GUIDELINES FOR YOUTH ATHLETE TRAINING
Early sport specialization appears to be increasing in young athletes and the pressure to select
one sport to the exclusion of others is believed to come from coaches, parents, and other youth
athletes. There is concern that engaging in year-round intense training programs in a single
sport at an early age may result in negative outcomes for some athletes resulting in overuse
injuries, burnout and dropping out of other sports.
The table below depicts the degree of sports specialization and the risk of all cause injuries
Degree of Specialization Risk of Injury Risk of Serious Risk of Acute
Overuse Injury Injury
Low specialization (0 or 1 of the following): Low Low Moderate
• Year-round training (>8 months per
year)
• Chooses a single main sport
• Quit all sports to focus on 1 sport
Moderately specialized (2 of the Moderate Moderate Low
following):
• Year-round training (>8 months per
year)
• Chooses a single main sport
• Quit all sports to focus on 1 sport
Highly specialized (3/3 of the following): High High Low
• Year-round training (>8 months per
year)
• Chooses a single main sport
• Quit all sports to focus on 1 sport
What Makes Sports Specialization a risk versus diversified sports experience?
1. The lack of diversified activity may not allow young athletes to develop the appropriate
neuromuscular skills that are effective in injury prevention and does not allow for the
necessary rest from repetitive use of the same segments in the body.
2. Specifically, exceeding 16 hours per week of total sports participation, regardless of the
number of sports, seems to carry the greatest risk
Contributing factors to early sport specialization:
Year-round exposure to a single sport:
Year-round exposure to a single sport may be one of the primary reasons for injury risk in
specialized athletes.
For Example:
In youth baseball pitchers, there was a greater risk for shoulder and elbow surgery in those that
pitched greater than 8 months per year and in those that pitched regularly with arm pain or
fatigue
Repetitive technical skill and high-risk mechanics:
Specific to tennis, the mean age for the introduction of the kick serves (a heavy topspin serve
that typically requires significant lumbar hyperextension and extreme abduction and external
rotation of the shoulder) to adolescent athletes was approximately 13 years old.
Baseball pitchers are much more likely to have overuse elbow injuries related to pitching
volume, pitching fatigue, and poor mechanics that result in increased elbow torque and forces.
Likewise, young gymnasts often have wrist pain that is related to the volume of training
intensity and skill level, likely related to repetitive impact forces in wrist dorsiflexion during
growth periods.
Overscheduling and Competition:
Scheduled intense competitions that can last 6 hours or longer without adequate rest and
recovery have been implicated as a risk factor for potential injury as well.
In ice hockey, players more prone to dropout began off-ice training at a younger age, while they
also invested a larger number of hours in off-ice training at a younger age compared with those
who continued participation.
Other studies in sports such as swimming and tennis suggest that retirement from sport may be
the consequence of burnout, which young athletes may experience with continued intense and
specialized participation.
For example, a study of junior tennis players indicated that the burned-out players had less
input into training and sport-related decisions and practiced fewer days with decreased
motivation compared with the players who did not exhibit similar levels of burnout.
Primary Injury and Effects of Fear of Reinjury:
Psychological readiness to return to sport after an injury does not always correspond with
physical readiness. Fear of reinjury is a frequently cited reason athletes do not return to sport or
reduce their level of physical activity.
Conclusion:
The emerging evidence indicates that intense, year-round training specialized to a single sport
can be a risk factor for various issues, and parents and coaches need to be cautious about
encouraging early sport specialization in youth.
Three components that define early sports specialization
1. Include year-round training (>8 months per year), choosing a single main sport, and
quitting all other sports to focus on 1 sport.
2. Increased degree of specialization is positively correlated with increased serious overuse
injury risk.
3. The volume of training defined by hours per week of organized sports can increase injury
risk either by exceeding 16 hours per week of organized sports or hours per week of
organized sports greater than the athlete’s age.
