Is specialization the big culprit? It's not so simple

By Mike Singleton

In recent years there has been a growing discussion on youth sport injuries which I applaud wholeheartedly as it is a part of all of our jobs in youth sport to make sure the safety of children is a primary focus. It is also our job to view the growing number of overuse injuries from all angles to determine all efforts that could be made to curb this growing trend.

Is this being done or are many focusing on specialization alone as the cause of these injuries?

Without question, overly repetitive movement and the lack of whole body motor development can play a large role in overuse injuries. However, is this solely the fault of specialization? Does specialization necessitate overly repetitive movement? When I see comments such as “Children who specialize in a single sport account for 50% of overuse injuries in young athletes according to pediatric orthopedic specialists” I would like to ask what percent of children who participate in youth sports are specializing?

What is the frequency rate of activity in these children vs. those who do not specialize? Further, what types of physical education classes are these populations enjoying and how often do they receive physical education in comparison to previous generations? Lastly, I ask, have we controlled for the education and expertise of the coaches with which these children have participated in a specialized environment? Prescriptively I wonder what the correlative associations are between type of sport and rate of overuse injury.

We cannot ignore that physical education classes have been cut in many schools across the country. Further, many of the same schools have cut recess time or banned physical interactive play during recess to protect against risk of injury. Suppose students are missing both gym class and 2 periods of recess per day. This amounts to between 1.5 and 2 hours of recreation time. If students only had gym class twice a week then we are looking at roughly 6.5 hours of recreation time/week that is not specialized. This is time in which children learn motor skills (physical education class) or craft schoolyard games in which they are moving freely, not doing drills, and are often developing muscles they do not use in practice. What role might this play in the increasing number of injuries?

Generations back we were allowed to go to the park on our own and play for hours every day in an unstructured environment. I recall playing stick ball, street hockey, football, basketball, soccer, tennis and even a game we called “relievio” that had us running, dodging, tagging and trying to catch each other for hours at a time. We did this every day and had at least one if not three hours of such free play. Over the course of the week this would typically account for another 7-10 hours of varied motor development. Sadly, most would feel unsafe allowing their children do play similarly these days. What role does free unstructured playtime disappearing play in the proliferation of overuse injuries?

We hear stories, every once in a while, of an extremely accomplished and educated coach working with the U-6 or U-8 or U-10 players at a club. When the coach or club is asked why he or she is doing this, as many are shocked that such a talented coach would work with such young players, the most often heard response is that the coach or club wholeheartedly believe in creating a solid foundational base for players. Such skilled coaches have taken coaching license courses, likely the U.S. Youth Soccer National Youth License, and demonstrate a large understanding of child motor development, body mechanics -- the developmental maturation process. With such an educated coach at the helm, players are not repeating the same motions over and over again at the neglect of others.

Children are taught body mechanics and coordination as these are crucial pieces to player development and physical maturation. However, more often, the youngest players are not coached by the most educated coaches. Some of these coaches do a wonderful job, but others simply do not know what they are not doing that may contribute to problems down the line. Some may feel not teaching these skills to 7- and 8 year-olds is not important, but if they are not taught how to move properly they will be more likely to incur an injury in a few years.

If we consider what occurs in other countries, knowing many children are playing soccer day in and day out, have there been similar overuse injuries rate spikes? If not, why not?

Part of it may have to with many countries’ national soccer body having a focus of physical well-being for life as part of their mission. I am not saying ours should as our school system and culture used to take care of this (the lower level soccer coaching classes do include a great deal of such education already), but with physical education classes being cut, recess time going away, and children rarely being free to go down to the park on their own for free-structured play … where is this education coming from in this country?

Are all sports now taking on the responsibility of movement education for younger players? If so, how are they accomplishing this? Through what routes are coaches being educated and parents being informed of prescriptive measures?

It seems there are many issues that may play a role in the amount of overuse injuries. I urge folks to stop myopically focusing on pointing a finger at specialization as the sole cause.

Look at all the factors that may being causing this phenomenon. What is occurring in these specialized environments that is contributing to the injuries and how could these environments be altered to avoid contributing to injuries? Education.

The cry to simply "not specialize" is not a fix in itself and specializing is the not the sole contributor. What must happen in physical education classes and how often should children be offered such classes? What should be allowed in recess? What motor skills should be taught at what ages … and how? Education is the route to help protect children from these injuries and it would be wonderful to hear more people talking prescriptively about this issue than accusatorily.

(Mike Singleton is the head men’s soccer at Washington & Lee University as well as an Associate Professor teaching Sport Psychology.)

5 comments about "Is specialization the big culprit? It's not so simple".
  1. Leia Ambra, April 1, 2016 at 2:59 p.m.

    From what I have seen of my children being involved in youth sports, in almost all sports (crew, soccer, baseball etc) that is virtually NO proper stretching and very little technique taught. I have seen research that this also contributes a lot to injuries.

  2. Wesley Hunt, April 2, 2016 at 8:45 a.m.

    I too grew up in an era where as youngsters we played multiple games in free play with little to no adult supervision. No one had to teach a kid how to stretch or move properly prior to age 10. We were too busy playing pick up games, tag, swimming, climbing trees and and every other kind of invented or made up game that we could think of. No overuse because when your were tired you quit and went inside with your buddies to eat lunch or whatever until a mom kicked you and your buddies out of the house or another outdoor adventure came to mind. This is very hard to mimic if say your a U8 coach for a soccer team. Supposedly you are to teach soccer and assume that all the other playing and coordination skills have progressed naturally. How shocked I was to find that was often not the case when I started volunteer coaching young kids 10 years ago. The level of obesity and lack of coordination in some of the players was shocking to me. Nonetheless, I tried to make the game fun and we kicked balls in every creative way I could think of. Against walls, up and down hills around benches. We taught dribbling tricks, juggling, and shooting techniques and almost never had lines or lectures at my practices. We made soccer golf courses out of garbage cans and soccer tennis on tennis courts. We played lots of futsal and small sided games. The obsession was the the game of soccer and the ball and my better kids stuck with it kicking balls around at home and coming back to practice to show me the tricks they had learned. My best kids never got over it and are now very good players. With out that focus they would not have gotten good but with out the variety of fun ways to play they would have certainly either incurred overuse injuries or burnout or both. The only way to come to high level of skill in endeavor is to focus and persist. However, as adults we interrupt this as work and drills and discipline but kids under 10 do not learn through work and being pushed. It has to be play if you want them to learn at maximum speed. It has to be their motivation not the parents or the coaches. The best you can do is set up the environment and tinker with the rules of your game to get them to focus on the subject or skill you are teaching. That is the hard thing for most coaches of youngsters to figure out. It is a mind shift. It helps if you can remember what it was like to be a 7 year old.

  3. Kent James, April 3, 2016 at 1:04 p.m.

    This column makes a lot of very good points, and raises some fundamental points. First, specialization is probably healthier than kids trapped in the home because parents are afraid to let them out. I think for soccer, specialization is less of a cause of injuries than mere overuse, primarily because soccer requires such a broad variety of movements (unlike baseball pitchers, or tennis players, who may be stressing joints in a very concentrated way). But specialization (at too young an age) has different problems; primarily, it may lock kids into a sport that may not be best for them. It also may make kids bored with the sport in which they specialize. Playing different sports provides a mental break (and sometimes a physical one, as different sports have different physical demands) without losing fitness. And for most athletes who are not going pro (in other words, most athletes), having alternative sports throughout your life is a healthy option, especially later in life, when physical ailments may prevent participation in some sports.

  4. Gary Allen, April 4, 2016 at 10:08 a.m.

    Good stuff Mike. I didn't realize that you were in Virginia now.

  5. Rob Kalal, April 7, 2016 at 9:54 a.m.

    This is a great article.
    I agree that the statistics, on specialization causing a spike in injuries, are incomplete. As you point out - what about countries that have pretty much always specialized? Specialization isn't a new phenomenon - there are many countries whose culture revolves around 1 sport. Also, as you mentioned, is specializing in track as bad as say specializing in football or basketball or soccer or gymnastics?
    If a player that specializes in soccer blows out their knee - did they blow out their knee because they specialized in soccer, would they have still blown out their knee if they played multiple sports?
    I think that to prevent injuries in sports you have to be conscious of any/all factors.

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