Children's Hospital Colorado

Sport Specialization – One or One Too Many?


During the spring seasons of my middle school years, I remember attending track practice, then off to club wrestling practice, and finally, to baseball practice. All of these practices in one evening were very overwhelming. Of course, this was eventually too much to handle for a young athlete, so I decided to stop playing baseball.

This common scenario plagues many young athletes today and can result in the athlete choosing to specialize in one sport. Youth sports specialization has changed significantly in the last few decades. We have seen a significant shift from multiple sports to a specialty sport earlier and earlier in a young athlete’s career.

Many athletes play on school teams and club teams during the same season which increases their playing time, however, it can increase their risk for overuse injuries. Travel teams usually involve long weekends participating in multiple games throughout the day on back-to-back days, which can increase the intensity of stress on the same muscles, bones, tendons, or growth plates.

The most common sports in which I see early sports specialization are gymnastics, soccer, hockey, swimming, and dance. Not surprisingly, these are common sports in which we treat overuse injuries in our sports medicine clinics throughout the Denver Metro area.

Is your young athlete ready to specialize in one sport?

Many excellent young athletes dream about making a career out of their sport. With professional and Olympic selection processes attempting to identify early talent and initiate early specialization even before the middle school years, it is no wonder athletes are specializing earlier and earlier. Of course, most young athletes will not make it to the pros or the Olympic medals ceremony, but this does not discourage athletes or their parents from continuing to strive and push towards their lofty goals.

Younger athletes should be encouraged to participate in a variety of sports to develop different skills and avoid maximum stress to the same areas of the body. Not to mention, multiple sports also allow the athlete to develop socially within different groups of people.

The American Academy of Pediatrics recommends the following guidelines on sports specialization:

  • Children should be encouraged to participate in sports at a level consistent with their abilities and interests
  • Pushing children beyond these limits is discouraged as is specialization in a single sport before adolescence
  • Young athletes should be coached by those who are knowledgeable about proper training techniques,equipment, and the unique physical and emotional characteristics of young competitors
  • Physicians and coaches should strive for early recognition and prevention of overuse injuries
  • Young athletes should never be encouraged to”work through” overuse injuries or significant pain
  • Treatment for overuse injuries that includes only “rest” are unlikely to be followed by the committed young athlete and are unlikely to adequately address the risk of further injury
  • Monitor for signs and symptoms of over training, including decline in performance, weight loss, decreased appetite, and sleep disturbances

Preventing overuse injuries

Highly-driven athletes specializing in one sport are at risk for overuse injuries. These are the athletes who receive the most praise from their parents, coaches, and teammates and typically push themselves through pain and injuries. Many assume the responsibility of the team to win big games, tournaments, and championships.

These athletes are often told to play or compete through their pain by their coaches or parents, many times avoiding a doctor visit until the end of the season. These expectations and pressures come together to make it very difficult for young athletes to take time to rest and rehab injuries.

Tips for preventing overuse injuries:

  • Make sure to use proper equipment and ensure proper fitting
  • Have coaches maintain proper playing surfaces
  • Ensure adequate adult supervision at games and practices
  • Encourage your young athlete to properly prepare and condition prior to their season
  • Strive to improve flexibility and core strength throughout their athletic career
  • See a healthcare professional for injuries or joint pain immediately
  • Limit weekly and yearly participation time, limits on sport specific movements and scheduled rest periods are recommended.
  • To reduce the likelihood of burnout, emphasis should be placed on skill development more than competition.

Is your child thinking of specializing in one sport? Children’s Hospital Colorado is a partner and supports the STOP Sports Injuries Campaign. For more information on prevention of overuse injuries visit STOP Sports Injuries.

Written by: Aaron J. Provance, MD, Co-Director Pediatric Sports Medicine Program, Children’s Hospital Colorado, Department of Orthopedics.