Sport Specialization, Club Sport Participation, Quality of Life, and Injury History Among High School Athletes

Abstract

Context Many factors can affect the injury risk and quality of life among high school athletes. Early sport specialization and club sport participation may be components to consider when assessing the injury risk and quality of life. Objective To investigate patient-reported quality-of-life and injury-history measures among adolescent athletes at different sport-specialization levels and to compare these measures between those who did and those who did not report participating in club sports. Design Cross-sectional study. Setting High school athletic facility. Patients or Other Participants High school student athletes 13 to 18 years of age were recruited and tested during their annual preseason athletic physical examinations. Main Outcome Measure(s) Our primary grouping variables were sport-specialization level (classified as low, moderate, or high) and club sport participation (organized sport outside of traditional school athletics). Our outcome variables were the Patient-Reported Outcome Measurement Information System Pediatric Profile-37 rating, Severity Measure for Depression–Child score, and injury history. Results A total of 97 individuals participated (mean age = 15.2 ± 1.1 years; 38% female). Relatively similar proportions of individuals reported participating at each level of sport specialization (low = 34%, moderate = 40%, high = 26%). Forty-six (48%) participants stated they participated in club sports. No differences were evident in quality of life (P values = .15–.92 across domains), depression (P = .60), or injury history (P > .70) among the specialization groups. Those who described participating in club sports had a higher proportion of time-loss musculoskeletal injuries (63% versus 29%; P = .002) and of injuries requiring imaging, injection, a cast, a brace, or crutches (72% versus 46%; P = .013) than those who did not. Conclusions Although no injury-history differences were found among the sport-specialization groups, a higher proportion of club sport athletes than nonclub sport athletes reported a history of injury. Club sports are generally seen as more competitive, and the higher number of injuries seen in this setting could be related to a higher level of play among club sport athletes.

Sport Specialization in Middle School and High School Long-Distance Runners

“…6,7 Recent studies report that 26.0-37.5% of adolescent athletes are classified as high-specialized. [8][9][10][11] There is a general consensus that sport specialization may negatively impact quality of life (QoL) in adolescent athletes 12,13 and increase the risk of sustaining an injury. [4][5][6]10,11,[14][15][16][17] Athletes who are more specialized in a sport may also have lower sleep quality and sport enjoyment.…”

“…12 Findings of lower QoL are not universal as similar levels of health-related QoL have been reported in high-school athletes across sport specialization level in other sports; however, cross-country athletes only represented 5.2% of participants (n=5). 8…”

“…The majority of prior studies examining differences in sport specialization level have included athletes from a wide range of sports. 4,8,10,11,[14][15][16] The impact of sport specialization on adolescent athletes may be influenced by sport type. Adolescent athletes who participate in individual sports are more likely to specialize in their sport, report higher training volumes, and have an increased injury risk than athletes who specialize in team sports.…”

“…Previous studies in adolescent athletes reported high-specialized athletes are at a higher risk of injury. 4,8,10,11,[14][15][16][17] Only one of these studies focused on long-distance runners 17 and long-distance runners were under-represented in the other studies. Our results differ from the previous findings as we found no significant difference in the frequency of runners reporting a history of RRIs among sport specialization level, regardless of sex.…”

Family Affluence Relationship to Sports Specialization in Youth Athletes

“…Among health care providers and public health policymakers, there is specific concern for increased musculoskeletal injury risk, altered movement patterns, and negative psychosocial outcomes involving children and adolescents who are highly specialized in one sport. [1][2][3][4] Despite these concerns, the benefits of sport are clear: greater self-esteem, social integration, enhanced motor control, and increased potential for healthy behaviors in the long term. 5 Thus, it is important to understand the characteristics of children and adolescents who choose to specialize in a single sport in order to accurately examine how sports specialization affects youth athletes.…”