When I was in high school, playing 3 sports was almost expected. For me, as soon as field hockey was over, I got 1-2 weeks after school to catch up on tv shows and rest, then basketball started. After basketball was over, depending on how much snow you had that winter, lacrosse started. That’s just how it was.
As college scholarships started to become more and more prevalent, so did sports “specialization.” As a PT, I noticed that when I asked what sports they played, they only said one. When I would ask what he or she did in the other seasons, I would get “what do you mean?”
As a younger PT, I’ll admit , I didn’t see the trend. But as I grew in the profession, I noticed that athletes as young as 11 or 12 were coming in with serious injuries like ACL tears or overuse injuries that were typically seen more towards late adolescence or college years. We started to see decline in different movements, slower motor coordination typically seen between sports, and an increase in specific injuries from 1 sport athletes. I have long advocated for multi sport playing; I feel there are fundamentals and concepts to every sport that have a carryover effect (think athletic stance, ready positions, etc), not to mention critical thinking and decision making required between the different sports. Our bodies can get used to one movement and have difficulty adapting to changing environments, leading to injury. In our profession, we call this variability, and is one of the hallmarks of continued growth, progression,motor control, and injury prevention.
Foundational movements like squats are in every sport from swimming to football. Our brain then takes the different stimuli like the feeling on turf vs. grass, sneakers vs. cleats, rain vs. a dry day etc and adapts this foundational movement to move with efficiency. If you are only participating in 1 specific type of pattern like jumping vertically and landing the same way, pushing off the same foot, or running the same way on a track, the brain has a hard time adapting to different circumstances resulting in decreased performance and potential injury. I had a hockey player who didn’t have an injury once in 5 years of competitive high school and prep school practice and games. He was playing a game of wiffleball in the summer and tore his ACL from a non contact injury saying his knee “just buckled when he ran.” Accidents happen, but was it that his body didn’t know how to adjust and apply different strategies?
I had my own “A Ha “moment recently during one of my son’s basketball games. All of my sons play different sports each season (well, if you know my youngest son Max, play is an aggressive word for the speed of his running….) My oldest son Alex loves lacrosse and practices with a club team all year around in addition to his other sports. While I was watching him defend in basketball, I noticed he wasn’t sliding like he usually did. When I really assessed it, he was applying the techniques from a lacrosse slide where you also check someone, because that was what he had been practicing. While a good thing in lacrosse, it slowed him down in basketball, leaving him unable to make a play at the time required .
A recent article by Bell et al, published in Pediatrics focused on the musculoskeletal injuries associated with sports specialization, finding that there was an 81% incident of injury greater with a high level of specialization vs. a low level. This means that if your son or daughter specializes specifically with a sport they are almost 2x more likely to develop an injury. 2x!!! That is a big number to think about. The authors also found that in comparing elite and nonelite athletes, and studies of professional or collegiate athletes, that elite athletes tend to specialize later in adolescence and participate more in high school than non elite athletes.
The take home message is this--Specialization isn’t the worst thing ever, but there definitely is a time and place. The younger the athlete is, the more they need to be exposed to different movement patterns. They key to injury prevention is variability. Whether it’s sports or any other action, our brain and our bodies do the best when they are challenged by different stimuli. Repetitive activities or are useful for learning, however there may be such thing as too much. This applies to all ages, but as a growing adolescent, it’s vitally important. The good news is that most coaches are also on board with this; they want to see your child stay healthy to play. Bottom line—2x more likely to have an injury...that’s something to really think about and worth a discussion.
