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August 16th, 2013

Sport Specialization: Take the summer off!

One significant change in the care of athletes over the last 10 years has been this concept of specialization. When I grew up you typically played football in the fall, basketball/hockey in the winter and baseball in the spring. The summer was spent going on vacation with your family or getting a job to make some cash for the rest of the year.

Now pre-teens and teens are selecting a sport that they excel at and play that sport 12 months a year. There are numerous arguments for this practice that Dr. Joel Fish enumerated in a previous blog such as not lagging behind other athletes in order to compete for a potential scholarship.

  • The median household income in 2011 was $50,000
  • The average cost for college is $43,000/year

A few years ago a friend of my daughter was a star athlete in 3 sports and never had an injury. He decided that he wanted to only play basketball. His family invested thousands of dollars paying for camps and leagues throughout the year for him to participate in his dream sport. That’s when all the injuries began. He had multiple stress fractures, knee sprains, hand fractures, recurrent ankle sprains that left him with unstable ankles and bursitis. It was this experience with this one patient that made me look deeper into this phenomenon of sports specialization.

Every sport that one plays, places stress on different anatomical structures of the body. All parts of our body such as bone, ligaments and tendons have a breaking point. So if you apply the same stress repetitively to that structure (as one does when they play one sport the entire year), it will eventually fail. Our bodies, independent of age, need time to recover and allow for healing. Each sport carries their own inherent risks but by playing different sports, one is stressing different structures for shorter periods of time thereby lessening the chance of injury to one particular part of the body.

“Tommy John” surgery was developed by Dr. Frank Jobe to solve a major problem in the elbow in the aging pitcher. The more someone throws, the greater the strain on the ulnar collateral ligament of the elbow to where it eventually tears. Many years ago this was an injury we saw in the 30-ish year old pitcher. Now we are seeing it in high school baseball players. The simple reason for this increase incidence of these elbow ligament tears is because these athletes are throwing all year-round and not having any “downtime” to allow the ligament to rest and recover.

I asked one of the Flyers about the time they spent playing hockey growing up in Canada. He said he played from August to April and played baseball for a few months. It seems this concept of sports specialization is indigenous to the United States only. This particular Flyer, as well as others, made it to the NHL without playing just one sport for 12 months a year.

Sports specialization does not guarantee that the athlete will get a scholarship to college or make it to the professional level, but studies are showing that it will increase the risk of injury. Experience the benefits that different sports offer and take the summer off.

This article originally appeared on the Sports Doc blog of Philly.com Health. Read more about Sports Medicine and Fitness