Journal of Athletic Training Releases Special Thematic Issue Focused on Youth Sports Specialization

Monday, October 21, 2019

DALLAS, TX – Kicking off National Youth Sport Specialization Awareness Week (third full week in October) the Journal of Athletic Training, the National Athletic Trainers’ Association’s (NATA) scientific publication, released today a special thematic issue focused on youth sport specialization. Youth sport specialization is intensive year-round participation in a single sport, often at the exclusion of other sports. The themed issue looks at the $15.3 billion youth sports industry1 and this increasingly hot topic as it pertains to general and sports-specific physical health, effects on public health, psychosocial well-being and burnout. The issue also addresses specialization in specific settings, such as club sports.
 

Key Information

  • While nearly 8 million adolescent athletes participated in high school interscholastic sports during the 2017-19 school year,2 it has been estimated that between 30 million and 60 million youth athletes in the United States participated in sports during 2017-18.3
  • Sport specialization often requires increased training hours and may predispose young athletes to social isolation, poor academic performance, increased anxiety, greater stress, inadequate sleep, decreased family time and burnout.4  
  • It is estimated that the United States spends $800 million to $5.2 billion per year on injuries attributed to sport specialization.5
  • Girls are more likely to be classified as highly specialized compared to boys. Also, students at large high schools or who live in urban settings are more likely to be classified as highly specialized.6
  • Sport sampling, or sport diversification, is the antithesis of sport specialization. It involves children trying out a variety of sports and physical activities. It’s critical for appropriate motor and social skill development, future athletic success, lifelong physical activity and reduced injury risk. It can also have a major impact on all aspects of physical literacy, is associated with lower rates of burnout in sport and creates opportunities for children to develop a variety of fundamental motor skills while evaluating activities for their own enjoyment.7
  • In a study of NBA players who were drafted first round from 2008 to 2015, players who were multiple-sport athletes in high school were less likely to sustain a major musculoskeletal injury than those who focused on basketball alone. Also, NBA athletes with a history of multiple-sport participation during high school demonstrated greater longevity and higher percentages of total games played than NBA athletes who pursued only basketball.8
  • Professional baseball players who participated only in baseball (single-sport athletes) before high school were more likely to suffer major injuries during their professional careers than players who participated in additional sports (multiple-sport athletes).9
     

“Specialization in youth sports has increasingly become a common practice for those wanting to successfully compete at elite levels, often at the potential risk of their short and long-term health,” said Journal of Athletic Training Editor in Chief Jay Hertel, PhD, ATC, FNATA. “This special thematic issue investigates the growing concern from athletic trainers and other medical professionals for youth athletes that feel specializing early is the only way to achieve their goals.” 

“A culture of unequal, non-universal access and poorly conceived early training may cause great harm to both the athlete and society,” said NCAA Chief Medical Officer Dr. Brian Hainline. “Society prioritizes and celebrates individual performance over general athletic participation. The result is most school children are relegated to the sidelines with little opportunity to participate in organized sport. The focus should be on long-term and safe development for all children under the supervision of medical professionals, such as athletic trainers.”


Highlights from the Special Issue:
 

Early Sport Specialization: Shifting Societal Norms
Brian Hainline, MD

  • Early sport specialization is thought to be the outcome of a clash of systems, policies and structures that produces requirements incompatible with long-term athlete development.
  • Specializing in a sport leads to successful peak performance as an adult when done later rather than earlier.
  • There is no data that supports the possibility that early specialization leads to a greater likelihood of a collegiate scholarship or a career as a professional athlete.
  • Long-term athlete development is a progressive model of sport participation that focuses on a foundation of fun and general athleticism. Sport specialization is gradually introduced once developmentally and age-appropriate talent and personal ambition are established.
  • Most Olympic athletes played multiple sports in their youth.
  • The athletic trainer is the foundation of any effort dedicated to ensuring the health and safety of our most sacred asset in sport: the athlete.
     

The Public Health Consequences of Sport Specialization
David R. Bell, PhD, ATC; Lindsay DiStefano, PhD, ATC, Nirav K. Pandya, MD; Timothy McGuine, PhD, ATC

  • The landscape of youth sports participation has drastically changed over the past 20 years. The emphasis has shifted from school-based programming centered on fitness, teamwork and participation to, in some cases, private-based programming centered on skill development, individual success and profit. This change has come at the expense of the physical and emotional health of the young athlete.
  • Recent data demonstrates that specialization is now ubiquitous across most youth sports. Soccer, volleyball, ice hockey, basketball, softball and lacrosse have the greatest prevalence of highly specialized athletes in team sports.
  • Specialization may serve as a barrier to exploring sports as a youth because the environment is not conducive to novice learners.
     

Economic Impact

  • 63% of club sport parents will pay from $1,200 to $6,000 per year, with nearly 20% paying upward of $12,000 per year.
  • Only a select few families will win the ‘‘jackpot’’ of youth sports: having a child who avoids serious injury while obtaining a scholarship amount that exceeds money paid to club sport entities on a yearly basis.
  • Adults have created a two-tiered environment that will have vast implications on the long-term health of our youth. One group is characterized by a highly specialized cohort that requires underwriting of significant economic costs and that also leads to overuse injury and burnout. The second group that may be less specialized, cannot afford the costs to play, has fewer opportunities to participate in physical activity and may be at risk for long-term sedentary-lifestyle diseases.
     

Recommendations for Advocacy

  • Advocate for policy and rule changes:  Parents and coaches must be educated about the current sports culture in order to concretely affect change. Encourage children to participate in a variety of sports and remove policies that penalize children wishing to do so.
  • Participate in injury prevention programs, follow and disseminate safe sport recommendations:  Evidence-based safe sport recommendations exist in order to provide parents, coaches and athletes with guidelines in order to reduce injury risk. Yet, recent data demonstrates that 80% of these individuals have no knowledge of these recommendations.
  • Increase opportunities for low-income and disadvantaged students:  The average cost of sport participation is approximately $302. However, more than half of all children receive free or reduced-price lunch and 1 in 5 lower-income parents report that cost forced them to cut back on their children’s sport participation
  • Reinvest in school-based physical education:  There is strong evidence that school-based physical education increases physical activity and fitness among children. Yet, most physical education lessons do not meet the Centers for Disease Control and Prevention recommendation that 50% of a student’s lesson time should be involved in moderate-to-vigorous physical activity.
     

The Psychosocial Implications of Sport Specialization in Pediatric Athletes
Joel S. Brenner, MD, MPH; Michele LaBotz, MD; Dai Sugimoto PhD, ATC; Andrea Stracciolini MD, FAAP, FACSM
 

General

  • Optimal levels of physical activity and sport participation are generally associated with improved mental health outcomes. However, sport specialization typically introduces multiple stressors that could be expected to adversely affect mental health and function in young athletes.
  • Sports enjoyment, rather than sports participation alone, appears to predict increased self-esteem.
     

Sleep

  • Sleep duration and quality is an important component of the health maintenance of all youth athletes.
  • The increase in training volume that is inherent to sport specialization may directly affect physical and psychological health by altering sleep duration and quality. It may also be related to increased muscle tension, pain after excessive participation or training, stress of competition and changes in core body temperature.
     

Burnout

  • Burnout is part of a spectrum of conditions that includes overreaching and overtraining. It can be defined as a “response to chronic stress in which a young athlete ceases to participate in previously enjoyable activity”
  • Burnout in young athletes can lead to serious physical and psychosocial implications, both short and long term. A young athlete who drops out of sports or all physical activities due to burnout is at risk for multiple comorbidities. Examples include obesity, depression, hypertension, diabetes and poor academic performance. Overall, burnout has been reported to have significant effects on motivation, performance and well-being.
  • Environmental factors that contribute to burnout in young athletes may include extremely high training volume, excessive time commitment, demanding performance expectations (imposed by self or significant others), frequent and intense competitions, inconsistent coaching practices, little personal control in sport decision-making and negative performance evaluations.
  • Personal characteristics contributing to burnout include perfectionism, a need to please others, non-assertiveness, unidimensional self-conceptualization (focusing only on one’s athletic involvement), low self-esteem and a high level of perceived stress (high anxiety).


About NATA: National Athletic Trainers’ Association (NATA) – Health Care for Life & Sport

Athletic trainers are health care professionals who specialize in the prevention, diagnosis, treatment, and rehabilitation of injuries and sport-related illnesses. They prevent and treat chronic musculoskeletal injuries from sports, physical and occupational activity, and provide immediate care for acute injuries. Athletic trainers offer a continuum of care that is unparalleled in health care. The National Athletic Trainers' Association represents and supports 45,000 members of the athletic training profession. For more information, visit www.nata.org.

 

References:

  1. David R. Bell, Lindsay DiStefano, Nirav K. Pandya, Timothy McGuine (2019) The Public Health Consequences of Sport. Journal of Athletic Training: October 2019, Vol. 54, No.10, pp. 1013–1020.
     
  2. Eric G. Post, Daniel A. Schaefer, Kevin M. Biese, Lisa A. Cadmus-Bertram, Andrew M. Watson, Timothy A. McGuine, M. Alison Brooks, David R. Bell (2019) A Comparison of Emergency Preparedness Between High School Coaches and Club Sport Coaches. Journal of Athletic Training: October 2019,Vol. 54, No.10, pp. 1074–1082.
     
  3. Christopher A. DiCesare, Alicia Montalvo, Kim D. Barber Foss, Staci M. Thomas, Timothy E. Hewett, Neeru A. Jayanthi, Gregory D. Myer. (2019) Sport Specialization and Coordination Differences in Multisport Adolescent Female Basketball, Soccer, and Volleyball Athletes. Journal of Athletic Training: October 2019, Vol. 54, No.10, pp. 1105–1114.
     
  4. Joel S. Brenner, Michele LaBotz, Dai Sugimoto Andrea Stracciolini (2019) The Psychosocial Implications of Sport Specialization in Pediatric Athletes. Journal of Athletic Training: October 2019,Vol. 54, No.10, pp. 1021–1029.
     
  5. David R. Bell, Lindsay DiStefano, Nirav K. Pandya, Timothy McGuine (2019) The Public Health Consequences of Sport. Journal of Athletic Training: October 2019, Vol. 54, No.10, pp. 1013–1020.
     
  6. David R. Bell, Lindsay DiStefano, Nirav K. Pandya, Timothy McGuine (2019) The Public Health Consequences of Sport. Journal of Athletic Training: October 2019, Vol. 54, No.10, pp. 1013–1020.
     
  7. David R. Bell, Lindsay DiStefano, Nirav K. Pandya, Timothy McGuine (2019) The Public Health Consequences of Sport. Journal of Athletic Training: October 2019, Vol. 54, No.10, pp. 1013–1020.
     
  8. Joel S. Brenner, Michele LaBotz, Dai Sugimoto Andrea Stracciolini (2019) The Psychosocial Implications of Sport Specialization in Pediatric Athletes. Journal of Athletic Training: October 2019,Vol. 54, No.10, pp. 1021–1029.
     
  9. Joel S. Brenner, Michele LaBotz, Dai Sugimoto Andrea Stracciolini (2019) The Psychosocial Implications of Sport Specialization in Pediatric Athletes. Journal of Athletic Training: October 2019, Vol. 54, No.10, pp. 1021–1029.

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