Sport-Specific Associations of Sport Specialization and Sport Volume with Overuse Injury in Youth Athletes

Abstract

Year-round participation in a single sport at the exclusion of other sports, also known as sport specialization, is associated with increased risk of overuse injury in youth athletes. To reduce this risk, several recommendations for participation volume have been developed. However, risk of overuse injuries may be dependent on specific movement profiles required by a given sport. PURPOSE: To examine sport-specific associations of sport specialization and exceeding sport volume recommendations with overuse injuries in adolescent basketball, soccer, and volleyball athletes. METHODS: 716 youth athletes (70.8% female, age 14.21.5 years old, 43.2% basketball, 19.4% soccer, 37.4% volleyball) were recruited to complete an anonymous questionnaire regarding their sport participation patterns and previous injury history. Sport specialization status was classified as low, moderate, or high using a widely utilized 3-point scale. Self-reported sport volume was used to classify athletes as either meeting or exceeding sport volume recommendations (playing their primary sport >8 months/year, hours/week of organized sport > age, days of sport participation per week >5). Multivariable logistic regression analyses were utilized to examine associations between variables of interest and overuse injury in the previous year. RESULTS: Highly specialized volleyball athletes were more likely to report an overuse injury compared to low specialization volleyball athletes (OR [95% CI]: 2.3 [1.1-4.8], p<.01). Volleyball athletes who trained: more than 8 months per year (OR [95% CI]: 2.0 [1.1-3.5], p<.05), more hours per week than their age (OR [95% CI]: 2.0 [1.2-3.4], p<.01), or more than 5 days per week (OR [95% CI]: 2.1 [1.2-3.9], p<.05) were more likely to report an overuse injury compared to volleyball athletes who did not violate these recommendations. No significant associations were observed in soccer or basketball athletes (P>0.05). CONCLUSIONS: The association between sport specialization, excessive sport volume, and overuse injuries may be specific to sports that are more repetitive or technical in nature, such as volleyball. Dissemination of sport-volume recommendations should be focused towards athletes, parents, and coaches in these sports.