It’s Saturday morning. Parents across the country are waking their sleepy kids at the last possible moment and urging them to dress quickly while the adults load equipment and snacks into the car. On the road, the adults drink coffee while their kid goes back to sleep as they head to the sports venue where they will spend the day, or possibly the entire weekend.

I spent a few Saturdays like that when my high-school-age daughter played club volleyball. And I wondered more than once if the benefits were worth the costs. But she was a teenager playing mostly for fun. The season only lasted a couple of months, and she wasn’t also playing a school sport at the same time.

Two decades later, for many families, this routine begins when their child is in elementary school. Seasons are longer and the demands on their time tend to reinforce the idea that specializing is the way to athletic success. 

But unless your child is destined to be a figure skater or a gymnast, sports where peak performance usually occurs before puberty, specializing in a sport at an early age is more likely to burn a child out than light a fire. Playing one sport too often and too early in life very likely contributes to 70% of kids dropping out of sports by age 13. And the costs of specialization to children, families, and society go far beyond the participation costs.  

What is sports specialization?

In 2021, Dr. David Bell (see bio below) and fellow researchers had a panel of 17 experts rank elements of sports specialization. Their work resulted in this working definition for future research:

Sport specialization is the intentional and focused participation in a single sport for a majority of the year that restricts opportunities for engagement in other sports and activities.

Using this definition, young athletes may be considered specialized if they participate in one sport with regular practices, competitions, or other training more than eight months of the year; limit or stop participating in other sports to focus on one; or limit participation in other sports, academics, other activities, or time with family and friends while focusing on one sport.

Unintended outcomes of specialization

There are many unexpected and unintended costs of kids specializing in sport. Some experiences can affect kids into adulthood and others impact our society in one way or another. In a 2019 study, Bell and another team of researchers looked at the public health consequences of sport specialization and how it:

• Contributes to a 70% dropout rate before age 13

• Increases the risk of overuse injuries and the number of acute injuries

• Limits late entrance to sport for kids who mature later or want to try several sports before high school

• Takes time away from other sports or activities a child may also benefit from

Medical costs

Because there is no system that captures the number of all types of youth sports injuries, it’s difficult to know the true costs and Bell’s team acknowledges that overuse injuries are underreported. It’s hard for most of us to relate to the hundreds of millions of dollars spent on youth sports injuries for nearly 10,000 hospitalizations and over 400,000 ER visits each year.

Something we can understand is that in 2016, the cost a family might face was $22,703 for a hospitalization and $709 for the average sports injury.

I’ve read elsewhere how medical problems and their costs can follow an athlete into adulthood if an injury leads to osteoporosis or other chronic conditions. And, if an injury prevents or discourages them from being an active adult, they are less likely to practice an active healthy lifestyle, making them more susceptible to other illnesses and injuries.

My take: Increased demand on the medical system leads to increased costs for all, and for those with inadequate insurance, they can be devastating. Ultimately, we all pay for youth sports injuries.

Restricted participation in other activities

Early specialization can prevent kids from sampling a variety of sports, like they do in Norway, before deciding which they might like to concentrate on in high school. They may miss out on a sport they would have enjoyed more OR, because they didn’t participate early, when they get to high school they may not be able to compete with teammates who did. Either way, kids lose.

Devoting the majority of their free time to one sport also takes away time from a child to explore non-athletic interests like music, art, chess, or many other activities. Extensive time spent on youth sports also takes time away from family activities.

Recommendations for participation

In a 2020 study, Bell’s research team learned that while many parents are aware of the risk of injury and believe youth sports specialization is a problem, 80% were unaware that there are recommendations for participation to help keep kids safe and healthy.

In fall 2022, the National Athletic Trainers’ Association hosted a Youth Sports Specialization Awareness Week. These guidelines for specialization are taken directly from the NATA website where you can learn more:

NATA Guidelines

1. Delay specializing in a single sport for as long as possible: Sport specialization is often described as participating and/or training for a single sport year-round. Adolescent and young athletes should strive to participate, or sample, a variety of sports. This recommendation supports general physical fitness, athleticism and reduces injury risk in athletes.

2. One team at a time: Adolescent and young athletes should participate in one organized sport per season. Many adolescent and young athletes participate or train year-round in a single sport, while simultaneously competing in other organized sports. Total volume of organized sport participation per season is an important risk factor for injury.

3. Less than eight months per year: Adolescent and young athletes should not play a single sport more than eight months per year.

4. No more hours/week than age in years: Adolescent and young athletes should not participate in organized sport and/or activity more hours per week than their age (i.e., a 12-year-old athlete should not participate in more than 12 hours per week of organized sport).

5. Two days of rest per week: Adolescent and young athletes should have a minimum of two days off per week from organized training and competition. Athletes should not participate in other organized team sports, competitions and/or training on rest and recovery days.

6. Rest and recovery time from organized sport participation: Adolescent and young athletes should spend time away from organized sport and/or activity at the end of each competitive season. This allows for both physical and mental recovery, promotes health and well-being and minimizes injury risk and burnout/dropout. Source: NATA website

 I have to wonder:

• How many of those kids on the road today follow these guidelines?

• And, will they still be playing their sport when they get to high school?

Read more about youth sports specialization

Consensus Definition of Sport Specialization in Youth Athletes Using a Delphi Approach, Journal of Athletic Training, November 2021, David Robert Bell, PhD, ATC; Traci R. Snedden, PhD, RN, CPNP-PC, CNE; Kevin M. Biese, MA, ATC; Evan Nelson, DPT, PhD; Andrew M. Watson, MD, MS; Alison Brooks, MD; Timothy A. McGuine, PhD, ATC; Roger L. Brown, PhD; Stephanie A. Kliethermes, PhD

How early specialization is hurting youth sports by Laura Yuen, Minneapolis Star Tribune, October 21, 2022

National Athletic Trainers’ Association, Youth Sports Specialization Awareness Week, 2022

Parents' Awareness and Perceptions of Sport Specialization and Injury Prevention Recommendations, Clinical Journal of Sports Medicine, November 2020, Bell, David R. PhD, ATC* Post, Eric G. MS, ATC, Trigsted, Stephanie M. PhD, ATC, Schaefer, Daniel A. MS; McGuine, Timothy A. PhD, ATC,  Brooks, Margaret Alison MD, PhD

The Public Health Consequences of Sport Specialization, Journal of Athletic Training, October 2019, David R. Bell, PhD, ATC, Lindsay DiStefano, PhD, ATC, Nirav K. Pandya, MD, and Timothy A. McGuine, PhD, ATC

Learn more about Dr. Bell’s work

Dr. David Bell, is an associate professor in the departments of kinesiology and orthopedics and rehabilitation at the University of Wisconsin – Madison and director of the Wisconsin Injury in Sport Laboratory. His research focuses on identifying risk factors for musculoskeletal injuries with a special focus on sport specialization in children.

Photo by Bruno Kelzer on Unsplash