The Rise in Youth Sports Injuries

In my last article, Specializing in Youth Sports, Good or Bad, I touched on the current increase in injuries to young competitors playing sports. Just the fact that the sheer number of young athletes participating has gone up over the last several decades, would automatically cause an upswing in the number of young sports enthusiasts having to seek medical attention. There is just an inherent physical risk in competitive sports that cannot be denied.

However, it does appear (even with the greater numbers participating) that the number of young athletes being injured, and the severity of those injuries, is quite large. If my memory serves me correct, I believe there were about 6 out of the 18 soccer players (or 1/3rd of the team) on my oldest daughter’s club soccer team (sophomores) that had torn their ACL. And 4 of those 6 eventually went on to tear the ACL of the opposite knee as well. These are some pretty serious injuries requiring major reconstructive surgery, something I never even heard of when I was competing in high school. I mean you did hear of the occasional male athlete blowing their knee in football, but that just did not seem to me to be as common as it is today. Even walking the halls in the high school where I teach I see more athletes on crutches, in casts, boots, and/or ace wraps (both male and female) than I can ever remember from my day. Sure you did see or hear about it at the professional levels of some sports, but that was expected.

The question then becomes, “Why?” I am sure there is more than one answer to this question. First (as I mentioned in the first paragraph), the large increase in numbers participating today compared to years past would suggest an increase in the number of injuries sustained. It is just a matter of percentages; more people equals more injuries.

Secondly, the continuous repetition of the same muscle groups doing the same thing all the time, especially when athletes specialize in one sport, can and does cause imbalances in muscle groups (around joints) if consideration is not given to proper training for this possibility. Now I do not want to give anybody the idea that specializing in one sport is a “bad” thing (my feelings on both sides of this issue are detailed in my 3 part article, Specializing in Youth Sports, Good or Bad), just that it is a factor needing to be considered when discussing the increase of youth sport injuries.

There is also research that demonstrates the increased risk to females, most notably at the knee, over males due to anatomical, neuromuscular, and biological differences. Years ago, before women engaged in the intense type training that you see today, how would anyone have known about this risk? Now both men and women are training, playing, and performing at maximal levels.

Another factor is the increased level of intense type training, in addition to the amount of time this type of training takes, that young athletes are putting in, in order to improve their abilities, has to be a consideration. Athletes are bigger, stronger, quicker, and faster (even the average athlete) than they ever were. This all amounts to more stress on body parts and thus, more risk of injury. This, in addition to the body not getting enough rest and/or time to recuperate, and not spending enough time keeping muscles flexible enough to move through wide ranges of motion, certainly seems to lend itself to increased risk of injury.

There are probably several other possibilities that I have not covered which may also be contributing factors in this issue. However, my purpose in this article is not to just list them all, but rather to give some food for thought as to why youth sport injuries are increasing, point you in the direction of some good articles that help support this (something I will do at the end), and give some alternative possibilities that may help in decreasing this risk.

Now the body is an amazing piece of machinery; able to heal, get stronger, and better if trained, fed, and treated properly (sleep, rest, etc.). That is why I strongly encourage any athlete to spend a good deal of time on proprioceptive (unconscious joint & limb awareness) training and preventive-type conditioning. The purpose of these types of exercises is to balance strength levels on all sides of a joint and help the body develop a more keen sense of internal subconscious awareness regarding limb and joint movement. This, coupled with functional sports specific type training, flexibility work, proper rest and diet, can and does help to decrease the risk of sustaining athletic injuries. At least that is what any level of logic would tell us. So, with some effort, thought, and research on your part, or the coach’s/trainer’s part, an athlete can increase strength and flexibility, and prevent injury all at the same time. It is worth the effort.

I will attempt to expand on the issue of injury prevention, as described above, and supply references to articles that will help in giving more specific information on decreasing the risk of injury to young athletes in my next article. In this way the athlete will be able to take more control over what happens to them, always a good thing, rather than giving up this control to chance.

I have identified several articles that detail what their authors believe to be underlying causes behind this increase of youth sport injuries. They not only give solid reasoning behind the “why” this is occurring, but also indicate that the severity of injuries has gone up, supporting much of what I have discussed in this article. These articles include:

The growing pains of childhood sports injuries by staff writer Erin Allday of the San Francisco Chronicle (http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/03/07/MN47VF2V8.DTL).

More Kids Are Suffering Sports Injuries by Serena Gordon of the HealthDay Reporter (U.S. Department of Health & Human Resources, (http://www.healthfinder.gov/news/newsstory.asp?docID=603037).

Minimizing the Risks of Organized Youth Sports from the Health Link at the Medical College of Wisconsin (http://healthlink.mcw.edu/article/1031002538.html).

ACL Injuries In Female Athletes by Dr. Steven Horwitz from experts on the MomsTeam website (http://www.momsteam.com/team-of-experts/steven-horwitz-dc/acl-injuries-in-female-athletes).

Increase in adult-type injuries among children and adolescents by Dr. Dieter Lindskog pediatric orthopedist at Yale-New Haven Hospital and assistant professor of orthopedics at the Yale University School of Medicine (http://www.ynhh.org/healthlink/pediatrics/pediatrics_8_05.html).


All of these articles, in some manner, support the idea of a current trend in increased youth sports injuries, and that it really is a concern needing to be addressed. Some even suggest possible avenues for prevention. I recommend their reading and hope they shed more light on a very important topic involving youth and their sports participation.

Part 3: Specialization in Youth Sports, Good or Bad?

Getting back to our focus on specialization, another factor that athletes (and their parents) need to keep in mind is that different sports can and do bring different circumstances into the mix. There are some sports that tend to have a genuine overlap between them, more so than do others, and because of this overlap they do not require as much specialization. It is almost as if the sports truly complement each other. Take football and wrestling as one example. I am sure you can find many good football players who are also very good wrestlers, especially in the middle and upper weight classes. In fact, I personally know of two who were solid football players and became state champions in wrestling. There are other sports that also tend to have similar overlapping characteristics. If size, speed, agility, jumping ability, coordination (hand/eye), etc. are high priorities in a sport, then usually these attributes easily carry over to another sport that has the same high priority for these athletic skills.

On the other hand, there are sports, usually ones with an extremely high level of repetition to gain mastery, where overlap of the above-mentioned skills does not have as great an impact. Sports like gymnastics, ice skating, tennis, and swimming tend to fall in this category. There are just so many repetitive motions that need to take place, and hours that need to be put in, that without some amount of specialization, reaching any level of mastery is nearly impossible for most. Think again about that research I mentioned earlier (article #2) on the amount of time and hours an athlete needs to put in to reach expert levels of performance. That is why you rarely see athletes in these types of sports reaching the highest levels without a certain amount of specialization along the way, and sometimes at a very early age (much earlier than high school).

And lastly there are certainly sports that contain both some overlap and a need for a high level of skill repetition like volleyball, baseball, softball, and soccer. The physical skills mentioned earlier (jumping, running, agility, etc.) definitely have strong overlapping tendencies here; however, so does the amount of repetitive motions that need to occur for gross and fine motor development to take place in order for these athletes to become exceptionally proficient.

Now I am not going to claim myself as an expert in this area and do not want anyone to look at the above divisions as comprehensive in nature. They are just simplified examples to prove a point. My purpose here is to demonstrate that overlap in sports is kind of on a continuum with some sports containing more overlap than others, thus requiring less of a need for specialization, while other sports need for mastery lend themselves more toward the concept of strong focus in one sport.

However, this does not mean that people should (as many coaches do) use sports that have great overlap as justification that specialization in a sport is wrong and unnecessary, and vice versa using sports that have little overlap for justification that specialization is the only way to go. This exemplifies the argument that I believe should not be taking place regarding there being only one right or best answer for every athlete when discussing the idea of specialization. I just do not think that that is the best or fairest way to look at this topic. To do otherwise does not take into account all of the factors that should play such a heavy role in an athlete’s decision as to whether they should focus in on only one sport or participate in a variety of sports. It is a personal decision that only they can make and no matter which way they decide, there will be a loss and a gain. That is the nature of choices and decisions; it is a life lesson. So, if the gain is more important than the loss to the individual athlete then, in either scenario, the decision should become easier to make for them.

Notice that very little of my discussion here mentions parents. That is due to my belief that their role is one of guidance only. The concepts of interest, desire, goals, and specialization must come from the athlete themselves. I cannot emphasize this enough. It is one thing to guide and encourage a young athlete toward their areas of interest and talent, or even hold them to commitments the athlete has made; however, it is quite another to force them to participate, train and/or practice on something they do not show a high level of interest in doing. The latter almost always ends in disaster for both parties.

Oh, and one last thing that needs to be addressed (even, ever so briefly) in relation to the long hours of sports participation many are engaging in today. There is growing evidence that overuse injuries and more severe injuries are certainly on the rise because of how much time athletes are now spending training in their sport or sports. This particular article was not written with the idea of addressing this issue; however, to not mention a couple of points with regard to this would be inappropriate to say the least. Whether an athlete chooses to participate in a variety of sports or specialize in one, it is very important that they learn to read the signals their body gives them when they are overworking, and that they train with as much, or more, emphasis on injury prevention as they do on skill development and conditioning. This is one area that a parent needs to take charge of at times. I know that my own children hated me asking all kinds of questions regarding how their bodies were feeling, in addition to encouraging training to prevent injuries. When they were injured, even slightly, I would always err on the side of caution. They both consistently would tell me, “Dad, I am not a baby or wimp; I am fine and am able to play.” As a coach I was a stickler for never placing winning above the safety of my athletes, and I was even worse with my own kids. I always had a long-term view of things and firmly believe that this is in the best interest of all athletes at all levels. I suppose, at some point in the near future, this topic, increase of injury in youth sports, will be something I address in a much-needed article on this blog.

Hopefully the information I have presented helps to clarify this current and continuing dilemma many young athletes are facing today making it easier for those involved to make an informed decision. In conclusion, I would like to leave you with a quote that no matter what path an athlete chooses to take, it will always hold relevance and meaning for them as they move forward through their athletic experiences.

“Extrinsic goals are achieved with greater efficiency and with greater reward (satisfaction) when intrinsic objectives are consistently held in the highest priority.”

Part 2: Specialization in Youth Sports, Good or Bad?

I suppose the best answer to this question of specialization in sports (and I know I might get some grief for this) is that there really is no best or right answer, at least no right answer for everyone and every situation. There are just too many variables in order for one answer to truly be beneficial for all. In fact, doing so would not only be inappropriate but completely unfair to the athlete and/or situation they might be faced with. So, even though it might seem vague at first, let’s start with some general guidelines (and I do mean general; some will even come up with scenarios that would simply not fit these general guidelines either).

I do, in general, believe that young people who participate in sports should, within reason (too many is not good either), participate in a variety of sports. There are several reasons behind this, not the least of which is to help them become more well-rounded individuals. Young athletes should learn and know how to run, jump, shuffle, sprint, jog, hop, and skip along with catching, throwing, shooting, balancing, kicking, batting, etc. All of these skills combine to make a well-coordinated individual, giving them the opportunity to choose a variety of activities throughout life to keep them fit and healthy. The physical and developmental benefits of doing this cannot be argued with. I also believe, again in general, that specializing at a young age does not take into account different rates of maturing, genetic makeup and talent, nor the changing level of interest that young people tend to go through as they grow and get older. So specializing, for most, at too young of an age pigeonholes kids, decreasing their opportunity to make choices and develop other interests and talents. Remember that the biggest, strongest, fastest kid at 7, 8 and 9 years old is rarely in the same position as a teenager. You just never know. And all of these factors are in addition to the increased risk of overuse injury that seems to be attributed to so much repetition occurring, especially at younger ages, when one participates/practices in the same activity all the time

Having said all of that, there does come a time when an athlete may want to consider moving from a framework of playing several sports to one where they narrow their focus and choices down, and yes, even down to only one sport (depending on the individual and/or sport). As far as when that best time is, I can only make a suggestion, and for most, in general, that suggestion would be in high school. Say, somewhere after their freshman year.

With regard to what factors determine whether this is the right decision, well, there are several that an athlete can rely on to help settle on what is best for them. First, would be the level of interest and desire the athlete has for specializing in a sport. And most importantly, and certainly relative to their interest/desire, are the objectives or goals they are seeking to achieve in that sport. For example, there unquestionably is a difference between an athlete who just wants to play sports because they are fun and they love to compete, and the athlete who is looking to compete at the Division I level on scholarship at college. In addition, there is also a difference between these two types of athlete above and the one who is looking to achieve elite/national, Olympic, or professional status. Basically, the higher the interest/desire and level, or goal, the athlete is looking to achieve, the greater the likelihood there is a need for specialization. In fact, there is solid research out there that shows that athletes need about 10 years and/or 10,000 hours of practice in order to reach what one might consider “expert” levels of performance, say the kind of mastery that would take on athlete to the national, Olympic, or professional levels.

This is why it is essential that each athlete look at their situation as an individual first and foremost, taking into account all the factors (talent, interest/desire, objectives/goals, current level of play, etc.) that impact where they are, where they want to be, and what they want to get out of their sports participation in order to make the best decision for themselves. The athlete who is merely looking to play high school sports should, in all likelihood, participate in all the sports they truly have an interest in and can realistically fit into their schedule, while the athlete looking for a higher level of mastery based on what they are looking to achieve will be the ones having to consider the route of specialization.

Before I continue, I do want to make a point regarding the low percentage of athletes who make it to the college level of sports on scholarship, let alone the elite/national, Olympic, and/or professional levels. It is a fact that only a very small percentage (I believe it’s less than 1 or 2 percent) of all young athletes who play sports will ever reach college scholarship status. And the percentage of athletes who reach levels even higher than this are much lower, the chances are very remote. So many may ask the question, “Why dedicate so much energy and time to playing one sport when the possibility of achieving goals, as you describe, are so low, and/or, if so many ‘fail’ to achieve what they want, even if they choose to specialize, isn’t what they are going to lose of far greater importance?” These are very good questions. However, this is where keeping sports participation in perspective is so important. It is not the “reward” (the scholarship, state, national, and/or Olympic championships) that should be of utmost importance, but going through the process of trying to achieve these goals that holds the most value to an athlete working toward objectives like this. This process far outweighs the extrinsic reward they may or may not receive through their efforts. It brings intrinsic value to them that can then be applied to other aspects of their lives.

Let’ say, for arguments sake, a young athlete dedicates themselves to becoming a state champion in swimming, and the only way they see this happening (for them) is through specializing in that one sport. They work very hard, putting in many hours and giving it everything they have; however, in their last season of high school (their senior year) they end up 2nd, 3rd, or maybe even lower. Now I know they may initially feel very disappointed, maybe even that they failed, but have they truly learned any less than if they had taken first and won that state championship? In reality, what they learned about themselves through their efforts, about what it takes to achieve something, and about who they are on the inside has so much more value to them than that first place medal would have had hanging around their neck. I am sure they wouldn’t see it that way initially, but they would someday.

You don’t have to just take my word for it, ask those who have been through it. If you were to ask a former National Champion athlete if they had taken second instead of first, would all of their efforts have gone for naught, I don’t think they would say that that was the case. I know I wouldn’t.


Article #3 will take a closer look at specialization with regard to the type of sport itself. Don’t miss this final piece to the puzzle of specialization, good or bad?