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Early Sports SpecializationJeff Ebel, D.O.

Paul Murray, PT, DPT, OCS, CSCS

DISCLOSURES

Neither I, Jeff Ebel, nor any family member(s), have any relevant financial relationships to be discussed, directly or

indirectly, referred to or illustrated with or without recognition with the presentation.

Neither I, Paul Murray, nor any family member(s), have any relevant financial relationships to be discussed, directly or

indirectly, referred to or illustrated with or without recognition with the presentation.

Objectives

Definition of Early Sports Specialization

Risk Factors for Early Sports Specialization

Types of injuries related to Early Sports Specialization

Success of Early Sports Specialization

What defines a successful athlete

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Definition

Still working to define…

Most accepted definition:

Intensive year-round training in a single sport at the exclusion of other sports.

Degree of Specialization

1. Choose a main sport

2. Participate > 8 months/ year in

main sport

3. Quit all other sports to focus on

main sport

Low (1) Moderate (2) High (3)

Myer GD, et al. Sports Health 2015

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Where did the idea come from?

Based off the theory of deliberate practice.

“10 year/10,000 hour rule”

Results in younger highly skilled and sport mature athletes.

Successful?*

NCAA Sport Specialization Data

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Soccer Tennis Ice Hockey Basketball Swimming Golf Football Baseball Wrestling Lacrosse Track

DI DII DIII

Borrowed with Permission Brian Hainline MD NCAA Research

**

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Why is it a problem?

Injury Statistics

Highly specialized: 2.25 greater odds of having a sustained overuse injury

20% of athletes report injury as the reason for quitting their sport

2 to 1 increased injury rate for organized play over free play

Physeal Overuse InjuriesCommon Physeal Injury Common Sports associated with injuryLittle League Shoulder ( Proximal humerus epiphysiolysis) Baseball, Softball, Tennis, Football (QB), VolleyballLittle League Elbow (Medial epicondyle apophysitis or avulsion) Baseball, Softball, Tennis, Football (QB), Volleyball, JavelinGymnast Wrist (Distal radial physeal stress syndrome) Gymnastics, CrossfitAnterior Superior Iliac Spine Avulsion Soccer, Track and Field, Baseball Anterior Inferior Iliac Spine Avulsion Soccer, Track and Field, Weightlifting Osteitis Pubis (Inflammation of pubic symphysis) Hockey, Soccer, Football, Track and FieldSinding-Larsen-Johansson syndrome (Inferior patellar pole apophysitis) Basketball, Volleyball, SprintersOsgood Schlatter's Disease ( Tibial tubricle apophysitis) Basketball, Volleyball, SprintersSever's Disease (Calcaneal Apophysitis) Basketball, Volleyball, Track and Field, Soccer, Gymnastics

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Early sports specialization isits own modifiable risk factor.

Myer GD, et al. Sports Health 2015

Please pause for a moreInteresting and engaging

Speaker.

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Movement Competence

Motor skills applied to situational needs. • A person who seems to pick up novel

movement tasks more quickly and is able to then transfer that skill to other tasks

• Example: Hockey player who excels at golf.

• ‘High kinesthetic sense’ or ‘good body awareness’

Can be very evident in youth sports • Athletes who seem to excel in all sports

at young age.

Athlete vs. Player

Player:• Someone who holds a high level of sport

specific skill but may or may not lack high kinesthetic sense to generalize movement outside of preferred practice method.

Athlete:• someone who possesses a high kinesthetic

sense and basic capacity for athletic or sport movement but make lack sport specific skill

Athlete vs. Player

Linear v. Non-linear pedagogy• “the practice of teaching”• Linear being progressive model of

instruction based on didactic cues directly related to the tasks

• Intrinsic cues/goals • Non-linear being non-specific task

completion based instruction• Extrinsic cues/goals and parameter

manipulation

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Athlete vs. Player

• Tested in study with tennis players by Lee et al.

• Linear instruction group showed improvement in shot accuracy and form related to tennis swing

• Non-linear group showed improvement in shot accuracy but did not show significant improvement in form

• Non-linear group showed improved retention after period of no instruction

Athlete vs. Player

• Did linear strategy create better player or athlete?

• Did non-linear strategy create a better player or athlete?

• Which of these groups may be able to apply this teaching of tennis swing to another task?

Athlete Exposure (AE)

Number of athletes participating x practices/games participated• Can be quantifying practices or games or both.• Example: a single soccer player playing in 2 practices per week over a 12 week

season would equal 24 athletes exposures.

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Injury Rates

Number of injuries x athlete exposure• Allows practitioners and researchers to standardize injury prevalence over

difference volumes. • Expressed in injuries/exposure ie. 5 injuries per 1000 athlete exposures.

If risk increases then rate increases.If exposure increases the rate increases.

Injury Rates by Sport

Youth football• 8.5 per 1000 exposures

Youth Soccer• 6.1-7 per 1000 exposures

Youth Baseball• 5.78 per 1000 exposures

Youth Basketball• 4.86 per 1000 exposures

Injury Rates by Sport

Consider the 10,000 hour rule• If 1 hour of practice can be considered

an athlete exposure, then 10,000 hour leads potentially 10,000 AE.

• Potential for 10 x the raw numbers of injuries based on the rate for each respective sport.

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Who benefits?

$17 billion per year industry nationwide according to Wintergreen Research.

On average participation fees average between $100-$400, according to Kids Play USA, but has been reported as high as $10,000.

27.5 percent of households making below $25k/year have at least one participant.

45.5 percent of households making greater than 100k/year have at least one participant.

High Level Athlete Stats

71% of D1 football players played multiple sports.

87%/91% D1 female/male runners played multiple sports.

88%/83% D1 lacrosse played multiple sports.

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High Level Athlete Stats

87% of D1 gymnasts specialized before age 12.

68%/62% of elite level soccer players specialized before age 12.

Current Sports Specialization

Age of Specialization

Depends on the sport• Sports like figure skating, ice dance, and gymnastics need to specialize earlier

(<12 years old) as peak performance is often before age 18. • Most studies show later specialization(> 16-18 years old) leads to elite athletes

compared to non elite professional colleagues.

Choice to specialize should always be driven by the athlete.

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Guiding Rules

• Take at least 4 weeks off consecutively• No more hours a week of sport than their age• Maximum of 16 hours of sport per week• Integrative neuromuscular training to prepare for the demands of sport

(Cross training with focus to reduce injury risk factors)

What is a successful athlete?

References (Paul)

• Advanced Solutions International, Inc. (n.d.). Youth Sports Injuries Statistics. Retrieved May 30, 2019, from https://www.stopsportsinjuries.org/STOP/Resources/Statistics/STOP/Resources/Statistics.aspx?hkey=24daffdf-5313-4970-a47d-ed621dfc7b9b

• Duffek, J., & Duffek, J. (2018, March 08). A few surprises in the data behind single-sport and multisport athletes. Retrieved May 27, 2019, from https://usatodayhss.com/2017/a-few-surprises-in-the-data-behind-single-sport-and-multisport-athletes

• Hopkins, W. G. (2007). Risk Factors for Sports Injuries. Clinical Journal of Sports Medicine, (17), 208-210. doi:10.4135/9781412961165.n429• Khodaee, M., et al. (2016). Nine-year study of US high school soccer injuries: Data from a national sports injury surveillance programme. British

Journal of Sports Medicine, 51(3), 185-193. doi:10.1136/bjsports-2015-095946• Kids Facts: Sports Participation Rates. (n.d.). Retrieved June 1, 2019, from https://www.aspenprojectplay.org/kids-sports-participation-rates• Lee, M. C., et al. (2014). Nonlinear Pedagogy: An Effective Approach to Cater for Individual Differences in Learning a Sports Skill. PLoS ONE, 9(8).

doi:10.1371/journal.pone.0104744• Overview and Cost of Youth Sports. (n.d.). Retrieved June 30, 2019, from http://kidsplayusafoundation.org/overview-and-cost-of-youth-sports.html• Peterson, A. R., et al(n.d.). Youth Football Injuries: A Prospective Cohort - Andrew R. Peterson, Adam J. Kruse, Scott M. Meester, Tyler S. Olson,

Benjamin N. Riedle, Tyler G. Slayman, Todd J. Domeyer, Joseph E. Cavanaugh, M. Kyle Smoot, 2017. Retrieved June 1, 2019, from https://journals.sagepub.com/doi/full/10.1177/2325967116686784

• Spinks, A. B., & McClure, R. J. (2007, September). Quantifying the risk of sports injury: A systematic review of activity-specific rates for children under 16 years of age. Retrieved June 1, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2465389/

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References (Jeff)