Youth participation in sport is recognised to benefit physical fitness, mental health, personal wellbeing, and even social integration.
What is sports specialisation?
Sports specialisation is defined as intensive year-round training (greater than 8 months per year) with a focus on a single main sport. It does not involve training in more than one sport at a time.1
Risks of high volume sports specialisation
To achieve elite athletic performance, children and adolescents commit to sports specialisation. However, the demands of early sports specialisation can be associated with risks, such as:
- Overuse injury
- Burnout/overtraining syndrome
“An overuse injury is microtraumatic damage to a bone, muscle, or tendon that has been subjected to repetitive stress without sufficient time to heal or undergo the natural reparative process.”2
There are 4 stages of overuse injuries:3
- Pain in the affected area after physical activity
- Pain during the activity, without restricting performance
- Pain during the activity that restricts performance
- Chronic, unremitting pain even at rest
The risks of overuse injury in pediatric and adolescent athletes is more serious than in adults. Pediatrics and adolescent bones are still developing, meaning that the skeleton has not completely hardened yet. Consequentially, the growing bones of the young athlete will not be able to handle the same amount of stress as the mature bones of adults.4
“A young baseball pitcher who has not yet learned proper throwing mechanics (ie, recruiting the entire kinetic chain—from foot to hand—instead of just the arm) is at risk of traction apophysitis of the medial elbow.
A young gymnast who performs repetitive hyperextension activities may develop spondylolysis (ie, a stress fracture of the spine), which is an injury particular to the pediatric age group.
In addition, young swimmers may not recognize signs of rotator cuff tendonitis, because they may be unable to cognitively connect vague symptoms, such as fatigue or poor performance, as a sign of injury.” 2
Burnout or overtraining syndrome is defined as a “series of psychological, physiologic, and hormonal changes that result in decreased sports performance”.5
Signs and symptoms of burnout may include:5,6
- Chronic muscle or joint pain
- Personality changes
- Elevated resting heart rate
- Lack of sport/competition passion
- Dropout from sport
Guidelines to prevent burnout: 5
- Keep workouts interesting, with age-appropriate games and training, to keep practice fun.
- Take time off from organized or structured sports participation 1 to 2 days per week to allow the body to rest or participate in other activities.
- Permit longer scheduled breaks from training and competition every 2 to 3 months while focusing on other activities and cross-training to prevent loss of skill or level of conditioning.
- Focus on wellness and teaching athletes to be in tune with their bodies for cues to slow down or alter their training methods
A case-control study published in The American Journal of Sports Medicine reported that:
“Athletes who participated in their primary sport for more hours per week than their age (ie, a 16-year-old athlete who participated in his or her primary sport for more than 16 h/wk) were more likely to report an injury of any type in the previous year.”1
Youth athletes training at “high levels of specialisation were associated with a history of injuries, independent of age, sex, and weekly organised sports volume. Athletes who exceeded volume recommendations were more likely to have a history of overuse injuries.”1
1.Post, EG, Trigsted, SM, Riekena, JW, Hetzel,, McGuine, TA, Brooks, A, Bell, DR (2017). The Association of Sport Specialization and Training Volume With Injury History in Youth Athletes. The American Journal of Sports Medicine; 45, Issue 6, pp. 1405 – 1412.
2.Brenner, J. S. and The Council on Sports Medicine and Fitness. (2007). Overuse, Overtraining, and Burnout in Child and Adolescent Athletes. American Academy of Pediatrics, 119(6): 1242-1245.
3.Mellion MB, Walsh WM, Madden C, Putukian M, Shelton GL. (2002) Team Physician’s Handbook. 3rd ed. Philadelphia, PA: Hanley & Belfus Inc
4.Maffulli N, Chan D, Aldridge M. (1992). Overuse injuries of the olecranon in young gymnasts. J Bone Joint Surg Br;74 :305– 308
5.Small E. Chronic musculoskeletal pain in young athletes. Pediatr Clin North Am.2002;49 :655– 662
6.Budgett R. (1998). Fatigue and underperformance in athletes: the overtraining syndrome. Br J Sports Med;32 :107– 110