Single-sport Athletes Research Articles

Sports Injury Surveillance Systems: A Scoping Review of Practice and Methodologies.

Background: Injury prevention/reduction strategies are driven by data collected through injury surveillance systems. The aim of this review was to describe injury surveillance systems that are used for ongoing surveillance in either a professional or amateur sporting environment. This was an update to a review done in 2015 to determine the gaps in injury surveillance. Methods: A systematic search process of five databases (MEDLINE, CINAHL, EMBASE, SCOPUS and ProQuest) was used to discover published research that presented methodological data about the injury surveillance systems implemented by clubs and organisations for ongoing surveillance. Inclusion criteria centred on the population under surveillance and the ongoing nature of that activity. Data extracted and summarised included the level of athlete under surveillance, the data collection mechanism and the personnel involved, the injury definitions applied and the date and country of origin to provide a comprehensive picture of the systems. Results: A total of 21 systems were documented as being used in ongoing injury surveillance, with 57% of these exclusively in the professional/elite landscapes and 33% at the amateur level. Surveillance systems cater for one sport per athlete entry so there is a gap in research for multi-sport athletes at the amateur level, especially where there is no early specialisation in a multi-sport participation environment. Conclusions: Research in this area will lead to a better understanding of subsequent injury risk for multi-sport athletes who have a higher athlete exposure than single-sport athletes.

Athletic Identity Associations in Young Sports Medicine Patients.

Few studies have assessed athletic identity levels in young patients. This study examined athletic identity in adolescents and explored associations between athletic identity, patterns of sport participation, and coping skills. Patients aged 12 to 18 years who received sports medicine care completed a one-time, voluntary, anonymous survey. Surveys included demographics, sport participation information, Athletic Identity Measurement Scale (AIMS), and Athletic Coping Skills Inventory (ACSI). Statistical analysis included Fisher exact test, Student t test, Wilcoxon rank sum test, Kruskal-Wallis test, and Pearson correlation. Three hundred thirty-four patients (mean ± SD age 15.0 ± 1.8 years, 64.7% girls) completed questionnaires. The mean AIMS and ACSI scores were 45.2 ± 11.5 and 50.2 ± 10.9, respectively. No notable differences were observed in AIMS scores between age groups or sexes. An increase in mean AIMS scores (higher athletic identity) was seen with greater weekly hours of sport participation (P < 0.001) and months per year of primary sport participation (P < 0.001). Multisport per season athletes had higher AIMS scores than single-sport athletes (48.2 ± 10.1 vs. 43.0 ± 11.9, P < 0.001). Team sport athletes reported higher athletic identities than individual sport athletes (47.0 ± 10.7, 41.4 ± 11.4, P < 0.001). Athletic Identity Measurement Scale scores positively correlated with ACSI scores (r = 0.31, P < 0.0001). Athletes with the highest athletic identity had markedly higher scores on ACSI subscales of Coachability, Concentration, Confidence and Achievement Motivation, Goal Setting and Mental Preparation, and Peaking Under Pressure than athletes with the least athletic identity. However, those with the highest athletic identities reported significantly lower scores on the ACSI Freedom From Worry subscale (P < 0.001). Athletic identity did not differ among adolescents by age or sex. Athletic identity was higher in team sport athletes and those with increased sport participation volumes. While high athletic identity was associated with higher scores on favorable coping skill dimensions, these athletes may also worry more, potentially placing them at greater psychological risk after injury.

Adequacy of usual intake of Japanese college athletes in various sports clubs.

While many studies have been published on nutrient intake assessment for performance improvement and deficiency prevention in single-sport athletes, few studies have addressed nutrient intakes in athletes from a various sports. The aim of this study was to determine whether Japanese college athletes meet the Dietary Reference Intakes (DRIs) and sports nutrition recommendations (SNRs). Dietary intake was assessed in 1049 Japanese college athletes from a variety of sports using a validated brief-type self-administered diet history questionnaire. The prevalence of inadequate intakes was estimated by comparing the DRIs and SNRs. For protein, riboflavin, niacin, vitamins B-6, vitamins B-12, folate, magnesium, zinc, and copper, <10% of females and males consumed diets that fell below the estimated average requirement (EAR) in the DRIs. A large proportion of female and male college athletes demonstrated intakes that were below the EAR for vitamin A (7.8% and 19.0%, respectively), thiamin (10.4% and 23.9%, respectively), calcium (20.4% and 29.7%, respectively), and iron (24.2% and 2.5%, respectively). Regarding DG for chronic disease prevention in the DRIs, over half of both female and male athletes exceeded the DG for saturated fat acid and sodium, and fell below the DG for dietary fiber. Few of both female and male had intakes below the SNRs for protein and carbohydrates. The results of the present study reveal the nutrient intake status of Japanese college athletes by comparing the DRIs and SNRs. Most meet the SNRs for optimal performance, but not the DRIs for health.

Sport Specialization and Sport Motivation in Middle School-Aged Athletes.

Sport specialization has been assumed to have psychosocial ramifications for athletes, especially autonomous motivation, which has been associated with continued sport participation. Sport dropout is common in youth athletes, yet it is unknown how sport specialization may affect this population psychosocially. To determine the association of sport specialization with autonomous and controlled motivation and amotivation in middle school-aged athletes. Cross-sectional study. An anonymous online questionnaire was distributed to athletes via schools, club sports, and social media. A total of 178 athletes (male = 59%; private school = 51%; grade: sixth = 20%, seventh = 32%, eighth = 48%) completed the questionnaire. The questionnaire assessed demographics, sport participation, and motivation using the Youth Behavioral Regulation in Sport Questionnaire. Sport specialization was defined using a modified 3-point scale (low, moderate, or high) and multisport versus single-sport athletes. Nonparametric tests were used to analyze the differences among the types of motivation and specialization levels and between multisport and single-sport athletes. Sport specialization categories were not significantly associated with autonomous motivation, controlled motivation, or amotivation. No significant associations were present between multisport or single-sport athletes and any type of motivation. However, multisport athletes had higher scores for intrinsic motivation, a subscale of autonomous motivation, compared with single-sport athletes (single sport: median = 5.00, 25th-75th quartile = 4.50-5.00; multisport: median = 5.00, 25th-75th quartile = 5.00-5.00; P = .04). Sport motivation did not differ between sport specialization groups in middle school athletes. Dropout from sport is common in this age group but is multifactorial in nature. A lack of sport motivation could be a factor for some athletes, but all specialization groups appeared to have similar outcomes. Our exploratory analysis suggests that clinicians may consider having an open dialogue with single-sport athletes, their parents or guardians, and coaches to ensure that athletes are enjoying their sport.

Visual representations of single- and multi-sport participation in a youth swimming sample: Implications for definitions and discussions of early specialization.

Academic literature and sport policy documents have cited concerns about an increasing prevalence of early sport specialization, with associated burnout, dropout, and injury. However, evidence to support such statements is limited. Definitions of early specialization vary, but a common criterion is continued participation in a single sport, prior to adolescence. We explored the prevalence of single-sport participation and other patterns of sport involvement from ages 6-12 in a Canadian swimming sample using retrospective longitudinal methods. Parents of 236 competitive swimmers (ages 12-17) completed surveys on their children's sport backgrounds, including the number of sports participated in annually from age 6-12. A cluster heat map elucidated single- and multi-sport patterns over time. Mixed analyses of variance tested for differences by gender and club type. Fourteen percent of our sample showed stable participation in either one sport or multiple sports per year over time, 25% decreased their annual number of sports, and 60% increased. This trend of increasing, rather than decreasing the number of sports in their annual activity roster when approaching age 12 was particularly pronounced for girls. Only 10 participants (4% of the sample) consistently engaged in a single sport each year from age 6-12. Summer (seasonal) swimmers consistently did more sports than year-round swimmers. Overall, our findings showed highly idiosyncratic longitudinal patterns of sport participation that did not easily conform to current sport activity guidelines. We also found similar idiosyncrasy in an ad-hoc analysis of participants who had dropped out of swimming a year later. If single-sport participation is considered a key criterion for defining early specialization, our findings suggest the prevailing narrative around early specialization may be overstated in relation to the number of single-sport athletes. Alternatively, other components of early specialization may be more prevalent and deserving of attention due to possible associations with harmful outcomes.

Most high school baseball pitchers are using weighted ball throwing programs to increase ball velocity: crosssectional analysis of US high school pitchers

Weighted-ball velocity training programs are popular but may be associated with increased injury risk. The purpose of this study was to determine the current frequency of these programs, as well as their association with range of motion, strength, velocity, injury, and utilization in high school baseball pitchers. This was a multicenter, prospective, community-based study including high schools from the Northeastern, Southeastern, Midwestern, and Western regions of the United States. Preseason pitchers were surveyed about their use of weighted ball velocity programs and history of injury. Preseason pitchers underwent standardized physical examinations and pitch velocity was measured. During a single high school season, pitch counts and injury incidence were prospectively collected. In total, 115 pitchers were recruited, of whom 63% had participated in a weighted ball program. There were no differences in range of motion or strength between groups who used weighted balls and those who did not. Pitchers that utilized weighted ball programs demonstrated a higher average fastball velocity (114.26 vs. 106.22 km/h [71 vs. 66 mph]; P < .001) as well as peak fastball velocity (115.87 vs. 109.44 km/h [72 vs. 68 mph]; P= .001) compared to those that did not use weighted ball programs. Pitchers that utilized weighted ball programs were no more likely to be single-sport athletes (44%) than those who were multisport athletes (49%, P= .667). Within the group who had used a weighted ball program 29% (13/45) reported a history of injury and within the group who had not used a weighted ball program 25% (10/40) reported a history of injury (P= .687). As only a single injury occurred in the entire cohort, comparison of injury rates could not be completed. In this prospective study, the majority of high school pitchers reported using weighted ball programs to increase velocity, and these programs were associated with increased average and peak velocity compared to pitchers who did not use weighted ball programs. There were no significant differences in injury history between the 2 groups. Further study is necessary to understand the injury risk associated with weighted ball programs.

Selectively Training in a Single Sport is Not Associated with Increased Injury in High School Female Athletes

Competing predominately in one sport instead of multiple sports has become increasingly prevalent in young athletes. However, there is a lack of data focused on female athletes who compete exclusively in one sport. We hypothesized that female athletes who selectively train in a single sport (SS) have higher rates of injury, body image concerns, and menstrual dysfunction compared to female athletes who play multiple sports (MS). Retrospective data was collected from a pre-physical questionnaire distributed among female athletes from five local high schools (n=611; 13-18 years of age). Odds ratios, 95% confidence intervals (CI), and effect size were calculated to investigate the association between SS training and injuries, irregular menses, and body image concerns (a priori p&lt; 0.05). SS training was not associated with higher rates of injury (p=0.48) and were less likely to have a history of stress fractures compared to MS athletes (p=0.03). There was a decrease in the number of menstrual cycles within the last 12 months among SS athletes (p=0.02, d=0.34). Exclusively competing in a single sport is not associated with higher injury rates in female high school athletes but is associated with dissatisfaction with one’s weight.

A Comparison Of Motivators Between Youth Single-sport, Multi-sport, And Single-sport Specialized Athletes

The motivation for youth sport involvement may differ for single-sport (non-specialists), multi-sport, and single-sport specialized athletes. PURPOSE: To investigate differences between adolescent single-sport athletes (SSA), multi-sport athletes (MSA), and single-sport specialized athletes (SSSA) on measures of sports enjoyment and motivation. A secondary aim was to compare these variables between age groups. METHODS: Adolescent sport participants in 6th, 7th, and 8th grade (n=306, age=13.0±1.0 yrs) completing the Sources of Enjoyment in Youth Sports Questionnaire (SEYSQ) that assesses sport enjoyment in the subscales of self-referenced competency (SRC), other-referenced competency and recognition (ORCR), effort expenditure (EE), competitive excitement (CE), affiliation with peers (AP), and positive parental involvement (PPI). The particpants also reported their age, gender, grade, years of sport participation and sport status (SSA, MSA, SSSA). RESULTS: SSSA reported significantly more enjoyment in all subscales except PPI when compared to SSA (p<0.05; ES 0.4 - 0.99). MSA and SSSA showed significant differences in the subscales of SRC and EE; however, effect size was small (0.37 and 0.33, respectively). Overall scores for intrinsic and extrinsic motivation were significantly lower among SSA compared to MSA and SSSA (p<0.01) with no differences between MSA and SSSA (p>0.05). Results revealed no significant differences in the SEYSQ 's subscales for age (p>0.05). CONCLUSION: Within the parameters of this study, adolescents that specialize in a single sport or those who compete in multiple sports both rely on intrinsic and extrinsic sources of enjoyment for motivation in very similar ways; whereas adolescent SSA are less motivated and experience less enjoyment from sport participation compared to MSA and SSSA. Key Words Adolescent Enjoyment SEYSQ

National Football League (NFL) quarterbacks who were multisport high school athletes have better in-season performance statistics and career success

ABSTRACT Objectives To determine (1) the proportion of National Football League (NFL) quarterbacks (QBs) who were multisport high school athletes (2) whether performance metrics in NFL QBs differed by playing multiple high school sports versus the single sport of football. Methods A comprehensive online search identified NFL QBs from 1995 to 2020, classifying them as single or multisport high school athletes. Performance data were collected for regular season and playoffs when applicable and were calculated as rates. Regular season comparisons were limited to players playing at least eight games. Accolades (Pro Bowls, MVP awards, and Super Bowl victories) were also recorded. Mann-Whitney U was utilized to compare performance metrics between multisport and single sport athletes. Results 403 QBs (223, 55.3% multisport) were included. In the regular season, multisport QBs played in more games (median 6.8, IQR 4–10.6 vs median 5, IQR 2.5–8.3; p = 0.0001), and had higher touchdowns/game (median 0.87, IQR 0.5–1.25 vs median 0.67, IQR 0.42–1; p = 0.0063), pass yards/game (median 159.4, IQR 103.9–206.7 vs median 139.4, IQR 96.3–179.6; p = 0.0392), and QB rating (median 78.5, IQR 69.4–85.2 vs median 74.4, IQR 66.7–81.2; p = 0.0063). There were no differences in pass completion %, interceptions/game, or rush yards/game. Multisport QBs played in more playoff games (median 0.5, IQR 0.22–0.81 vs median 0.33, IQR 0.2–0.62; p = 0.027), and had more Pro Bowl appearances, MVP awards, and Super Bowl victories per athlete (p < 0.05). Conclusion Over half of NFL QBs played multiple high school sports. Multisport involvement is associated with benefits in regular season including a higher proportion of games played, and more touchdowns/game, pass yards/game, and QB rating. Playing multiple sports was also associated with playing more playoff games and having more Pro Bowl appearances, MVP awards, and Super Bowl victories. This data supports the benefits of youth multisport training.

Sport Participation and Specialization Characteristics in a Pediatric Sports Medicine Clinic

Background:Recent trends in youth sports demonstrate athletes specializing in a single sport at younger ages in an effort to increase athletic success. Research suggests that increased training volume and early sport specialization are associated with increased injury risk, overuse injury, and athlete burnout. Although the exact threshold to avoid injuries has not been elucidated, some pediatric studies have shown increased risk of overuse injury with training more hours per week than their age in years.Hypothesis/Purpose:To determine if athletes presenting to a pediatric sports medicine clinic are participating in more hours per week than their age in years and associated factors related to sport participation.Methods:Data were prospectively collected from participants who presented to a tertiary sports medicine clinic for injury evaluation between October 2016-May 2021. Participants aged 5-<19 years who reported playing sports and had hours per week in their primary sport documented were included. Demographic and sport-related variables were reviewed. Participants were separated into two groups based on whether number of hours per week in their primary sport exceeded their age: UNDER (chronologic age and under) and OVER.Results:10,586 total participants: 8846 (83.6%) UNDER and 1740 (16.4%) OVER. There was no difference in age (13.7±2.6 vs 13.6±2.6 years, p=0.27) between the UNDER and OVER group. There were more males (49.7 vs 38.5%, p<0.0001) and more Hispanic or Latinos (20.2 vs 16.4%, p<0.0001) in the UNDER compared to the OVER group. Soccer (23.0%) was the most common primary sport for the UNDER group while gymnastics (27.1%) was for the OVER group. More participants considered themselves single-sport athletes (68.5 vs 54.1%, p<0.0001) and reported their highest level of competition as club/select/travel (52.0 vs 38.2%, p<0.0001) in the OVER group than the UNDER group. The OVER group reported a significantly higher number of sport participation hours per week than the UNDER group (20.5±8.2 vs 6.9±3.7 hours, p<0.0001, Figure 1), an additional year (6.8±3.2 vs 5.6±3.3 years, p<0.0001), and weeks per year participating in their primary sport (41.7±13.4 vs 32.0±15.5 weeks, p<0.0001).Conclusion:About 15% of athletes seen at the sports medicine clinic reported participating in more hours per week than their age. These athletes were more likely to report being single-sport athletes and participating in club-style teams. Understanding this information may aid providers in educating families in the OVER group about potential increased risk for injury due to high weekly participation volumes and sport specialization.Figure 1.Average number of participation hours per week in the OVER compared to the UNDER group

Youth athletes sleep more, practice less, and may lose interest in playing sports due to social distancing mandates

In-person sport participation was suspended across the United States in the spring of 2020 to slow the spread of the novel coronavirus (COVID-19). The purpose of this study was to survey the impact of COVID-19 on young athletes during a period of social and organized sports restrictions. An anonymous cross-sectional survey study was conducted of youth athletes in the midst of social distancing mandates and consisted of six components: demographics, sport participation, changes in sport-related goals/aspirations, sleep habits, and measures of anxiety and depression. 711 individuals who accessed the survey link yielded 575 (81%) participants with responses available for analysis. All respondents (aged 13.0 years) played organized sports, 62% were single-sport athletes, and 74% considered high-level. Participants were training ∼3.3 h less per week, spending more time outside, and 86% of participants continued to train while social distancing. Sleep duration increased (∼1.2 h/night) and sleep quality improved in 29% of young athletes. Additionally, 22% and 28% reported PROMIS® anxiety and depression scores characterized as ‘mild’, ‘moderate’, or ‘severe’. Older single-sport participants reported higher depression scores, while higher anxiety scores were seen in female participants with fewer years played. 10% of young athletes and 20% of teenagers changed their sports-related goals. Training style modifications, decreased training, and increased sleep quantity and quality were positive effects of COVID-19 restrictions, while athletic aspirational changes were undesirable effects. Single-sport athletes may be at greater risk for psychological symptoms when their routine is altered.

Motivation Differences between Youth Single-Sport, Multi-Sport, and Single-Sport Specialized Athletes in the Western United States

The motivation for youth sport involvement may differ for single-sport (non-specialists), multi-sport, and single-sport specialized athletes. To investigate differences between adolescent single-sport athletes (NSSA), multi-sport athletes (MSA), and single-sport specialized athletes (SSSA) on measures of sport enjoyment and motivation. A secondary aim was to compare these variables between age groups. Adolescent sport participants in 6th, 7th, and 8th grade from the Western United States (n=306, age=13.0±1.0 yrs) completing the Sources of Enjoyment in Youth Sport Questionnaire (SEYSQ) that assesses sport enjoyment in the subscales of self-referenced competency (SRC), other-referenced competency and recognition (ORCR), effort expenditure (EE), competitive excitement (CE), affiliation with peers (AP), and positive parental involvement (PPI). The participants also reported their age, gender, grade, years of sport participation and sport status (NSSA, MSA, SSSA). SSSA reported significantly more enjoyment in all subscales except PPI when compared to NSSA (p&lt;0.05; ES 0.4 – 0.99). MSA and SSSA showed significant differences in the subscales of SRC and EE; however, effect size was small (0.37 and 0.33, respectively). Overall scores for intrinsic and extrinsic motivation were significantly lower among NSSA compared to MSA and SSSA (p&lt;0.01) with no differences between MSA and SSSA (p&gt;0.05). Results revealed no significant differences in the SEYSQ’s subscales for age (p&gt;0.05). Within the parameters of this study, adolescents that specialize in a single sport or those who compete in multiple sport both rely on intrinsic and extrinsic sources of enjoyment for motivation in very similar ways; whereas adolescent NSSA are less motivated and experience less enjoyment from sport participation compared to MSA and SSSA. Keywords: adolescent, enjoyment, SEYSQ, motivation, sport psychology

ELEVADO RISCO DE LESÕES ESPORTIVAS EM ALUNOS DE MEDICINA: ESTUDO TRANSVERSAL

ABSTRACTObjective: To evaluate the nature and rate of sports injuries in medical students, as well as the risk factors at these events.Methods: All student-athletes (218) from a Medical School, integrated in at least one of the six team sport modalities (soccer, rugby, indoor soccer, handball, basketball, and volleyball) in 2017, were included. Injuries affecting their performance, regardless of time loss, were included. Athlete-exposure (A-E) was defined as one student-athlete participating in one practice or game.Results: Injury rates were significantly higher in junior medical students (1st - 3rd year) (7.58 per 1000 A-E, 95%CI = 6.11-9.06) than in senior medical students (4th - 6th year) (4.49 per 1000 A-E, 95%CI = 3.26-5.73) (p < 0.001). Multi-sports athletes had higher injury rates (10.69 per 1000 A-E, 95%CI = 8.22-13.17) than single-sport athletes (4.49 per 1000 A-E, 95%CI = 3.51-5.47) (p = 0.002). More than 60% of reported injuries occurred in the lower limbs and the mechanism that accounted for most injuries in games was player contact (51%); whereas in practice, it was non-contact (53%).Conclusion: Junior medical students present a higher injury rate than seniors. Medical students practicing more than one modality had a higher injury rate than those involved in just one sport modality. Level of Evidence IV, Cross-Sectional Study.

PEDI-CHAMP© AGILITY TEST VARIES BY AGE, GENDER AND SPORT SPECIALIZATION IN YOUTH ATHLETES

Background:The Pediatric Comprehensive High-Level Activity Mobility Predictor (Pedi-CHAMP©) is a 4-part agility test aimed to assess functional performance in children with and without sports medicine injuries or orthopedic conditions. The Pedi-CHAMP© assesses bilateral single limb balance, lateral agility, directional changes, and acceleration/deceleration.Hypothesis/Purpose:To determine if the Pedi-CHAMP component (Single-Limb-Stance [SLS], modified Edgren Side Step [mESS], L-Test, Illinois Agility Test [IAT]) and composite scores are stratified based on age, sex, and sport-type/specialization in youth athletes.Methods:Youth athletes were recruited to complete the Pedi-CHAMP© either as an independent test or as part of larger battery of tests (Specialized Athlete Functional Evaluation [SAFE] Program). Completion times for each test component were converted to points using age-sex matched scoring algorithms. Each participant also answered questions to determine specialization in organized sports (defined as competition with a referee, umpire, etc.). Kruskal-Wallis was used to assess differences based on age groups (elementary [E, 5-9yrs], preteen [PT, 10-12yrs], early teen [ET, 13-15yrs], late teen/young adult [LT, 16-22yrs]), with Mann-Whitney U pairwise post-hoc comparisons (α<0.05). Independent Mann-Whitney U tests were used to assess differences based on sex, sport type (low vs high impact) and specialization (single vs multi-sport) within each age group.Results:A total of 251 youth athletes (134 females, age 13.7±3.3yrs; BMI 20.9±5.9) completed Pedi-CHAMP© testing. Significant differences were seen with the Pedi-CHAMP© component and composite scores between all ages (p<0.001, Table 1), however, there were no differences between ET and LT groups for the SLS or mESS. When assessing age and sex, elementary-aged girls demonstrated improved SLS balance (p=0.017), and mESS scores were higher in preteen boys compared to girls (p=0.022). However, all 3 agility components (mESS, L-Test, IAT) and the Pedi-CHAMP© composite scores were significantly higher in boys compared to girls for the ET and LT groups. When accounting for age, there were no differences in single-sport vs. multi-sport athletes. ET and LT low-impact athletes scored lower on the L-test compared to high-impact athletes.Conclusion:The Pedi-CHAMP© was able to detect differences based on age, sex and sport impact-type (low- vs. high-impact). Performance improves with age for the L-Test and IAT, however, no differences in SLS and mESS were seen between younger and older teens which may indicate a ceiling effect for these two components. Further research should focus on correlating the Pedi-CHAMP© to other performance measures in youth athletes.Tables/Figures:

Financial and medical burdens of youth sports specialization: survey of pediatric sports patients

The trend towards youth sports specialization has led to increased costs from higher injury rate and from private club fees. The aim of this study was to represent the financial and medical burdens of sports specialization with single sport participation or club sports involvement. An 18-item survey on sports participation and musculoskeletal injury was administered to parents of patients visiting the clinic of a pediatric sports medicine orthopaedic surgeon over a three-month period. Comparisons were made between groups to identify differences in medical and financial burdens. Logistic regressions were performed to evaluate Odds Ratios for binary outcomes. Club athletes were significantly younger than non-club athletes (12.9±3.1 years versus 14.9±2.8 years, P=0.0002) with club athletes starting sports at average of 7.2±3.1 years. Club sports participation (adjusted OR 5.88, 95% CI: 1.10, 31.4) and female sex (adjusted OR 3.47, 95% CI: 1.12, 10.74) were significant predictors of spending >$1000 USD on sports annually. Multisport participation (OR 5.72, 95% CI: 1.21, 26.96) and spending >$1000 on sports annually (OR 17.21, 95% CI: 1.49, 199.25) were significant predictors of presenting to clinic for a sports-related injury. Single sport athletes had a higher number of medical appointments for sports injuries (18.6±23.0 versus 9.3±10.0 for multisport, P=0.0042). Youth sports specialization is of substantial financial and medical burden to families. This data can help identify areas of intervention to mitigate injury risk and reduce financial barriers to youth sports participation.

Genomic profile in association with sport-type, sex, ethnicity, psychological traits and sport injuries of elite athletes.

In the last few years, some inherited determinants have been associated with elite athletic performance, but its polygenic trait character has limited the correct definition of elite athlete's genomic profile. This qualitative descriptive study aims to summarize the current understanding about genetic and epigenetic factors in elite athletes, as well as their genomic profile in association with sport-type, sex, ethnicity, psychological traits and sport injuries. A narrative review of the literature across a broad cross-section of the elite athletes' genomic profile was undertaken. Elite performance relies on rare gene variants within a great interface between molecular, cellular and behavioral sport-related phenotypes and the environment, which is still poorly understood. ACTN3 rs1815739 and ACE I/D polymorphisms appear to be associated to specific sprint phenotypes and influence the athletic status, i.e., the rs1815739 variant is more influential to 200-m performance and the ACE ID polymorphism is more involved in the longer, 400-m sprint performance. Generally, athletes show endurance-based sports characteristics or power-based sports characteristics, but some studies have reported some genes associations to both sports-based characteristics. Furthermore, genetic studies with larger cohorts of single-sport athletes might be preferable than studies combining athletes of different sports, given the existence of distinct athlete profiles and sport demands. Athletic performance may be influenced by the serotonergic pathway and the potential injury risk (namely stress fracture) might be associated to a genetic predisposition associated to the mechanical loading from the intense physical exercise. The study of gene variants associated to sex and ethnicity-related to athletic performance needs further investigation. The combination of genome-wide association studies addressing the genetic architecture of athletes and the subsequent replication and validation studies might for additional genetic data is mandatory.

The prevalence of high school multi-sport participation in elite national football league athletes

ABSTRACT Objectives: Early youth specialization is increasingly being researched and identified as a risk factor for overuse injuries and burnout. This study aimed to characterize high school sport specialization in top National Football League (NFL) athletes and determine whether associations exist between single-sport specialization and future injury risk, performance, and longevity. Methods: For NFL first-round draft picks from 2008–2017, data on the number of games played in the NFL, overuse injuries causing athletes to miss one or more regular season games, Pro Bowl selections, and current status in the NFL were collected using publicly available information. Results: A total of 318 athletes were analyzed. Multi-sport athletes were highly prevalent (88%, n = 280), while only 12% (n = 38) of athletes were classified as single-sport. No difference between multi-sport and single-sport athletes was found regarding games missed to upper (p = 0.93) or lower extremity injuries (p = 0.49), total games played (p = 0.57), or NFL longevity (p = 0.97). There was no significant difference in the proportions of athletes reaching at least 1 Pro Bowl. Conclusion: The majority of NFL first-round draft picks were multi-sport athletes in high school. Single-sport football participation in high school does not appear to aid athletes in reaching or succeeding in the NFL.

The Curse of the All-Star Team: A Single-Season Prospective Shoulder MRI Study of Little League Baseball Players.

Throwing guidelines have been implemented in Little League baseball in an attempt to minimize injuries in young baseball players. We hypothesized that playing pitcher or catcher and increased innings played during the season would result in dominant shoulder magnetic resonance imaging (MRI) abnormalities. A prospective evaluation of Little League players aged 10 to 12 years was performed. Players recruited before the start of the season underwent bilateral preseason and dominant shoulder postseason MRI, physical examination, and questionnaires addressing their playing history and arm pain. Innings played, player position, pitch counts, and all-star team selection were recorded. In total, 23 players were enrolled. The majority (19/23, 82.6%) were right-handed and 16 of 23 (69.6%) played at least 10 innings as pitcher or catcher. Sixteen were selected for the all-star team. Fourteen players (60.9%) had positive dominant shoulder MRI findings not present in their nondominant shoulder. Eight players (34.8%) had new or worsening postseason MRI findings. Thirteen players (81.3%) selected to the all-star team had abnormal MRI findings whereas only one (14.3%) player not selected as an all-star had MRI abnormalities (P=0.005). Year-round play (P=0.016), innings pitched (P=0.046), innings catcher (P=0.039), and number of pitches (P=0.033) were associated with any postseason MRI abnormality, but not for new or worsening MRI changes. Single sport athletes and players playing for multiple teams were significantly more likely to have abnormal MRI findings (P=0.043 and 0.040, respectively) when compared with multisport athletes playing on a single team. MRI abnormalities involving the dominant shoulder are common in Little League baseball players and often develop or worsen during the season. Contrary to our hypothesis, MRI abnormalities were not associated with player position and pitch counts. Instead, they were most closely associated with year round play, single sports participation, and all-star team selection. The increased demands required for all-star selection comes at a price to the young athlete as the majority of players selected for this honor had abnormal MRI findings in their throwing shoulder while few non all-stars demonstrated such pathology. Level II.

Evaluating a Commonly Used Tool for Measuring Sport Specialization in Young Athletes.

Sport specialization has been defined as year-round intensive training in a single sport to the exclusion of other sports. A commonly used survey tool created by Jayanthi et al, which classifies athletes as having a low, moderate, or high level of specialization, categorizes only athletes answering yes to "Have you quit other sports to focus on a main sport?" as highly specialized. We hypothesized that a measureable number of year-round, single-sport athletes have never played other sports and, therefore, may be inaccurately classified as moderately specialized when using this tool, even though most experts would agree they should be viewed as highly specialized. To determine the proportion of athletes misclassified as moderately rather than highly specialized because they never played a previous sport. Cross-sectional study. Hospital-based pediatric outpatient sports medicine clinic. Injured athletes aged 12 to 17 years who presented to the clinic between 2015 and 2017 and completed a sports-participation survey (n = 917). Sport-specialization level. Of 917 participants, 299 (32.6%) played a single sport more than 8 months per year, and 208/299 (69.6%) had previously quit other sports (highly specialized), whereas 91 (30.4%) had never played other sports (highly specialized and misclassified as moderate). Individual-sport athletes had a 2.03 times greater risk of being highly specialized and misclassified as moderate than team-sport athletes (relative risk = 2.03 [95% confidence interval = 1.37, 3.00]). Females had a 1.70 times greater risk of being misclassified as moderately specialized than males (relative risk 1.70 [95% confidence interval = 1.07, 2.70]). Of the 3 sports with the largest number of athletes, artistic gymnastics had the highest proportion (51.2%) who had never played other sports. The commonly used specialization survey misclassified a substantial number of highly specialized athletes as moderately specialized. Researchers should consider adding a fourth survey question, "Have you only ever played 1 sport?" to identify and better study this unique subset of misclassified athletes.

Early Sports Specialization Is Associated With Upper Extremity Injuries in Throwers and Fewer Games Played in Major League Baseball.

Background:Single-sport athletes who specialize in baseball at a young age may have a greater predisposition to overuse injury, burnout, and decreased career longevity when compared with multiple-sport athletes. The effect of sport specialization has not been studied in professional baseball players.Hypothesis:Major League Baseball (MLB) players who played multiple sports in high school would experience fewer injuries, spend less time on the disabled list, play more games, and have a longer career than athletes who played only baseball in high school.Study Design:Descriptive epidemiology study.Methods:First- and second-round MLB draft picks from 2008 to 2016 who played in at least 1 professional game were included in this study. Athletes who participated in 1 or more sports in addition to baseball during high school were considered multisport athletes, and athletes who participated in only baseball were considered single-sport athletes. For each athlete, participation in high school sports, injuries sustained in MLB and Minor League Baseball, number of days on the disabled list for each injury, number of games played in both leagues, and whether the athlete was still active were collected from publicly available records.Results:A total of 746 athletes were included in this study: 240 (32%) multisport and 506 (68%) single sport. Multisport athletes played in significantly more mean total games (362.8 vs 300.8; P < .01) as well as more mean MLB games (95.9 vs 71.6; P = .04) than single-sport athletes. There was no difference in the mean number of seasons played in the major leagues (1.8 vs 1.6; P = .15) or minor league (5.25 vs 5.20; P = .23) between multisport and single-sport athletes. Single-sport athletes had a significantly higher prevalence of upper extremity injuries compared with multisport athletes (136 [63%] vs 55 [50%]; P = .009). Single-sport pitchers also had a higher prevalence of shoulder and elbow injuries (86 vs 27; P = .008) and were more likely to have recurrent elbow injuries (33% vs 17% recurrence; P = .002) compared with multisport pitchers.Conclusion:Professional baseball players who participated in multiple sports in high school played in more major league games and experienced lower rates of upper and lower extremity injuries than players who played only baseball in high school.