Is It Wise to Specialize

By Robin Waxenberg

Is It Wise to Specialize?
Watch "Is It Wise to Specialize? What the Pros Have to Say About Overuse Injuries and Burnout.

The National Athletic Trainers’ Association (NATA) and At Your Own Risk hosted a webinar, “Is It Wise to Specialize? What the Pros Have to Say about Overuse Injuries and Burnout,” on Friday, October 21. The event culminated NATA’s annual Youth Sport Specialization Awareness Week. A panel of interdisciplinary health care and medical experts, moderated by NATA President Kathy Dieringer, EdD, LAT, ATC, addressed the latest trends and guidelines specific to youth sport specialization.

“Our event wraps up our annual youth sport specialization awareness week that has been filled with good education, new research and a steadfast commitment to helping reduce injury from youth sport specialization, said Dieringer.

“When it comes to the prevention, assessment, treatment and rehabilitation from injury or sport-related illnesses, the athletic trainer has the expertise to provide the gold standard of care,” she added. “Yet only 37% of U.S. public high schools have access to an athletic trainer. If your school has sports, they should have athletic trainers. We are there to help reduce risk of injury and put the right protocols in place.”

Panelists included:

Neeru Jayanthi, MD, Associate Professor Orthopedics and Family Medicine; Director Emory Sports Medicine Research and Education; Co-director Emory Youth Sports Medicine Program; Director, Emory Tennis Medicine, Emory Sports Medicine Center

Michele LaBotz, MD, FAAP, Board Member, Maine chapter, American Academy of Pediatrics; Assistant Clinical Professor, Department of Pediatrics, Tufts University School of Medicine in Boston; sports medicine physician, InterMed, Portland, Maine

Tamara Valovich McLeod, PhD, ATC, FNATA, Chair, Department of Athletic Training, Professor of Athletic Training, Research Professor in the School of Osteopathic Medicine; John P. Wood, DO, Endowed Chair for Sports Medicine, A.T. Still University (Mesa, Arizona)

Dieringer highlighted NATA recommendations to reduce risk of injury from youth sport specialization:

· Delay specializing in a single sport for as long as possible: Participate in or sample a variety of sports.

· One team at a time: Participate in one organized sport per season.

· Less than eight months per year: Play a single sport for no more than eight months per year.

· No more hours/week than age in years: Participate in organized sport and/or activity hours per week equal to the same number of your age.

· Two days of rest per week: Ensure a minimum of two days off per week from organized training and competition.

· Rest and recovery time from organized sport participation: Spend time away from organized sport and/or activity at the end of each competitive season.

Highlights of the panel discussion included, among other topics:

· The affect the pandemic has had on youth sport specialization

· New trends or types of injuries and those that remain most common

· Sports with the highest rates of injury from specialization

· Burnout from specialization and the mental and physical consequences

· How specialization injuries at the high school level potentially affect sports performance should athletes participate in college sports

“People have reverted to old practices and are trying to make up for lost time. Our athletes are playing a lot more tournaments due to what they’ve missed.” With regard to new injuries, “I think they are not just from the pandemic, but when we track our injuries we’re seeing them four years younger than we should be seeing them.” -Neeru Jayanthi, MD

“Burnout doesn’t happen just with isolated sports stress, it’s all the other stressors in life that come into play. Its family stress, its academic stress, its social stress. As much as you can, assure within the athletic realm, enough variety and recovery, both physical and mental…If you can eliminate other stressors the capacity to be resilient in sports goes up.” -Michele LaBotz, MD, FAAP

As athletic trainers, we know that regardless of injury type, having a prior injury is a number one risk factor for sustaining that injury again. When we look at overuse data of early sports specializers…they are coming into college with a number of injuries on their medical record that can certainly affect other injuries and subsequent recovery while they are pursuing collegiate athletics. -Tamara Valovich McLeod, PhD, ATC, FNATA

The panelists did agree on the importance of rest and recovery, sleep, good nutrition and finding the fun in sport for its physical and mental benefits. They collectively encouraged young athletes to explore different activities and to move in different ways. They also commented on the importance of family support and listening to not only what a child says but what their bodies may say from overuse symptoms.

Dieringer concluded the event by encouraging all participants to “share our recommendations forward. If you are a parent, coach, athletic director or administrator, ensure these guidelines are put into practice. Through our collaborative efforts we can champion young athletes, encourage their love of sport and the game, and help reduce incidence of injury from specialization so they can excel with all best practices in place.” For more information on reducing risk from sport specialization visit

Resources · Youth Sport Specialization Safety Recommendations endorsed by AT Pro Societies · Overuse Injuries · Avoiding Baseball Related Injuries · Shin Splints and Stress Fractures · Understanding Athlete Burnout and Mental Health · Video: Youth Sport Specialization Safety Recommendations · Journal of Athletic Training Special Issue on Youth Sport Specialization

About NATA: National Athletic Trainers’ Association – Health Care for Life & Sport Athletic trainers are health care professionals who specialize in the prevention, diagnosis, treatment and rehabilitation of injuries and sport-related illnesses. They prevent and treat chronic musculoskeletal injuries from sports, physical and occupational activity, and provide immediate care for acute injuries. Athletic trainers offer a continuum of care that is unparalleled in health care. The National Athletic Trainers' Association represents and supports 40,000 members of the athletic training profession. Visit for more information.

About At Your Own Risk:

The mission of At Your Own Risk is to educate, provide resources and equip the public to act and advocate for safety in work, life and sport. Developed by NATA in 2016, the At Your Own Risk campaign is a way of showing employers, workers, legislators, school administrators, parents, and student athletes the value of athletic trainers within the health care team. By employing an athletic trainer, you provide a safer approach to work, life, and sport.

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