What is it?
Sport specialization may be considered as intensive, year-round training in a single sport at the exclusion of other sports. There is concern that sport specialization early in youth may make overuse injuries and sport burnout more likely to happen. Except for gymnastics and diving, young athletes have not been shown to be more successful in their sport when choosing to focus only on one sport before the age of 12.

Causes
Sport specialization happens when a young athlete chooses to participate in one sport all year round in order to master the skill set for that sport, in the hope of reaching an elite level. This may be influenced by the athlete, parent, or coach.

Risk Factors

• Adult expectations for success
• Athletes participating in individual sports
• Athletes competing at the highest level of their sport

Symptoms

• Symptoms of burnout and overtraining from sport specialization may include low self-esteem, low personal performance expectation, and concern about failure
• Increased parental pressure to participate is associated with increased anxiety
• Loss of sleep and appetite
• Decreased fun, satisfaction, and sport enjoyment
• Physical injuries, decreased performance level

Diagnosis
The diagnosis of overuse injuries and sport burnout from sport specialization is typically made upon history, physical examination, and, at times, with the use of x-rays, especially if there is concern for an overuse injury, as deemed necessary by the sport medicine physician.

Sports Medicine Evaluation and Treatment

• If there are symptoms of an overuse injury or burnout from sport specialization, removing the young athlete from the sport for a period of time may be necessary
• If there are significant psychological symptoms, such as depression, lack of interest in the sport, anxiety, and low self-esteem, the sports medicine physician may refer the athlete to a sports psychologist

Injury Prevention

• Limiting weekly and yearly participation time
• Limiting sport-specific repetitive movements
• Scheduled rest periods
• Increased amount of free, unstructured activities rather than organized practices
• Delayed training in a single sport until 12 years of age in girls and 14 years of age in boys (during adolescence)
• Allowing at least 2 months off from the sport to avoid year round training and allow for recovery

Return to Play
Young athletes who specialize in one sport and experience an injury, illness, or burnout should have adequate treatment, physical rest, and mental rest prior to returning to sport.

AMSSM Member Authors: Nick Monson, DO, Fran O’Connor, MD

References

Jayanthi NA, Pinkham C, Dugas L, Patrick B, LaBella C, “Evidence-Based Recommendations: Counseling the Young Athlete on Sports Specialization,” Journal of Sports Health, May 2013 5:251-257.

Difiori JP, Benjamin HJ, Brenner JS et al. Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine. Br J Sports Med. 2014 Feb;48(4):287-8.