Specialization & Overuse Injuries in Young Athletes

Author Malcolm Gladwell contends that it takes 10,000 hours of “deliberate practice” to truly master a skill. While this may be true, it’s not without consequence for young athletes.

Children are beginning to specialize in a single sport at younger ages. With this specialization, we see an increase in overuse injuries that are caused by repetitive trauma to tendons, bones, and joints. These injuries can be subtle and happen over time. They can also plague children into adulthood.

young baseball league pitcher

According to a 2013 study, adolescents who spend more hours per week than their age playing one sport are 70% more likely to experience overuse injuries than other injuries. For example, a 15 year old who plays 16 hours of hockey per week is at increased risk for an overuse injury. Another study shows that kids who play one sport for eight months out of the year are nearly three times more likely to experience an overuse injury in their hip or knee.

We understand the pressure for kids to succeed. The competition for playing time can be fierce.  Many aspire to compete at an elite level and earn college scholarships. However, studies show that specializing early in a sport does not increase one’s chance of becoming an elite athlete. In fact, 88% of college athletes played more than one sport as children and 70% didn’t specialize until they over twelve years of age. Specialization really begins to show a benefit in the teen years.

Young athletes are more susceptible to overuse injuries because their bodies are still developing. While they are still growing, their muscles and tendons are stronger than their bones. This can lead to overuse injuries to the growth plate and chronic pain. We also see overuse injuries caused by improper techniques. Examples include:

  • Baseball and Softball – Repetitive throwing can cause elbow and shoulder injuries. Tommy John surgery for the elbows of pitchers is well-known.
  • Hockey – The mechanics of a skating stride can cause hip problems.
  • Gymnastics – Wrist and elbow injuries are common from tumbling, twisting, etc.

We can’t prevent all injuries, but here are 5 tips to help your young athletes avoid overuse injuries.

Katherine J. Coyner, M.D., orthopaedic surgeon in the UConn Musculoskeletal Institute
  1. Age vs. Hours – Restrict the amount of time your child is playing one sport each week. The rule of thumb is that they should not be spending more hours per week than their age. For example, a nine year old should spend nine hours or less each week at soccer practice.
  2. Take Rest Breaks – One or two days of rest each week and longer breaks throughout the year are beneficial to avoiding overuse injuries.
  3. Communicate Discomfort – Young athletes must know that it is important to let their parents and coaches know if they’re experiencing pain, discomfort, or something just doesn’t feel right. Overuse injuries develop over time, so it is important to address them quickly to reduce recovery time and long-term impact.
  4. You Know Your Child – Parents know their children best. Keep a close eye on their performance and behavior so you can recognize if something is ‘off.’ Listen when they tell you something hurts. Prolonged complaints, requests for medication, a sudden disinterest in practice or competition, and changes in performance are all signs that your child should be seen by a doctor. It’s better to err on the side of caution, rather than pushing a child to continue play.
  5. Cross-Train – Play multiple sports or perform varied exercises to develop different muscle groups and give others a much-needed rest. This variation makes children better overall athletes and increases their agility.

Already battling an injury or want more information about UConn Health Orthopedics & Sports Medicine?

Call 860-679-6600 for an appointment today.