SPORTS MEDICINE
Many young athletes and their families foster dreams of competing in sport at the highest levels, including college and professional sports. However, the percentage of high school athletes who advance to play at the collegiate and professional levels is very small. While there are millions of high school athletes in the U.S., only 7% (roughly 1 in 13) will play a varsity sport in college, and less than 2% will compete at the Division I level. Beyond college, fewer than 5% of collegiate athletes will go on to play sports professionally.
As opportunities for participation in youth sports have grown in recent years, there has been an increase in early sports specialization. Early sports specialization refers to the practice of focusing on one sport year-round, often to the exclusion of other sports and activities, generally before age 12. This may be driven by a child’s interest, parental or coach pressure, or aspirations for scholarships or elite status. This contrasts with multisport participation—also known as diversification or sport sampling—where athletes participate in a variety of sports throughout the year.
While early specialization may be beneficial in a small number of sports (e.g., gymnastics), specializing in one sport before puberty increases the risk of injury and burnout. For parents and coaches who want to support young athletes, research clearly shows that developing physical literacy through playing multiple sports during childhood and adolescence leads to stronger, healthier, and more well-rounded athletes throughout life.
Children need free play (which builds creativity and problem solving), movement diversity (moving their bodies in many different ways to develop awareness and control), and fun. Instead, many young athletes are pushed into early, year-round programs that contribute to overuse, under-recovery, and the misconception that they should “train like a pro.” Children cannot and should not train like adults—their developing bodies and brains have different needs and limitations.
Athletes who play a single sport more than eight months per year are significantly more likely to report upper or lower extremity overuse injuries such as Little Leaguer’s elbow (Post et al., 2017).
Athletes who train more hours per week than their age (for example, a 9-year-old playing soccer 12 hours a week) have a higher risk of injury of all types (Jayanthi et al., 2015).
Early diversification is linked to longer sports careers. Early specialization, on the other hand, is associated with shorter peak performance, higher dropout rates, burnout, and increased injuries in youth athletes (Côté et al., 2008).
Young athletes who specialize early are more likely to experience regret. In fact, 43% of NCAA athletes wish they had played more sports growing up.
88% of NCAA Division I athletes played multiple sports as kids. At the professional level, multisport youth athletes—such as many NBA players—have longer careers than those who specialized early.
The research aligns with what I see in the clinic as a family medicine–trained sports medicine physician. This is a conversation I have often with student athletes and their families—frequently after preventable injuries. Early sports specialization may provide short-term gains, but it often leads to long-term setbacks. Multisport athletes, however, are less likely to burn out, less likely to suffer overuse injuries, and more likely to stay active and healthy throughout life. Let them play more sports.
Charlotte Moriarty, MD, PhD, CAQSM, CF-L2
Primary Care Sports Medicine Physician
Mother of two multisport athletes
Youth strength & conditioning coach
