESIGN Delphi Study Setting: Directed Surveys Patients or Other Participants: A consensus panel of 17 experts was created to provide a broad multidisciplinary perspective on sport specialization in youth athletes. DATA COLLECTION AND ANALYSIS The final definition was developed per an iterative process that involved four rounds of review. A comprehensive review of literature and expert input supported our initial proposed umbrella definition that included six additional elements. The study team reviewed the results after each round and changes were made to the definition based on panel feedback. MAIN OUTCOME MEASURE(S) Panel members were provided with the definition and six elements and then asked to rate each specific to importance, relevance, and clarity using a 4-point Likert scale. RESULTS In four Delphi consensus rounds, 17 experts reviewed the umbrella definition and six elements before consensus was reached. The umbrella definition and three of the initial six elements achieved >80% agreement for importance, relevance, and clarity after the fourth round of review. The remaining 3 components did not reach >80% agreement even after iterative edits and were removed. The process resulted in a final consensus definition: Sport specialization is intentional and focused participation in a single sport for a majority of the year that restricts opportunities for engagement in other sports and activities. CONCLUSIONS A consensus-based conceptual definition for sport specialization has been developed using a Delphi method. This definition has important implications for clinicians and sports medicine professionals who support youth athletes.
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Affiliation(s)
- David R Bell
- Department of Kinesiology1, University of Wisconsin-Madison, Madison, WI.,Department of Orthopedics and Rehabilitation2, University of Wisconsin-Madison, Madison, WI
| | - Traci Snedden
- Department of Orthopedics and Rehabilitation2, University of Wisconsin-Madison, Madison, WI.,School of Nursing3, University of Wisconsin-Madison, Madison, WI
| | - Kevin Biese
- Department of Kinesiology1, University of Wisconsin-Madison, Madison, WI
| | - Evan Nelson
- Department of Family Medicine and Community Health4, University of Wisconsin-Madison, Madison, WI
| | - Andrew Watson
- Department of Orthopedics and Rehabilitation2, University of Wisconsin-Madison, Madison, WI
| | - Timothy McGuine
- Department of Orthopedics and Rehabilitation2, University of Wisconsin-Madison, Madison, WI
| | - M Alison Brooks
- Department of Orthopedics and Rehabilitation2, University of Wisconsin-Madison, Madison, WI
| | - Roger Brown
- School of Nursing3, University of Wisconsin-Madison, Madison, WI
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Kliethermes SA, Marshall SW, LaBella CR, Watson AM, Brenner JS, Nagle KB, Jayanthi N, Brooks MA, Tenforde AS, Herman DC, DiFiori JP, Beutler AI. Defining a Research Agenda for Youth Sport Specialization in the United States: The AMSSM Youth Early Sport Specialization Summit. Clin J Sport Med 2021; 31:103-112. [PMID: 33587486 DOI: 10.1097/jsm.0000000000000900] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/28/2020] [Indexed: 02/02/2023]
Abstract
ABSTRACT Sport specialization is becoming increasingly common among youth and adolescent athletes in the United States and many have raised concern about this trend. Although research on sport specialization has grown significantly, numerous pressing questions remain pertaining to short- and long-term effects of specialization on the health and well-being of youth, including the increased risk of overuse injury and burnout. Many current elite athletes did not specialize at an early age. Methodological and study design limitations impact the quality of current literature, and researchers need to prioritize pressing research questions to promote safe and healthy youth sport participation. The American Medical Society for Sports Medicine hosted a Youth Early Sport Specialization Summit in April 2019 with the goal of synthesizing and reviewing current scientific knowledge and developing a research agenda to guide future research in the field based on the identified gaps in knowledge. This statement provides a broad summary of the existing literature, gaps and limitations in current evidence, and identifies key research priorities to help guide researchers conducting research on youth sport specialization. Our goals are to help improve the quality and relevance of research on youth sport specialization and to ultimately assure that opportunities for healthy and safe sport participation continue for all youth.
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Affiliation(s)
- Stephanie A Kliethermes
- Department of Orthopedics & Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Stephen W Marshall
- Department of Epidemiology, Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Cynthia R LaBella
- Department of Pediatrics, Northwestern University's Feinberg School of Medicine, Chicago, Illinois
- Institute for Sports Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Andrew M Watson
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Joel S Brenner
- Sports Medicine Division, Children's Specialty Group, PLLC, Sports Medicine Program, Children's Hospital of The King's Daughters, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia
| | - Kyle B Nagle
- Department of Pediatrics and Orthopedics and Rehabilitation, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington
| | - Neeru Jayanthi
- Department of Orthopedics, Department of Family Medicine, Emory Sports Medicine Center, Emory University School of Medicine, Atlanta, Georgia
| | - M Alison Brooks
- Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Adam S Tenforde
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daniel C Herman
- Department of Orthopaedics and Rehabilitation, College of Medicine, University of Florida, Gainesville, Florida
| | - John P DiFiori
- Primary Sports Medicine Service, Hospital for Special Surgery, New York, New York
| | - Anthony I Beutler
- Musculoskeletal Clinical Program, Intermountain Healthcare, Salt Lake City, Utah; and
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Rugg CM, Coughlan MJ, Li JN, Hame SL, Feeley BT. Early Sport Specialization Among Former National Collegiate Athletic Association Athletes: Trends, Scholarship Attainment, Injury, and Attrition. Am J Sports Med 2021; 49:1049-1058. [PMID: 33719607 DOI: 10.1177/0363546520988727] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Many youth athletes focus on 1 sport to gain a competitive advantage, but early sport specialization may increase risk of overuse injuries and burnout. College athletes have successfully achieved advanced status; therefore, the study of their specialization patterns is a method to assess how specialization affects an athletic career. PURPOSE To determine trends in sport specialization by sex, sport, and decade of participation in National Collegiate Athletic Association (NCAA) athletes and assess the effect of specialization on scholarship attainment, injury, and attrition. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS An electronic survey was distributed to NCAA athletes who participated from 1960 to 2018. Survey topics included sex, sport, decade of participation, scholarship status, ≥30-day time-loss injuries sustained in college, orthopaedic surgery in college, career length, and age of single-sport specialization. Early specialization was defined as specialization in a single sport before age 15 years. Rates of early specialization were calculated for each sport, sex, individual and team sports, and decade of participation. Rates of scholarship attainment, injury, and attrition were compared between groups. Univariate associations were queried with logistic regression analysis to determine predictors of specialization, scholarship attainment, injury, and early attrition. RESULTS Of 1550 athletes who participated (17% response rate), 544 (35.1%) were women. Overall, 18.1% of athletes specialized before age 15 years (n = 281). Athletes in gymnastics, tennis, swimming and diving, and soccer were significantly more likely to specialize early, whereas football and baseball athletes were more likely to specialize late (P < .05 for all groups). Early specialization was more common among women (23.4% vs 15.2%; odds ratio, 1.72; P < .01). There was a trend toward earlier specialization for recent college graduates, with graduates from the last decade more likely to be classified as early specialization than those from previous decades (P = .036). Scholarship attainment was overall equivalent between groups. Time-loss injuries, lower extremity injuries, and orthopaedic surgery in college were not statistically different between groups. Career lengths were similar, but burnout was more common among early specialization athletes (10.5% vs 7.0%; odds ratio, 3.76; P < .01). CONCLUSION Less than one-fifth of NCAA athletes surveyed specialized before age 15 years, and neither scholarship attainment nor time-loss injury rate was affected by early specialization. Early specialization is on the rise but is associated with increased burnout.
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Affiliation(s)
- Caitlin M Rugg
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Monica J Coughlan
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, USA
| | - Justine N Li
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, USA
| | - Sharon L Hame
- Department of Orthopaedic Surgery, University of California-Los Angeles, Los Angeles, California, USA
| | - Brian T Feeley
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, USA
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Different Perceptions of Parents and Children on Factors Influencing Sport Specialization. J Sport Rehabil 2021; 30:190-197. [DOI: 10.1123/jsr.2019-0357] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/06/2020] [Accepted: 02/16/2020] [Indexed: 11/18/2022]
Abstract
Context: Sport specialization among youth athletes has been associated with increased risk of overuse injuries. Previous research demonstrates that children perceive specialization to be beneficial in making their high school team and receiving athletic college scholarships. Previous research demonstrates that parents play a significant role in their child’s sport experience. However, it is unknown if parents and children answer questions related to specialization factors in a similar manner. Objective: To evaluate the beliefs of youth athletes and parents on factors related to sport specialization and evaluate the level of agreement between dyads on sports specialization. Design: Cross-sectional. Setting: Online and paper surveys. Patients or Other Participants: Aim 1: 1998 participants (993 children and 1005 parents). Aim 2: 77 paired parent–child dyads. Interventions: Self-administered survey. Main Outcome Measures: The responses were summarized via frequency and proportions (%). Chi-squares were calculated between parent and child responses. Kappa coefficients were calculated for dyads to determine level of agreement. Sport specialization was classified using a common 3-point scale. Results: The parents were more concerned about risk of injury in sports compared with children (P < .001, χ2 = 231.4; parent: extremely: 7.1%; child: extremely: 3.7%). However, children were more likely to believe that specialization was associated with their chances of obtaining an athletic college scholarship compared with parents (P < .001, χ2 = 201.6; parent: very/extremely likely: 13.7%; child: very/extremely likely: 15.8%). Dyad subanalysis indicated a moderate level of agreement for “quitting other sports to focus on one sport” (κ = .50) and a low level of agreement for “identifying a primary sport” (κ = .30) and “training >8 months per year in primary sport” (κ = .32). Conclusions: Parents and youth athletes had differing beliefs on the factors related to sport specialization. Dyad analysis shows that parents and children answer sport specialization classification questions differently. Health care providers should be aware of these differences, and messaging should be individualized to the audience.
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Mosher A, Fraser-Thomas J, Baker J. What Defines Early Specialization: A Systematic Review of Literature. Front Sports Act Living 2020; 2:596229. [PMID: 33345176 PMCID: PMC7739675 DOI: 10.3389/fspor.2020.596229] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 09/30/2020] [Indexed: 01/28/2023] Open
Abstract
Introduction: While practitioners and organizations advise against early specialization, the lack of a consistent and clear definition of early specialization reduces the impact of recommendations and policies in youth sport. An important first step in understanding the consequences of early specialization is establishing what early specialization is. Objectives: This PRISMA-guided systematic review aimed to determine the types, characteristics, and general content of early specialization papers within the literature, and examine how early specialization has been defined and measured in order to advance knowledge toward a clear and consistent definition of early specialization. Data sources: Four different electronic databases were searched (SPORTDiscus, Web of Science, Sports Medicine and Education Index, and Scopus). Both non data-driven and data-driven studies were included to ensure a comprehensive understanding of the literature. Eligibility Criteria: In order to be included in the review, the paper must: (a) Focus on specialization and explicitly use the term "specialization" (b) Focus on sport and athletes (c) Be papers from a peer-reviewed (d) Be in English. And finally, (e) be available in full text. Results: One thousand three hundred and seventy one articles were screened resulting in 129 articles included in the review after applying inclusion/exclusion criteria. Results indicated a clear discrepancy between key components of early specialization and the approaches used to classify early specializers. Conclusion: Future research should work toward developing a valid and reliable approach to classifying early specializers and establishing a consistent definition across studies.
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Affiliation(s)
- Alexandra Mosher
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
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Abstract
Early sports specialization (ESS) is a relatively new trend that has led to many youth athletes to focus on only 1 sport at an increasingly young age. Although parents and coaches perceive that this will improve their athlete's chances of success at the collegiate and professional levels, studies have shown the opposite. ESS leads to increased injury risk, higher rates of burnout, and lower lifelong sports participation without increasing elite achievement. Throwing athletes are particularly vulnerable to these overuse injuries of the shoulder and elbow, which have been shown to correlate directly to the number of throws and innings played.
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Carder SL, Giusti NE, Vopat LM, Tarakemeh A, Baker J, Vopat BG, Mulcahey MK. The Concept of Sport Sampling Versus Sport Specialization: Preventing Youth Athlete Injury: A Systematic Review and Meta-analysis. Am J Sports Med 2020; 48:2850-2857. [PMID: 31961703 DOI: 10.1177/0363546519899380] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The prevalence of youth athletes specializing in 1 sport has been increasing over the past decade. Subsequently, the rate of youth athlete injury has also been increasing. It is possible that an association exists between youth specialization and sports injury rate. PURPOSE To determine if sport sampling is associated with a lower sports injury rate in youths compared with youths who specialize in 1 sport. STUDY DESIGN Systematic review and meta-analysis. METHODS A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed, Embase, and the Cochrane library. Inclusion criteria included studies written in the English language, studies with athletes between 7 and 18 years of age, studies that report injury rates, and studies that specify if athletes were sport samplers or specialized in a sport. Data relevant to this study, including injuries and patient characteristics, were extracted and statistically analyzed. RESULTS The initial search identified 324 studies, 6 of which met inclusion criteria. From these 6 studies, the total participant number was 5736. Of those, 2451 (42.7%) were "sport samplers," 1628 (28.4%) were "sport specializers," and 1657 (28.9%) were considered "others" (ie, could not be classified as true samplers or true specializers). The average age of all the athletes was 14.6 years (range, 7-18 years). Sport specializers had a significantly higher injury risk than the sport samplers (RR, 1.37; 95% CI, 1.19-1.57; P < .0001). There was a higher risk of injury in the "others" group when compared with the "sport sampler" group (RR, 1.21; 95% CI, 1.14-1.29; P < .0001). There was a higher risk of injury in the "sport specializer" group over the "others" group (RR, 1.09; 95% CI, 1.04-1.14; P < .005). CONCLUSION Sport sampling is associated with a decreased risk of sports injury in youth athletes when compared with those who specialize in 1 sport. Injury rates increase as a youth athlete becomes increasingly specialized. Youth athletes would benefit substantially from participating in sport sampling.
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Affiliation(s)
- Seth L Carder
- The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Nicolas E Giusti
- The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Lisa M Vopat
- The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Armin Tarakemeh
- The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jordan Baker
- The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Bryan G Vopat
- The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Mary K Mulcahey
- Tulane University School of Medicine, New Orleans, Louisiana, USA
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Abstract
Youth sport participation patterns have drastically changed over the past two decades. Increasingly, young individuals are specializing in single sport while skeletally immature. Sport specialization in the growing athlete has profound effects on performance, short- and long-term injury risks, and joint health. Evidence continues to mount as the detrimental effects of this trend on the immature athlete. The knee, shoulder, and elbow of these young athletes are particularly affected by this emphasis on skill-based sporting activity as opposed to generalized fitness and participation. An understanding of the epidemiology of sport participation, particularly financial impacts, and the effects on elite sport performance are critical so that the clinician can effectively educate athletes, parents, and coaches.
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Is the incidence of paediatric stress fractures on the rise? Trends in New York State from 2000 to 2015. J Pediatr Orthop B 2020; 29:499-504. [PMID: 31305361 DOI: 10.1097/bpb.0000000000000650] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
The purpose of this study is to analyze trends in the epidemiology of paediatric stress fractures. The New York Statewide Planning and Research Cooperative System database was queried for stress fractures in children between the ages of 6 and 18 years. After checking for monotonicity of the data, Spearman's correlation coefficient was calculated. Multivariate regressions were used to test for associations between demographic variables and risk of stress fracture. Analysis of 11 475 386 outpatient visits between 2000 and 2015 showed that the annual incidence of paediatric stress fractures increased from 1.37 cases per 100 000 outpatient visits in 2006 to 5.32 per 100 000 visits in 2015 (ρ = 0.876, P < 0.01). The mean age at the time of injury was 14.4 ± 2.8 years. Children younger than 14 years accounted for 33.6% of the cohort. Age, male sex, white ethnicity, and private insurance were statistically significant predictors of stress fractures in a multivariate model. This study is the first to document an increase in the annual incidence of paediatric stress fractures.
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Brett BL, Bobholz SA, España LY, Huber DL, Mayer AR, Harezlak J, Broglio SP, McAllister TW, McCrea MA, Meier TB. Cumulative Effects of Prior Concussion and Primary Sport Participation on Brain Morphometry in Collegiate Athletes: A Study From the NCAA-DoD CARE Consortium. Front Neurol 2020; 11:673. [PMID: 32849177 PMCID: PMC7399344 DOI: 10.3389/fneur.2020.00673] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/05/2020] [Indexed: 12/14/2022] Open
Abstract
Prior studies have reported long-term differences in brain structure (brain morphometry) as being associated with cumulative concussion and contact sport participation. There is emerging evidence to suggest that similar effects of prior concussion and contact sport participation on brain morphometry may be present in younger cohorts of active athletes. We investigated the relationship between prior concussion and primary sport participation with subcortical and cortical structures in active collegiate contact sport and non-contact sport athletes. Contact sport athletes (CS; N = 190) and matched non-contact sport athletes (NCS; N = 95) completed baseline clinical testing and participated in up to four serial neuroimaging sessions across a 6-months period. Subcortical and cortical structural metrics were derived using FreeSurfer. Linear mixed-effects (LME) models examined the effects of years of primary sport participation and prior concussion (0, 1+) on brain structure and baseline clinical variables. Athletes with prior concussion across both groups reported significantly more baseline concussion and psychological symptoms (all ps < 0.05). The relationship between years of primary sport participation and thalamic volume differed between CS and NCS (p = 0.015), driven by a significant inverse association between primary years of participation and thalamic volume in CS (p = 0.007). Additional analyses limited to CS alone showed that the relationship between years of primary sport participation and dorsal striatal volume was moderated by concussion history (p = 0.042). Finally, CS with prior concussion had larger hippocampal volumes than CS without prior concussion (p = 0.015). Years of contact sport exposure and prior concussion(s) are associated with differences in subcortical volumes in young-adult, active collegiate athletes, consistent with prior literature in retired, primarily symptomatic contact sport athletes. Longitudinal follow-up studies in these athletes are needed to determine clinical significance of current findings.
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Affiliation(s)
- Benjamin L Brett
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Samuel A Bobholz
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Lezlie Y España
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Daniel L Huber
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Andrew R Mayer
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, United States.,Neurology and Psychiatry Departments, University of New Mexico School of Medicine, Albuquerque, NM, United States.,Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Jaroslaw Harezlak
- Department of Epidemiology and Biostatistics, Indiana University, Bloomington, IN, United States
| | - Steven P Broglio
- School of Kinesiology and Michigan Concussion Center, University of Michigan, Ann Arbor, MI, United States
| | - Thomas W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Bloomington, IN, United States
| | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, United States
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Zech P, Schuch F, Pérez-Chaparro C, Kangas M, Rapp M, Heissel A. Exercise, Comorbidities, and Health-Related Quality of Life in People Living with HIV: The HIBES Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145138. [PMID: 32708664 PMCID: PMC7400584 DOI: 10.3390/ijerph17145138] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/05/2020] [Accepted: 07/12/2020] [Indexed: 12/13/2022]
Abstract
(1) Background: People with HIV (PWH) may perform more than one type of exercise cumulatively. The objective of this study is to investigate recreational exercise and its association with health-related quality of life (HRQOL) and comorbidities in relation to potential covariates. (2) Methods: The HIBES study (HIV-Begleiterkrankungen-Sport) is a cross-sectional study for people with HIV. The differences between non-exercisers versus exercisers (cumulated vs. single type of exercises) were investigated using regression models based on 454 participants. (3) Results: Exercisers showed a higher HRQOL score compared to non-exercisers (Wilcox r = 0.2 to 0.239). Psychological disorders were identified as the main covariate. Participants performing exercise cumulatively showed higher scores in duration, frequency, and intensity when compared to participants performing only one type of exercise. The mental health summary score was higher for the cumulated and single type of exercise if a psychological disorder existed. Duration and intensity were associated with an increase of HRQOL, whilst a stronger association between psychological disorders and exercise variables were evident. Exercise duration (minutes) showed a significant effect on QOL (standardized beta = 0.1) and for participants with psychological disorders (standardized beta = 0.3), respectively. (4) Conclusions: Psychological disorders and other covariates have a prominent effect on HRQOL and its association with exercise. For PWH with a psychological disorder, a stronger relationship between HRQOL with exercise duration and intensity emerged. However, differentiation of high-HRQOL individuals warrants further investigation by considering additional factors.
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Affiliation(s)
- Philipp Zech
- Social and Preventive Medicine, Department of Exercise and Health Sciences, University of Potsdam, 14469 Potsdam, Germany
- Correspondence: ; Tel.: +49-(0)-331-977-4049
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, 97105 Santa Maria, Brazil;
| | - Camilo Pérez-Chaparro
- Outpatient Clinic—Center for Sports Medicine, Department of Sports & Health Sciences, University of Potsdam, 14469 Potsdam, Germany;
| | - Maria Kangas
- Department of Psychology, Centre for Emotional Health, Macquarie University, 2109 Sydney, Australia;
| | - Michael Rapp
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit “Cognitive Sciences”, Faculty of Human Science, and Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, 14469 Potsdam, Germany; (M.R.); (A.H.)
| | - Andreas Heissel
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty unit “Cognitive Sciences”, Faculty of Human Science, and Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, 14469 Potsdam, Germany; (M.R.); (A.H.)
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Knapik DM, Rizzone KH, Voos JE. Timing and Reasons Behind Single-Sport Specialization in Soccer: A Survey of 64 Major League Soccer Athletes. Sports Health 2020; 12:355-360. [PMID: 32286914 DOI: 10.1177/1941738120911373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Single-sport specialization at the exclusion of other sports has become increasingly popular in youth sporting culture. The purpose of this study was to survey Major League Soccer (MLS) athletes to examine factors influencing the timing of single-sport specialization in soccer. HYPOTHESIS The majority of surveyed athletes will have participated in multiple sports prior to specialization and specialized primarily as a result of a coach's recommendation, with no significant impact on specialization timing stemming from birth or high school location, obtaining a collegiate scholarship, MLS experience, or position. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 4. METHODS Anonymous surveys were distributed to 3 MLS organizations and completed by MLS athletes during preseason physicals. Surveys evaluated the age and reason(s) behind an athlete's decision to specialize in soccer, birth location, geographic high school location for US-born athletes, participation in a developmental league, college scholarship, years in the MLS, and position played. RESULTS Approximately 74% (64/86) of athletes returned completed surveys. Athletes reported beginning soccer at a mean age of 5.1 ± 2.1 years and specializing at age 12.6 ± 4.3 years. Athletes who participated in no other sports prior to specialization (P < 0.001), athletes reporting soccer to be their first sport played at an advanced level (P < 0.001), and athletes receiving a college scholarship (P = 0.02) specialized at a significantly younger age. Internationally born athletes specialized at significantly younger ages when compared with US-born athletes (P < 0.001). CONCLUSION The majority of athletes participated in multiple sports prior to specialization and eventually specialized to focus exclusively on soccer. The timing of sport specialization in professional MLS athletes was not associated with multisport participation prior to specialization, playing soccer at an advanced level prior to other sports, receiving a college scholarship, or being born outside the United States. CLINICAL RELEVANCE Timing of sport specialization is associated with multiple factors prior to athlete promotion to the MLS that warrant further investigation to better understand the impact of specialization on injury incidence, performance, and career length.
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Affiliation(s)
- Derrick M Knapik
- University Hospitals Sports Medicine Institute, Cleveland, Ohio.,Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | | | - James E Voos
- University Hospitals Sports Medicine Institute, Cleveland, Ohio.,Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
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Buckley PS, Ciccotti MC, Bishop M, Kane P, Selverian S, Exume D, D'Angelo J, Emper W, Freedman KB, Hammoud S, Cohen SB, Ciccotti MG. Youth Single-Sport Specialization in Professional Baseball Players. Orthop J Sports Med 2020; 8:2325967120907875. [PMID: 32232067 PMCID: PMC7092410 DOI: 10.1177/2325967120907875] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: An increasing number of youth baseball athletes are specializing in playing baseball at younger ages. Purpose: The purpose of our study was to describe the age and prevalence of single-sport specialization in a cohort of current professional baseball athletes. In addition, we sought to understand the trends surrounding single-sport specialization in professional baseball players raised within and outside the United States (US). Study Design: Cross-sectional study; Level of evidence, 3. Methods: A survey was distributed to male professional baseball athletes via individual team athletic trainers. Athletes were asked if and at what age they had chosen to specialize in playing baseball at the exclusion of other sports, and data were then collected pertaining to this decision. We analyzed the rate and age of specialization, the reasons for specialization, and the athlete’s perception of injuries related to specialization. Results: A total of 1673 professional baseball athletes completed the survey, representing 26 of the 30 Major League Baseball (MLB) organizations. Less than half (44.5%) of professional athletes specialized in playing a single sport during their childhood/adolescence. Those who reported specializing in their youth did so at a mean age of 14.09 ± 2.79 years. MLB players who grew up outside the US specialized at a significantly earlier age than MLB players native to the US (12.30 ± 3.07 vs 14.89 ± 2.24 years, respectively; P < .001). Additionally, MLB players raised in the US recalled a significantly higher incidence of sustaining an injury attributed to specializing in baseball than MLB athletes raised outside the US (27.7% vs 20.6%, respectively; P = .05). Conclusion: This study challenges the current trends toward early youth sport specialization, finding that the majority of professional baseball athletes studied did not specialize as youth and that those who did specialize did so at a mean age of 14 years. With the potential cumulative effects of pitching and overhead throwing on an athlete’s arm, the trend identified in this study toward earlier specialization within baseball is concerning.
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Affiliation(s)
| | - Michael C Ciccotti
- Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Meghan Bishop
- Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Patrick Kane
- Premier Orthopaedic Bone and Joint Care, Lewes, Delaware, USA
| | | | - Dominique Exume
- University Orthopaedic Associates, Wall Township, New Jersey, USA
| | | | - William Emper
- Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Kevin B Freedman
- Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Sommer Hammoud
- Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Steven B Cohen
- Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Michael G Ciccotti
- Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
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Ahlquist S, Cash BM, Hame SL. Associations of Early Sport Specialization and High Training Volume With Injury Rates in National Collegiate Athletic Association Division I Athletes. Orthop J Sports Med 2020; 8:2325967120906825. [PMID: 32201707 PMCID: PMC7068747 DOI: 10.1177/2325967120906825] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 11/19/2019] [Indexed: 11/16/2022] Open
Abstract
Background: There are 60 million US youth who participate in organized athletics, with
large increases in both sport participation and specialization during the
past 2 decades. There is some evidence that increased sport specialization
and training volumes may be associated with increased injuries in adolescent
populations. This study examines these variables in a population of elite
college athletes. Hypothesis: Early sport specialization (ESS) and a high training volume are risk factors
for injury and/or surgery in National Collegiate Athletic Association (NCAA)
Division I athletes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: All Division I athletes at a single institution were surveyed regarding
demographics, scholarship status, reason for specialization, age at
specialization, training volume, and injury history. Chi-square and
Mann-Whitney U tests were performed to identify significant
differences. Results: Athletes who specialized in their eventual varsity sport before age 14 years
were more likely to report a history of injuries (86.9% vs 71.4%), multiple
injuries (64.6% vs 48.8%), multiple college injuries (17.2% vs 6.0%), a
greater number of total injuries (2.0 vs 1.0), and require more time out for
an injury (15.2 vs 6.5 weeks) than those who did not. They were also more
likely to be recruited (92.9% vs 82.1%) and receive a scholarship (82.8% vs
67.9%). Athletes who trained for greater than 28 hours per week in their
eventual varsity sport before high school were more likely to report
multiple injuries (90.0% vs 56.3%), multiple college injuries (40.0% vs
12.5%), a surgical injury (60.0% vs 22.9%), multiple surgical injuries
(30.0% vs 4.7%), a greater number of total injuries (2.5 vs 2.0), and more
time out for an injury (36.5 vs 11.0 weeks) than those who did not (all
P < .05). However, these athletes were not more
likely to be recruited (90.0% vs 89.8%) or receive a scholarship (80.0% vs
74.5%). Conclusion: NCAA Division I athletes with ESS and/or a high training volume sustained
more injuries and missed more time because of an injury, but those with ESS
were more likely to be recruited and receive a college scholarship. This
knowledge can help inform discussions and decision making among athletes,
parents, coaches, trainers, and physicians.
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Affiliation(s)
- Seth Ahlquist
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA
| | - Brian M Cash
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA
| | - Sharon L Hame
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA
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McGowan J, Whatman C, Walters S. The associations of early specialisation and sport volume with musculoskeletal injury in New Zealand children. J Sci Med Sport 2020; 23:139-144. [DOI: 10.1016/j.jsams.2019.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 08/05/2019] [Accepted: 09/04/2019] [Indexed: 10/26/2022]
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DiSanti JS, Post EG, Bell DR, Schaefer DA, Brooks MA, McGuine TA, Erickson K. Exploring Coaches' Perceptions of Youth Sport Specialization: A Comparison of High School and Club Sport Contexts. J Athl Train 2020; 54:1055-1060. [PMID: 31633416 DOI: 10.4085/1062-6050-409-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
CONTEXT Previous researchers have identified sport specialization as being associated with various negative outcomes (eg, overuse injuries and adverse psychosocial outcomes). However, little is known regarding how the underlying attitudes, beliefs, and values of sport stakeholders may be shaping this trend. OBJECTIVE To examine the perceptions of coaches in the high school versus club sport setting and compare their attitudes and behaviors toward sport specialization. DESIGN Cross-sectional survey. PATIENTS OR OTHER PARTICIPANTS A total of 769 coaches (497 high school coaches, 272 club sport coaches). MAIN OUTCOME MEASURE(S) Participants completed a novel measure that surveyed their perceptions regarding various aspects of youth sport specialization. Additionally, each coach completed a questionnaire detailing his or her relevant demographic and sport background information. RESULTS High school coaches and club sport coaches differed in their perceptions of sport specialization (t767 = 1.41, P < .001); club coaches (2.43 ± 0.25) were more likely than high school coaches (2.31 ± 0.21) to rate specialization as a positive, adaptive practice. The multiple linear regression equations for both the high school and club coaches indicated that no educational, experiential, or demographic factors predicted coaches' perceptions of specialization (P values > .05). CONCLUSIONS Club sport coaches were more likely to possess attitudes in favor of sport specialization. Additionally, coaches' background characteristics did not predict their perceptions of specialization, suggesting that the competitive context itself (high school versus club) may be the most salient influencer of these perceptions. Athletes and sports medicine practitioners should be aware of the heightened expectation of specialized participation and resulting increased injury risk in these contexts. Pediatric sport researchers and practitioners should continue to explore how these different group perceptions manifest in participation behaviors and may link to overall athlete health, wellbeing, and development.
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Affiliation(s)
- Justin S DiSanti
- Department of Kinesiology, College of Education, Michigan State University, East Lansing
| | - Eric G Post
- School of Exercise and Nutritional Sciences, San Diego State University, CA
| | - David R Bell
- Departments of Kinesiology, University of Wisconsin-Madison.,Orthopedics and Rehabilitation, University of Wisconsin-Madison
| | | | - M Alison Brooks
- Orthopedics and Rehabilitation, University of Wisconsin-Madison
| | | | - Karl Erickson
- Department of Kinesiology, College of Education, Michigan State University, East Lansing
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42
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DiFiori JP, Quitiquit C, Gray A, Kimlin EJ, Baker R. Early Single Sport Specialization in a High-Achieving US Athlete Population: Comparing National Collegiate Athletic Association Student-Athletes and Undergraduate Students. J Athl Train 2020; 54:1050-1054. [PMID: 31633415 DOI: 10.4085/1062-6050-431-18] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
CONTEXT Early single-sport specialization and the relative age effect are often cited as improving the chances of sport success. Both concepts suggest that genetics and the environment have little influence on sport success. OBJECTIVE To compare National Collegiate Athletic Association Division I student-athletes (SAs) with their undergraduate nonathlete peers (NAs) in terms of birth month, age of sport initiation, and age of single-sport specialization. A family history of sport participation was examined as a potential marker for genetic and social influences. DESIGN Cross-sectional survey. SETTING Large urban university. PATIENTS OR OTHER PARTICIPANTS A total of 273 Division I SAs (138 women, 135 men) and 155 NAs (78 women, 77 men) participated. The NAs had been involved in competitive youth sports before entering the university. MAIN OUTCOME MEASURE(S) Participants were asked to complete a questionnaire that addressed the age of sport initiation, birth month, age of single-sport specialization, and parental and sibling sport achievement. MAIN RESULTS Neither birth month nor the age of sport initiation differed between groups (age of sport initiation = 7.16 ± 2.6 years for the SAs versus 7.71 ± 3.5 for the NAs; P = .176). A larger proportion of SAs began participating before 10 years of age (80% versus 63%; P = .02). The parents of SAs were more likely to have participated in collegiate (32.4% versus 8.4%; P < .0001) and professional (10.9% versus 1.3%; P = .0005) sports. The SAs specialized in a single sport at an older age (15.38 ± 2.7 years versus 14.30 ± 2.6 years; P = .002). Both groups participated in multiple sports in childhood (SAs = 3.9 ± 1.8 sports, NAs = 3.2 ± 1.8 sports; P = .366). CONCLUSIONS The Division I SAs did not specialize in a single sport at a younger age than the NAs. No evidence of a relative age effect was present. Importantly, higher levels of sport achievement among the parents and siblings of SAs suggest that genetic endowment and family or other environmental dynamics play a large role in athletic performance. Overall, the results are not consistent with deliberate practice theory and point toward an alternative model that includes not only sport-specific skill development but also genetic and social factors as key elements of long-term sport achievement.
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Affiliation(s)
- John P DiFiori
- Primary Sports Medicine, Hospital for Special Surgery, and National Basketball Association, New York, NY
| | | | - Aaron Gray
- Department of Family Medicine and Orthopaedics, University of Missouri, Columbia
| | | | - Ryan Baker
- Shriners Hospital for Children, Spokane, WA
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43
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Miller M, Malekian S, Burgess J, LaBella C. Evaluating a Commonly Used Tool for Measuring Sport Specialization in Young Athletes. J Athl Train 2020; 54:1083-1088. [PMID: 31633410 DOI: 10.4085/1062-6050-379-18] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
CONTEXT Sport specialization has been defined as year-round intensive training in a single sport to the exclusion of other sports. A commonly used survey tool created by Jayanthi et al, which classifies athletes as having a low, moderate, or high level of specialization, categorizes only athletes answering yes to "Have you quit other sports to focus on a main sport?" as highly specialized. We hypothesized that a measureable number of year-round, single-sport athletes have never played other sports and, therefore, may be inaccurately classified as moderately specialized when using this tool, even though most experts would agree they should be viewed as highly specialized. OBJECTIVE To determine the proportion of athletes misclassified as moderately rather than highly specialized because they never played a previous sport. DESIGN Cross-sectional study. SETTING Hospital-based pediatric outpatient sports medicine clinic. PATIENTS OR OTHER PARTICIPANTS Injured athletes aged 12 to 17 years who presented to the clinic between 2015 and 2017 and completed a sports-participation survey (n = 917). MAIN OUTCOME MEASURE(S) Sport-specialization level. RESULTS Of 917 participants, 299 (32.6%) played a single sport more than 8 months per year, and 208/299 (69.6%) had previously quit other sports (highly specialized), whereas 91 (30.4%) had never played other sports (highly specialized and misclassified as moderate). Individual-sport athletes had a 2.03 times greater risk of being highly specialized and misclassified as moderate than team-sport athletes (relative risk = 2.03 [95% confidence interval = 1.37, 3.00]). Females had a 1.70 times greater risk of being misclassified as moderately specialized than males (relative risk 1.70 [95% confidence interval = 1.07, 2.70]). Of the 3 sports with the largest number of athletes, artistic gymnastics had the highest proportion (51.2%) who had never played other sports. CONCLUSIONS The commonly used specialization survey misclassified a substantial number of highly specialized athletes as moderately specialized. Researchers should consider adding a fourth survey question, "Have you only ever played 1 sport?" to identify and better study this unique subset of misclassified athletes.
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Affiliation(s)
| | - Sina Malekian
- Ann & Robert H. Lurie Children's Hospital, Chicago, IL
| | - Jamie Burgess
- Ann & Robert H. Lurie Children's Hospital, Chicago, IL
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44
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Jayanthi NA, Post EG, Laury TC, Fabricant PD. Health Consequences of Youth Sport Specialization. J Athl Train 2020; 54:1040-1049. [PMID: 31633420 DOI: 10.4085/1062-6050-380-18] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Sport specialization is a training method now commonly used by young athletes who hope to achieve elite-level success. This may be defined as (1) choosing a main sport, (2) quitting all other sports to focus on 1 sport, and (3) year-round training (greater than 8 months per year). A number of sports medicine organizations have published recommendations based on the limited evidence available on this topic. The objective of this article was to perform a narrative review of the currently available evidence and sports medicine organizational recommendations regarding sport specialization and its effects on health to guide athletic trainers and sports medicine providers. To accomplish this goal, we conducted a narrative review of articles and position statements on sport specialization published from 1990 through 2018. Injury, overuse injury, serious overuse injury, and lower extremity injury were likely associated with higher degrees of sport specialization in various populations. Sports medicine organizations in general recommended against sport specialization in young athletes and instead promoted multisport participation for physical and psychological benefits. Few long-term data suggest that sport specialization has negative health-related quality-of-life consequences. Higher degrees of sport specialization likely pose risks of overuse injury; however, the age of specialization at which this risk occurs is not known. Because different populations and sports activities may put children at risk for certain injuries, future researchers should monitor large populations with sport-specific prospective active surveillance.
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Affiliation(s)
- Neeru A Jayanthi
- Emory Sports Medicine Center.,Department of Orthopedics, Department of Family Medicine, Emory University School of Medicine, Atlanta, GA
| | - Eric G Post
- School of Exercise and Nutritional Sciences, San Diego State University, CA
| | | | - Peter D Fabricant
- Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, and Department of Orthopaedic Surgery, Weill Cornell Medical College, New York, NY
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45
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Snyder Valier AR, Bliven KCH, Gibson A, Simon J, Dompier TP, Wasserman EB, Rynard KL, Kerr ZY. Non-Time-Loss and Time-Loss Softball Injuries in Secondary School Athletes: A Report From the National Athletic Treatment, Injury and Outcomes Network (NATION). J Athl Train 2020; 55:188-194. [PMID: 31913657 DOI: 10.4085/1062-6050-105-19] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Most studies of injury trends associated with softball focus on injuries requiring at least 24 hours of missed participation time (time-loss [TL] injuries), with little focus on those that do not (non-time-loss [NTL] injuries). A better understanding of injury trends associated with softball will improve athlete care. OBJECTIVE To describe NTL and TL injuries experienced by secondary school girls' softball players. DESIGN Descriptive epidemiology study. SETTING Secondary school athletic training clinics. PATIENTS OR OTHER PARTICIPANTS Secondary school girls' softball players. MAIN OUTCOME MEASURE(S) Aggregate data were collected from schools participating in the National Athletic Treatment, Injury, and Outcomes Network surveillance program during the 2011-2012 through 2013-2014 academic years. Frequencies and rates of injuries (NTL and TL) according to time of season, event type, body part injured, and diagnosis were analyzed. RESULTS In total, 1059 injuries were reported during 140 073 athlete-exposures (AEs): overall injury rate = 7.56/1000 AEs. Of these injuries, 885 (83.6%) were NTL (NTL rate = 6.32/1000 AEs) and 174 (16.4%) were TL (TL rate = 1.24/1000 AEs). Of the NTL and TL injuries, the largest numbers occurred during the regular season (NTL: n = 443 [50.1%]; TL: n = 131 [75.3%]). Injuries sustained during practices accounted for the majority of NTL and TL injuries (NTL: n = 631 [71.3%]; TL: n = 104 [59.8%]). The NTL injuries occurred most often at the shoulder (n = 134 [15.1%]) and hand/fingers (n = 109 [12.3%]) and were diagnosed as contusions (n = 316 [35.7%]), strains (n = 157 [17.7%]), and abrasions (n = 151 [17.1%]). The largest numbers of TL injuries were to the head/face (n = 71 [40.8%]) and diagnosed as concussions (n = 50 [28.7%]) and strains (n = 28 [16.1%]). CONCLUSIONS Secondary school softball players sustained a larger proportion of NTL injuries than TL injuries. Although NTL injuries may be less severe, they are numerous. Efforts are needed to ensure that injury-prevention programs are incorporated into the care of softball athletes to promote health and reduce injury occurrence.
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Affiliation(s)
- Alison R Snyder Valier
- Athletic Training Programs, A.T. Still University, Mesa.,Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa.,School of Osteopathic Medicine in Arizona and Research Support, A.T. Still University, Mesa
| | - Kellie C Huxel Bliven
- Athletic Training Programs, A.T. Still University, Mesa.,Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa
| | - Amy Gibson
- Athletic Training Programs, A.T. Still University, Mesa.,Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa
| | - Janet Simon
- Department of Applied Health Sciences and Wellness, Ohio University, Athens
| | - Thomas P Dompier
- Department of Athletic Training, Lebanon Valley College, Annville, PA
| | - Erin B Wasserman
- Datalys Center for Sports Injury Research and Prevention, Inc, Indianapolis, IN
| | - Kelsi L Rynard
- Datalys Center for Sports Injury Research and Prevention, Inc, Indianapolis, IN
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
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Ryder SC, Gnirke M, Laker SR, Hoffmire C, Comstock RD. Relationship of Overuse Injuries and Extrascholastic Sport Participation in High School Athletes 2009-2010 through 2015-2016. PM R 2019; 12:882-890. [PMID: 31769926 DOI: 10.1002/pmrj.12297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 11/19/2019] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Overuse injuries (injuries due to repetitive loads with inadequate rest) can negatively affect high school athletes, but limited data exist on the effect of sports participation outside of the school-sanctioned season on the development of overuse injuries. OBJECTIVE Compare overuse injury patterns among high school athletes who participate in extrascholastic athletics to those participating only in scholastic sports. DESIGN Descriptive cross-sectional, secondary analysis of injury data collected on high school athletes across 22 sports over the 2009-2010 through 2015-2016 academic years. SETTING Deidentified data collected as part of the High School Reporting Information Online study (HS RIO). PARTICIPANTS High school athletes from a large convenience sample of U.S. high schools. MAIN OUTCOME MEASUREMENTS Injury proportion ratios (IPRs) were computed overall and for individual sports to compare the proportion of overuse injuries in athletes competing in extrascholastic sports to athletes participating only in scholastic athletics. RESULTS Overall, extrascholastic athletes experienced a higher proportion of overuse injuries compared to scholastic-only athletes (IPR = 1.21, 95% confidence interval [CI] 1.13-1.30), but this association varied by sport. Among extrascholastic athletes, a higher proportion of overuse injuries occurred in those simultaneously playing the same sport outside the school setting (IPR = 1.32, 95% CI 1.11-1.57) as well as having experienced an injury within the past year (IPR = 1.63, 95% CI 1.36-1.95) compared to those sustaining non-overuse injuries. CONCLUSIONS Overuse injuries were associated with extrascholastic athletics and occurred in higher proportion in extrascholastic athletes who were playing the same sport in more than one league.
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Affiliation(s)
- Stephanie Cowherd Ryder
- Department of Physical Medicine and Rehabilitation, University of Colorado, School of Medicine, Aurora, CO
| | - Matthew Gnirke
- Department of Physical Medicine and Rehabilitation, University of Colorado, School of Medicine, Aurora, CO
| | - Scott R Laker
- Department of Physical Medicine and Rehabilitation, University of Colorado, School of Medicine, Aurora, CO
| | - Claire Hoffmire
- Department of Veterans Affairs, VISN 19 Rocky Mountain Mental Illness Research, Education and Clinical Care Center (MIRECC), Denver, CO
| | - R Dawn Comstock
- Department of Epidemiology and Pediatric Injury Prevention, Education and Research (PIPER) Program, Colorado School of Public Health, Aurora, CO
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Impact of youth sports specialisation on career and task-specific athletic performance: a systematic review following the American Medical Society for Sports Medicine (AMSSM) Collaborative Research Network’s 2019 Youth Early Sport Specialisation Summit. Br J Sports Med 2019; 54:221-230. [DOI: 10.1136/bjsports-2019-101365] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2019] [Indexed: 12/14/2022]
Abstract
ObjectiveThe impact, positive or negative, of youth sport specialisation (YSS) on short-term and long-term performance is not fully understood; however, the desire to maximise performance goals is generally considered the primary reason children and adolescents specialise at a young age. We performed a systematic review of original research to establish the association of YSS and task-focused or career-focused performance outcomes.DesignSystematic review.Data sourcesDatabases searched include PubMed, EMBASE, Cochrane, CINAHL and SPORTDiscus.Eligibility criteriaWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify peer-reviewed research articles published in English between 1 January 1990 and 31 December 2018 that reported original findings on the association of YSS and performance outcomes. Studies without an explicit measure of sport specialisation, for example, volume measures without measuring sport specialisation, were excluded.ResultsTwenty-two articles were included in the final review; 15 addressed career performance outcomes and 7 considered task performance outcomes. All identified studies were cross-sectional or retrospective in design. The proportion of elite athletes who specialised early ranged between 7% and 85%, depending on sport and definition of specialisation. Elite athletes often specialised between the ages of 14 and 15 compared with their non-elite or semi-elite peers who typically specialised prior to 13 years. In addition, neuromuscular control, anterior reach asymmetry and physical task outcomes did not differ by specialisation status.ConclusionThe volume and methodological rigour of published research in this field are limited. Our review suggests that YSS is not required to achieve success at elite levels. YSS also does not appear to improve task-related performance (eg, anterior reach, neuromuscular control) outcomes for specialised athletes when compared with non-specialised athletes during childhood and adolescence.
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48
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Post EG, Biese KM, Schaefer DA, Watson AM, McGuine TA, Brooks MA, Bell DR. Sport-Specific Associations of Specialization and Sex With Overuse Injury in Youth Athletes. Sports Health 2019; 12:36-42. [PMID: 31724908 DOI: 10.1177/1941738119886855] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Significant evidence has emerged that sport specialization is associated with an increased risk of overuse injury in youth athletes. Several recommendations exist to reduce the risk of overuse injury in youth sports, but the risk of overuse injuries may be dependent on specific movements required by a given sport. HYPOTHESES Associations between specialized sport participation and overuse injury will exist in volleyball athletes but not soccer or basketball athletes. Female athletes will be more likely to report an overuse injury in the previous year, regardless of sport. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS Youth athletes between the ages of 12 and 18 years were recruited in-person at club team tournaments, competitions, and events around the state of Wisconsin during the 2016-2017 school year. Participants were asked to complete an anonymous questionnaire that consisted of (1) participant demographics, (2) sport specialization status, (3) monthly and weekly sport volume, and (4) sport-related injury history in the previous year. RESULTS A total of 716 youth athletes completed the questionnaire (70.8% female; mean age, 14.21 ± 1.50 years; 43.2% basketball, 19.4% soccer, 37.4% volleyball; 41.8% highly specialized; 32.3% reported overuse injury in the previous year). Sex was associated with overuse injury among basketball athletes, with female basketball athletes nearly 4 times more likely to report an overuse injury compared with male basketball athletes (odds ratio, [OR], 3.7; 95% CI, 2.1-6.6; P < 0.001). High specialization (OR, 2.3; 95% CI, 1.1-4.9; P = 0.02) and participating in a single sport for more than 8 months per year (OR, 2.0; 95% CI, 1.1-3.5; P < 0.05) were associated with overuse injury only among volleyball athletes. CONCLUSION Specialization and exceeding 8 months per year in a single sport was associated with overuse injury in volleyball, which is one of the most popular youth sports for female athletes. Specialization was not associated with overuse injury in basketball or soccer athletes. Female basketball athletes were nearly 4 times more likely to report a history of overuse injury compared with male basketball athletes. The sex of a youth athlete and the sport that he or she plays may influence the risk of overuse injury associated with sport specialization. CLINICAL RELEVANCE Youth athletes, parents, and clinicians should be aware that the potential risks of specialization might vary based on the athlete's sport and sex.
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Affiliation(s)
- Eric G Post
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California
| | - Kevin M Biese
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Daniel A Schaefer
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Andrew M Watson
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
| | - Timothy A McGuine
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
| | - M Alison Brooks
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
| | - David R Bell
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
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49
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Confino J, Irvine JN, O'Connor M, Ahmad CS, Lynch TS. Early Sports Specialization Is Associated With Upper Extremity Injuries in Throwers and Fewer Games Played in Major League Baseball. Orthop J Sports Med 2019; 7:2325967119861101. [PMID: 31384622 PMCID: PMC6661792 DOI: 10.1177/2325967119861101] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Single-sport athletes who specialize in baseball at a young age may have a greater predisposition to overuse injury, burnout, and decreased career longevity when compared with multiple-sport athletes. The effect of sport specialization has not been studied in professional baseball players. Hypothesis Major League Baseball (MLB) players who played multiple sports in high school would experience fewer injuries, spend less time on the disabled list, play more games, and have a longer career than athletes who played only baseball in high school. Study Design Descriptive epidemiology study. Methods First- and second-round MLB draft picks from 2008 to 2016 who played in at least 1 professional game were included in this study. Athletes who participated in 1 or more sports in addition to baseball during high school were considered multisport athletes, and athletes who participated in only baseball were considered single-sport athletes. For each athlete, participation in high school sports, injuries sustained in MLB and Minor League Baseball, number of days on the disabled list for each injury, number of games played in both leagues, and whether the athlete was still active were collected from publicly available records. Results A total of 746 athletes were included in this study: 240 (32%) multisport and 506 (68%) single sport. Multisport athletes played in significantly more mean total games (362.8 vs 300.8; P < .01) as well as more mean MLB games (95.9 vs 71.6; P = .04) than single-sport athletes. There was no difference in the mean number of seasons played in the major leagues (1.8 vs 1.6; P = .15) or minor league (5.25 vs 5.20; P = .23) between multisport and single-sport athletes. Single-sport athletes had a significantly higher prevalence of upper extremity injuries compared with multisport athletes (136 [63%] vs 55 [50%]; P = .009). Single-sport pitchers also had a higher prevalence of shoulder and elbow injuries (86 vs 27; P = .008) and were more likely to have recurrent elbow injuries (33% vs 17% recurrence; P = .002) compared with multisport pitchers. Conclusion Professional baseball players who participated in multiple sports in high school played in more major league games and experienced lower rates of upper and lower extremity injuries than players who played only baseball in high school.
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Affiliation(s)
- Jamie Confino
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, New York, USA
| | - James N Irvine
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, New York, USA
| | - Michaela O'Connor
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, New York, USA
| | - Christopher S Ahmad
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, New York, USA
| | - T Sean Lynch
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, New York, USA
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50
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DiSanti JS, Erickson K. Youth sport specialization: a multidisciplinary scoping systematic review. J Sports Sci 2019; 37:2094-2105. [PMID: 31135271 DOI: 10.1080/02640414.2019.1621476] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Despite continued interest in youth sport participation, the consensus among researchers is that a thorough understanding of the phenomenon of youth sport specialization is still lacking. The popular and scholarly narratives regarding sport specialization challenge the adaptive nature of this practice. However, the lack of synthesis of youth sport specialization research makes existing practical recommendations potentially tenuous. This scoping review utilized a multidisciplinary lens to survey and integrate the full spectrum of youth sport specialization research by summarizing empirical findings and examining the characteristics of empirical research (e.g., field of publication, participant role, study design). Multiple databases were utilized to span the various disciplines in which sport specialization has been studied. The systematic review protocol yielded 906 publications for screening. After analysis of these records through inclusion/exclusion criteria, 40 empirical research publications examining youth sport specialization were included in this review. Analysis of these empirical findings indicated two higher-order emerging themes of this research: 1) Sport specialization participation behaviours; 2) Sport specialization outcomes. Descriptive results of the research characteristics are also explored. This review examined key findings that underlie recommendations for structuring youth sport participation, and highlighted future research avenues vital towards a more holistic understanding of this phenomenon.
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Affiliation(s)
- Justin S DiSanti
- a Department of Kinesiology, College of Education , Michigan State University , East Lansing , MI , USA
| | - Karl Erickson
- a Department of Kinesiology, College of Education , Michigan State University , East Lansing , MI , USA
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