1. Early Sports Specialization
Wise to Specialize?
Brian Purchase, DO, FACOEP, CAQ Sports Medicine
Covenant Sports Medicine

2. Goals and Objectives Define Sports Specialization Why is it important?
What should we do and recommendations?
Specific examples
Trivia Question

3. $$$$$ Cross Train Rest Compete: but just one team Have Fun
Stay in the Game

4. Definition Early Sports Specialization
Year round training in one sport at the exclusion of other sports before the age of 12

5. Benefits of Sports Teamwork Socialization Leadership Discipline
Exercise
Downside
Sports related injuries
Burnout

6. Statistics 30 million children participate in sports
7.3 million high school students participate in athletics annually
High school athletics accounts for more than 2 million injuries annually
500,000 doctor visits
30,000 hospitalizations

7. The Problem Young athletes are specializing in sports at earlier ages
More than 3.5 million children < 14 are treated annually for sports injuries
Immature bones, not enough rest, and poor training and conditioning contribute to overuse injuries
Overuse injuries account for half of all sports injuries in middle and high school

8. Importance Overuse The lasting problem
Excessive and repeated use that results in injury to bones, muscles or tendons involved in the action
The lasting problem
Risk for future injury
Contributor to long term degenerative diseases
Leads to higher rates of adult physical inactivity
If commit at a young age, often first to quit

9. Importance
Burn out
70% of kids participating in sports drop out by the age of 13 because of stress, decreased motivation and lack of enjoyment

10. How to Spot Overuse Continued pain with activity
Pain with drastic increase in workouts
Burnout
Change in technique
Nighttime pain
Swelling
Numbness

11. Overuse Pain that lasts until the next workout
Can’t perform at usual level
Loss of accuracy or form
Dead-arm sensation, heaviness or numbness
Child complains (more than usual)
Loss of motivation – doesn’t want to go to practice

12. Recommendations Stress the importance of rest
Enforce warm-up and cool down sessions
Encourage proper strength training/techniques
Encourage Multiple sports/Discourage early specialization
Limit quantity
Eg. Pitch counts
Limit tournaments/matches played/multiple teams
Eliminate Radar Gun

13. Benefit of Multi-sport Participation
Better overall skills and ability
Smarter, more creative players
Most college athletes come from a multi-sport background
In fact, colleges are increasingly recruiting multi-sport athletes
Urban Meyer scouted Tim Tebow when he was playing right field on his HS baseball team
10,000 hours is not a rule
Free play equals more play

14. Examples
Baseball
Tennis
Swimming
Gymnastics
Soccer
Basketball

15. Baseball Elbow Injuries >50-75% of youth baseball players
Elbow surgery has increased 50% in high school pitchers in the past 5 years
Can be preventable
Fewer pitches = Longer Career

16. Baseball
Elbow Injuries

19. Common Injuries Ligament/Tendon Bone/Growth Plate UCL (Tommy John)
Medial/Lateral
epicondylitis
Bone/Growth Plate
Occur in growing children
Medial apophysitis
(Little Leaguer’s Elbow)

23. Pitch Recommendations

24. Age Recommended for Learning Various Pitches
Pitch Age Fastball 8 ± 2 Change-up 10 ± 3 Curveball 14 ± 2 Knuckleball 15 ± 3 Forkball 16 ± 2 Slider 16 ± 2 Screwball 17 ± 2

25. References
(Sports Trauma and Overuse Prevention)

28. Benefits of running Healthy Inexpensive
Engaging activity that promotes fitness and discipline

29. Pitfalls of running
Physically and Psychologically damaging if not carefully supervised
Adverse conditions
Inadequate clothing or equipment
Improper form: quality/quantity
Burn out is high if child starts too early (i.e. pre-teen)

30. Recommendations Soft running surfaces Less stress on growing bodies
Avoid competitive environment
Keep it low-key and keep it fun
Avoid pressures of high expectations for others (i.e. parents and/or coaches)
Parents need to be careful not to push a child beyond their mental or physical limits

31. Avoiding overuse injury
Adhere to comprehensive program of strength training and stretching
Resistance training
High repetitions/lower weight
Core exercises
Push-ups
Abdominal crunches

32. Common injuries Knee Lower leg Foot/ankle Pelvis/hip Heat injuries
Skin injuries

33. Signs/Symptoms Pain with running Pain at rest Can’t sleep Limping
Stiffness
Other symptoms to be aware of
Increased shortness of breath
Headache during or after runs
Dizzy or light headed

34. Further prevention strategies
Stop at first sign of injury/pain
Do not run through pain
Proper techniques and training
Stick to appropriate goals
Determine reason for running
Fitness
Recreation
Training
Competition
Set safe and achievable goals and advance slowly and cautiously

35. Safety tips when starting out
Hydrate
Stretch
Speed up slowly
Proper attire
Flat terrain
Soft, all-purpose track surfaces
Well lit areas
Run with partner
Run in safe temperatures/humidity

36. How young is too young to run a Marathon?
International Marathon Medical Directors Association
If attempted at a younger age
Must enjoy the activity
Be asymptomatic
Runners choice to do so

40. $ummary Cross Train: Rest: Take time off
Play multiple sports
Learn proper mechanics
Rest: Take time off
Compete: but avoid multiple teams
Have Fun: Prevent burn out
Stay in the Game: Remain injury free.

41. Trivia Question
How many Little League World Series pitchers have made it to the MLB?

42. 4
In fact, fewer than 30 LLWS players have made it to the Majors

43. Counter Argument Available data on injury rates is not accurate
No proof that single sport specialization is more harmful than free play
Need to be cautious with some sports and certain positions
Inactivity is more detrimental than the risk of overuse injuries

44. THANK YOU