Sports Specialization
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1 Sports Specialization Scott McKay, MD Orthopedics Physical Benefits Why Sports for Youth? Decreased obesity Better sleep Cardiovascular benefits Strength benefits Bone health 1
2 Why Sports for Youth? Psychosocial Benefits Self confidence Friendships Purpose Alternative to more nefarious activities Sports Specialization DEFINITION: SPORTS SPECIALIZATION Focus on one sport Year round AOSSM has defined EARLY SPORTS SPECIALIZATION Participation of one sport at the exclusion of other sports More than 8 months per year Prior to age 12 2
3 Why Specialize? Scholarship Win Improve skills Certain sports demand it Certain Sports Require Specialization for Success Competitive gymnastics Ballet?Golf?Fencing?Competitive cheer 3
4 Specialization Possibly Harmful? Track Basketball Wrestling Baseball Football Softball Volleyball Soccer Odds of Playing College 1% receive scholarship 4
5 Sports Specialization: Why Do We Care? Growing body of literature to suggest that early sports specialization contributes to Injuries: Acute & Overuse Burnout Depression Sports Specialization The Business of Youth Sports Estimated $9-15 billion industry Families spend thousands of dollars/year Travel teams Showcases High level private coaching Personal trainers/performance 5
6 Sports Specialization Studies Showing Association with Specialization and Injury Roos KG, Marshall SW, Kerr ZY, et al. Epidemiology of overuse injuries in collegiate and high school athletics in the United States. Am J Sports Med. 2015;43(7): Schroeder AN, Comstock RD, Collins CL, Everhart J, Flanigan D, Best TM. Epidemiology of overuse injuries among high-school athletes in the United States. J Pediatr. 2015;166(3):
7 MLB Pitch Smart 2014 Age Daily Max (Pitches in Game) Required Rest (Pitches) 0 Days 1 Days 2 Days 3 Days 4 Days 5 Days N/A N/A N/A N/A N/A N/A N/A N/A
8 AAP/AOSSM/Pitch Smart Recommendations No year round pitching (<8 months preferred) No pitching while fatigued Follow pitch-count and rest guidelines Do not pitch on 2 simultaneous teams Do not catch and pitch No curveball until 14, slider at 16 Appropriate strength & conditioning Watch yourself at showcases Put away the radar gun Am J Sports Med. April 2018 Age, height, multiple teams, velocity, arm fatigue Pitches per game for shoulder injuries GIRD, shoulder adduction not significant 8
9 AAP/AOSSM/Pitch Smart Recommendations No year round pitching (<8 months preferred) No pitching while fatigued Follow pitch-count and rest guidelines Do not pitch on 2 simultaneous teams Do not catch and pitch No curveball until 14, slider at 16 Appropriate Strength & Conditioning Watch yourself at showcases Put away the radar gun PRiSM Pediatric Research in Sports Medicine Multidisciplinary society dedicated to furthering knowledge to improve the care of young athletes Multiple Research Interest Groups Sports Specialization Group 9
10 Texas Children s Professional Education Series Project Multicenter, multi-region athlete self-reported study of teenage soccer specialization and its effects on injuries Online survey hosted by Qualtrics. IRB approved for link distribution via , social media, flyers 761 completed surveys by soccer players age female Specialization Correlated with Knee Injuries 10
11 Texas Children s Professional Education Series Overuse Injuries by sport Baseball shoulder/elbow Internal Impingement Undersurface of supraspinatus hitting posterior superior glenoid rim
12 Texas Children s Professional Education Series Elbow Issues Traction forces medially Medial epicondyle apophysis Ulnar collateral ligament Compression forces laterally Osteochondritis dissecans Soccer ACL injuries Patellofemoral pain 12
13 Texas Children s Professional Education Series Prevention of Knee Injuries Sportsmetrics US club soccer 11+ CHOP ready set prevent Santa Monica ACL prevention project (US Soccer) Swimmer s Shoulder Repetition of bad technique = injury PT & relative rest Prehab & maintenance 13
14 Texas Children s Professional Education Series Water Polo Shoulder Injury 25-80% of elite players age Acute dislocation and chronic overuse pain Need proper swim & shot technique Track/Cross Country Stress fractures Tibia/foot/femur Shin splints Foot pain 14
15 Texas Children s Professional Education Series Lots of Organizations Have Position Statements AAP Brenner JS, Council on Sports Medicine and Fitness. Sports Specialization and Intensive Training in Young Athletes. Pediatrics. 2016;138(3):e doi: /peds
16 Texas Children s Professional Education Series Others AMSSM AOSSM NATA European College of Sport Science Summary Sports are good Odds of scholarship are small Specialize by late adolescence if at all Follow published guidelines to avoid psychological and physical consequences 16
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