Pediatricians say children shouldn’t specialize in a single sport until age 15-16, if at all

Children who specialize in a single sport and train intensively for it are at higher risk of experiencing overuse injuries, as well as burnout, anxiety and depression, according to a new report from the American Academy of Pediatrics (AAP).

In the report, the AAP encourages parents to keep their children from specializing in a single sport until late adolescence — age 15 or 16 at the earliest. Children should instead be encouraged to play many different sports, with an emphasis on having fun and learning fundamental movement and sports skills rather than on training for competition.

The AAP also called for a ban on the national ranking and college recruitment of student-athletes until they have reached their late high school years.

“More kids are participating in adult-led organized sports today, and sometimes the goals of the parents and coaches may be different than the young athletes,” said Dr. Joel Brenner, the report’s lead author and past chair of the AAP Council on Sports Medicine and Fitness, in a released statement. 

“Some are aiming for college scholarships or a professional athletic career, but those opportunities are rare,” he added. “Children who play multiple sports, who diversify their play, are more likely to enjoy physical activity throughout their lives and [be] more successful in achieving their athletic goals.”

A harmful trend

As background information in the report points out, the culture around youth sports in the United States has changed dramatically in recent decades. Instead of neighborhood “pick-up” games, the norm today is to funnel children and teens into organized sports overseen by parents and coaches.

Children are also increasingly pressured — again, usually by parents and coaches — to specialize in one sport and to play it year-round, often on several different teams.

In 2008, about 1 in 4 of the 60 million children aged 6 to 18 who participated in organized sports play only one sport, according to the National Council of Youth Sports. That number is most likely higher today.

Year-round, single-sport participation is fostered, the AAP report says, by select or travel leagues, which children often join at the age of 7.

And here’s another troubling statistic: Most children in the U.S. — 70 percent — drop out of organized sports by their 13th birthday.

“One reason could be pressure to perform better and lack of enjoyment due to a variety of reasons, including a lack of playing time,” said Brenner. 

Unrealistic expectations

The belief of parents that sport specialization at a young age will help their child get a college scholarship or a professional career is misguided, the AAP report stresses.

Here’s the reality: Only 1 percent of high school athletes receive an athletic scholarship, and only 0.03 percent to 0.5 percent of high school athletes make it to the professional level.

What parents don’t realize, the report says, is that “athletes who participate in a variety of sports have fewer injuries and play sports longer than those who specialize before puberty.” They are therefore more, not less, likely to end up playing at a top level: 

Most authorities agree that sports specialization, in general, leads to higher athletic “success,” but the optimal timing of specialization is only becoming clearer. Studies have shown that Division 1 NCAA athletes are more likely to have played multiple sports in high school and that their first organized sport was different from their current one. …

Other studies in elite athletes have shown that intense training did not start until late adolescence and that these athletes played other sports before specializing. [Two reviews] of studies of elite athlete specialization history … revealed that, for the majority of sports, late specialization with early diversification is most likely to lead to elite status. In addition, athletes who engaged in sport-specific training a young age had shorter athletic careers.

A variety of risks

The AAP report describes the long string of scientific research that has been conducted on the physical and mental risks associated with specializing in sports at a too-early age. Here are some of those evidence-based findings:

• Young athletes who specialize
 too soon are at risk of physical, emotional, and social problems. Athletes
 may become socially isolated 
from their peers and may have altered relationships with family, overdependence on others with 
a loss of control over their lives, arrested behavioral development, or socially maladaptive behaviors.

• Specializing early with intense training can lead to overuse injuries, which can cause pain and temporary loss of playing time or may lead to early retirement from the sport.  … One study in high school athletes showed an increased risk of injury when the training volume exceeded 16 hours per week. Another study determined that sports specialization was an independent risk factor for injury and that athletes who participated in organized sports compared with free play time in a ratio of >2:1 had an increased risk 
of an overuse injury.

• Burnout, anxiety, depression, and attrition are increased in early specializers. Social isolation from peers who do not participate in the athlete’s sport and lack of being exposed to a variety of sports also are concerns.

• Restriction in exposure to a variety of sports can lead to the young athlete not experiencing a sport that he or she may truly enjoy, excel at playing, or want to participate in throughout his or her adult life.

“The combination of these and other adverse outcomes could lead to a decrease in lifelong physical activity,” the AAP report adds.

What parents can do

We’re going to need a society-wide shift in the youth sports culture if we’re going to reverse the unhealthful trend toward single-sport specialization. In the meantime, the AAP makes the following recommendations for pediatricians, young athletes and their families:

• Delay sports specialization until at least age 15-16 to minimize risks of overuse injury.

• Encourage participation in multiple sports.

• If a young athlete has decided to specialize in a single sport, a pediatrician should discuss the child’s goals to determine whether they are appropriate and realistic.

• Parents are encouraged to monitor the training and coaching environment of “elite” youth sports programs.

• Encourage a young athlete to take off at least three months during the year, in increments of one month, from their particular sport. They can still remain active in other activities during this time.

• Young athletes should take one to two days off per week to decrease changes of injury.

“The ultimate goal of sports is for kids to have fun and learn lifelong physical activity skills,” said Brenner. “We want kids to have more time for deliberate play, where they can just go out and play with their friends and have fun.”

FMI: The report — a must-read for parents — was published in the September issue of the journal Pediatrics, where it can be accessed in full.