James Slauterbeck, MD, is an orthopedic surgeon at the University of Vermont Medical Center and associate professor at the Larner College of Medicine at UVM.

James Slauterbeck, MD, is an orthopedic surgeon at the University of Vermont Medical Center and associate professor at the Larner College of Medicine at UVM.

In the past, generalizing in multiple sports was a prized endeavor, like earning three varsity letters in three different sports, or participating in the heptathlon.

Nowadays, there is a trend for early specialization in a single sport or even a single position. We see year-round participation in baseball, soccer, basketball, and hockey. Athletes like Michael Phelps and Mia Hamm both began competitive careers well before puberty.

How do we balance between the young athlete’s desire to be the best high school, college, or professional athletes and the statistics that demonstrate that only about 1 percent of high school athletes participate in college sports and about 1 percent of college athletes participate in professional sports? Is one – specialization or generalization – a better pathway?

The Argument for Specialization

Supporters of specialization in a single sport state that early participation in that sport will increase skills and help one develop in his or her sport better than other athletes participating in multiple sports. Single sport advocates often define success by the number of athletes who become members of the elite traveling, high school, or college team.

The Argument for Generalization

Supporters of multi-sport athletes argue that exposing children to diverse skills and sports as children helps develop a well-rounded athlete. The athlete will take these diverse skills and talents into high school and be able to compete with his or her peers because of the assorted motor skills strategies they learned. Tim Tebow, for example, was homeschooled and played in many youth sports and diverse youth activities and went on to become a Heisman Trophy winner as a college quarterback.

The Risk of Injury

In either case, too much of any one sport or too many sports played at one time puts a young athlete with an immature body at risk for a single traumatic injury or overuse injuries. Moderation is probably the best practice in either case. Developing skills in and out of a sport are both very important.

Serious injury risk is associated directly with exposure to high-risk activity. Modifying practice sessions and game schedules and relative rest periods give athletes time to recover. Practices full of scrimmaging and hard cutting carry different exposures to injury compared to shooting practices. For example, a NCAA football conference is considering no contact practices for the 2017 season to decrease head injury risk. Modifying injury exposure directly modifies injury risk either within the sport or out of the sport.

One of the problems I see with young athletes who specialize in a single sport early in life is that it places them at high risk for injury. Injuries are often seen at growth plates and in growing bones, ligaments and joints. For example, in the past, athletes played soccer or football in the fall, basketball in the winter and baseball or track in the spring and had the summer. The injury risk of each sport is very different and even alternates from shoulder and elbow to knee and ankle. This gives the body time to adapt to the changes of loads being placed upon it. Today, a young athlete may play soccer four or five times in one year. Just by sheer injury exposure, these single-sport athletes participating are at a higher risk for knee than others playing multiple sports.

Multiple sport athletes often get injured if they participate in too many sports at one time. Diverse athletes can play baseball, lacrosse and soccer during the same season and somehow find the way to practice all sports throughout the week. Overuse injuries often occur because the body cannot rest as it is always practicing or playing a game. Often growth plate disturbances or stress fractures may occur and shut down play.

In my opinion, one of the strategies to decrease injury risk is to limit injury exposure by participating in different sports. If one desires to specialize early, one might consider working on skills, but limiting scrimmage and games in the off-season. To decrease injuries in the multisport athlete, one should consider limiting an athlete to only one practice per day (e.g., skip participating in both a soccer and lacrosse practice in a day).

Most of all, our young athletes should have fun at sports and enjoy their experiences. A healthy active lifestyle begins in childhood and is a good lifelong learning habit.

Learn more about Orthopedic Care at the University of Vermont Medical Center. 

James Slauterbeck, MD, is an orthopedic surgeon at the University of Vermont Medical Center and associate professor at the Larner College of Medicine at UVM. 

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