Context: Sport specialization among youth athletes has been associated with increased risk of overuse injuries. Previous research demonstrates that children perceive specialization to be beneficial in making their high school team and receiving athletic college scholarships. Previous research demonstrates that parents play a significant role in their child’s sport experience. However, it is unknown if parents and children answer questions related to specialization factors in a similar manner. Objective: To evaluate the beliefs of youth athletes and parents on factors related to sport specialization and evaluate the level of agreement between dyads on sports specialization. Design: Cross-sectional. Setting: Online and paper surveys. Patients or Other Participants: Aim 1: 1998 participants (993 children and 1005 parents). Aim 2: 77 paired parent–child dyads. Interventions: Self-administered survey. Main Outcome Measures: The responses were summarized via frequency and proportions (%). Chi-squares were calculated between parent and child responses. Kappa coefficients were calculated for dyads to determine level of agreement. Sport specialization was classified using a common 3-point scale. Results: The parents were more concerned about risk of injury in sports compared with children (P < .001, χ2 = 231.4; parent: extremely: 7.1%; child: extremely: 3.7%). However, children were more likely to believe that specialization was associated with their chances of obtaining an athletic college scholarship compared with parents (P < .001, χ2 = 201.6; parent: very/extremely likely: 13.7%; child: very/extremely likely: 15.8%). Dyad subanalysis indicated a moderate level of agreement for “quitting other sports to focus on one sport” (κ = .50) and a low level of agreement for “identifying a primary sport” (κ = .30) and “training >8 months per year in primary sport” (κ = .32). Conclusions: Parents and youth athletes had differing beliefs on the factors related to sport specialization. Dyad analysis shows that parents and children answer sport specialization classification questions differently. Health care providers should be aware of these differences, and messaging should be individualized to the audience.
BACKGROUND: Recent studies have demonstrated that a large population of high-school aged athletes participate on club sport teams. Studies have documented emergency preparedness and medical coverage standards in the high school athletic setting. However, similar examinations do not exist for youth club sport teams. PURPOSE: To determine if differences in emergency preparedness and medical coverage exist between high school team coaches and high school-aged club team coaches. A secondary purpose was to compare emergency training characteristics between high school and club coaches. METHODS: A total of 769 coaches (female N=266, 34.6%, age: 41.0±11.5 years) completed an anonymous online questionnaire regarding their emergency preparedness and training. Coaches from 3 sports were surveyed (basketball N=290, volleyball N=256, soccer N=223). The questionnaire consisted of 1) demographics and information regarding the teams that the respondent coaches, 2) emergency preparedness factors such as automated external defibrillator (AED) availability, emergency action plan (EAP) awareness, and medical coverage, and 3) emergency care training requirements (CPR, AED, first aid). Chi-square tests were used to compare response frequencies to various emergency preparedness questions between high school and club coaches. RESULTS: Overall, 64.6% (N=497) respondents were coaches of a high school team, and 35.4% (N=272) were coaches of a club team with high school-aged athletes. High school coaches were more likely than club coaches to be aware of the EAP for their practice venue (83.9% vs. 54.4%, p<.001), but most coaches in both categories had not practiced their EAP in the past 12 months (70.0% vs. 68.9%, p=.54). During competitions, high school coaches were more likely than club coaches to be aware of the EAP (47.5% vs. 37.1%, p=.02). However, the majority of coaches in each category reported that they were never aware of EAPs during competition. High school coaches were more likely than club coaches to 1) have an AED available at practice (87.9% vs. 58.8%, p<.001), 2), to report that athletic trainers were responsible for medical care at practices (31.2% vs. 8.8%, p<.001) and competitions (57.9% vs. 31.2%, p<.001), and 3) to be required to have CPR, AED, or first aid training (p<.001). Nearly all (98.8%) high school coaches were required to have CPR training, and overall, 58.6% of high school coaches were required to have training in all 3 categories (CPR, AED, first aid) compared to 23.9% of club coaches (p<.001). CONCLUSIONS: High school sport coaches displayed greater levels of emergency preparedness and training compared to coaches of high school-aged club teams. Significant attention and effort is needed to improve emergency preparedness and medical coverage at the club sports level among basketball, soccer, and volleyball coaches.
BACKGROUND: Retrospective studies of high school aged athletes have demonstrated that participating in one sport for more than 8 months of the year is a risk factor for overuse musculoskeletal injuries. This research has driven the recommendation that suggests youth athletes should not play a single organized sport for more than 8 months out of the year. However, these recommendations have never been prospectively examined in middle school aged athletes. The purpose of this study is to determine if year-round participation, operationally defined as participating in one sport for more than 8 months of the year, is associated with increased risk of overuse injuries in middle school aged athletes. METHODS: A total of 281 children (female N= 113, 40.2%, age= 12.1±1.2 years; range 10-14 years of age) completed an anonymous online survey with their parents for 39 weeks. A baseline survey was conducted in the first week of September 2017 and then weekly surveys were completed until June 2018. The baseline survey consisted of demographic information, previous injury history, and sport participation volume (months per year in primary sport). The weekly surveys asked participants to report their sleep habits, musculoskeletal injuries, and illnesses. Parents and children were asked to complete the surveys together. Participants were included in the analysis if they completed at least 80% of the total surveys. In the baseline survey, participants identified the previous months for which they played their primary sport. Those who marked more than 8 months out of the past 12 months were classified as “year-round participants.” Logistic regression was used to determine if year-round participation (>8 months/year) was a significant predictor of overuse musculoskeletal injuries during the study period. A second logistic regression model was created using the participant’s total reported months participating in a single sport as a predictor of overuse injuries. RESULTS: 80 (28.5%) participants were identified as participating year-round in a single sport and 49 overuse injuries were reported during the study period. Athletes who participated in a single sport year-round were more than twice as likely to sustain an overuse injury during the study period compared to non-year-round athletes (OR [95%CI]: 2.20[1.10-4.39], p=0.025), even after adjusting for sex, age, and previous injury history. The odds of sustaining an overuse injury increased approximately 17% for every additional month of participating in a single sport (OR [95%CI]: 1.17 [1.04 -1.32], p=0.012) again while controlling for sex, age, and previous injury. CONCLUSION: This is the first prospective study in middle school aged athletes examining year-round participation and overuse musculoskeletal injuries. Middle school aged athletes are at a 2-times increased risk of overuse musculoskeletal injuries when participating in a single sport for more than 8 months of the year compared to middle school aged athletes who participated 8 or less months in a single sport. Sport specialization has been identified as a risk factor for high school aged athletes for overuse injury – and our observations indicate that a similar trend may exist in middle school aged athletes. Recommendations regarding monthly sport participation for adolescents have been supported in the high school aged population and these recommendations may extend to an even younger population.
BACKGROUND: A recent focus of the literature that has bridged the sports medicine and sport psychology domains relates to the topic of youth sport specialization. Previous work has identified specializing in one sport – particularly at an early age – to be associated with increased risks of negative physical (i.e., overuse injuries, lower extremity injuries) and psychosocial outcomes. As a result, medical organizations have advocated for a more diversified, multisport experience. Despite these recommendations, concerns regarding the rising prevalence of sport specialization have been a continued fixture of the literature, with little known regarding how underlying attitudes, beliefs, and values of sport stakeholders may be shaping this trend. One proposed avenue for better understanding this gap between recommendations and perceived participation behaviors is to examine and compare the club and high school sport contexts. Specifically, club sports have been linked to more professionalized climates of competition, in turn suggesting that specialization may be viewed more favorably than in the high school setting. Therefore, the purpose of the current study was to examine the perceptions of coaches in the high school and club sport contexts related to youth sport specialization to better understand how these youth sport leaders compare in their endorsement of attitudes and behaviors promoting this phenomenon. METHODS: This cross-sectional study examined 769 currently-practicing coaches (497 high school, 272 club; 533 male, 266 female). Participants completed a novel perceptual measure which surveyed their attitudes, values, and beliefs related to various aspects of youth sport specialization (e.g., effectiveness in developing talent, likelihood of leading to an enjoyable experience, likelihood that their competition specializes). The participant’s mean rating across the 25 items denoted their global perception of sport specialization (i.e., higher scores indicated a more favorable view of specializing). Additionally, each coach completed a questionnaire detailing their relevant demographic and sport background information. To analyze the data, an independent samples t-test was conducted between the two groups while using their perceptual score of specialization as the dependent variable. Finally, a multiple linear regression was calculated separately for each coach group to predict participants’ perceptual scores of specialization based on their demographic and sport background responses (i.e., age of athletes coached, years of experience as a coach, post-secondary education in sport, additional coaching certifications, self-rating of coaching quality). RESULTS: High school coaches (M = 2.31; SD = 0.21) and club coaches (M = 2.43; SD = 0.25) differed in their average perceptions of sport specialization (t(767) = 1.412; p < .001), meaning that the club sport coaches were more likely to rate specialization as a positive, adaptive practice in comparison to their high school counterparts. For high school coaches, the overall regression equation was significant, but explained only a small amount of variance (F(5, 491) = 2.542, p = .028, R2 = .025); however, no demographic characteristics were strong independent predictors. The multiple linear regression for the club coaches did not yield a significant equation to predict perceptual scores of specialization based on their sport background characteristics (F(5, 256) = .224, p = .952, R2 = .004). SIGNIFICANCE: This study was the first to examine sport specialization by comparing the high school and club sport contexts. These findings indicate that club sport athletes are more likely to be exposed to messaging and attitudes that posit sport specialization as favorable, despite the proliferating base of evidence detailing the physical and psychosocial risks of this pattern. Additionally, the multiple linear regression analyses specify that elements of coach education, experience, and demographic characteristics do not strongly predict perceptions of specialization, suggesting that the competitive contexts themselves (high school vs. club) may be the most salient influencer of these perceptions. Therefore, club sports appear to be a critical point-of-impact for a cultural shift to better account for the potential drawbacks of specializing in one sport stemming from previous sports medicine literature. Athletes in these contexts should also be aware of the heightened expectation of specialized participation by those leading their teams. Pediatric sport researchers and practitioners should continue to explore how these differing group perceptions manifest in terms of participation behaviors, as well as their link to overall athlete health, well-being, and development.
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