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Young female soccer team

Overuse injuries due to Sport Specialization and the Overextended Athlete

By: Deborah Fischi, ATC

Sports specialization of children at a young age is on the rise. The trend is for kids to specialize in playing just one specific sport and often doing so starting at a very young age. These children often play a sport all year with very little, if any, downtime between seasons. Parents and athletes tend to believe that if they specialize in just one sport, it will give them an advantage over others in the hopes of progressing to the elite level within their sport, receiving scholarships, or making it to the professional level. Unfortunately, this is not the case. Studies have shown that specializing in a specific sport at a young age does not increase the likelihood of competing at an elite level, but more often leads to overuse injuries instead.

Young athlete’s bodies are still developing and their bones are not completely formed yet. This causes muscles and tendons to put increased stress on open growth plates, which can lead to overuse injuries. When the athlete is using the same muscles over and over again, without any rest time in between, the muscles do not have a chance to recover. Over time, as the muscles and tendons themselves get weaker, injuries occur due to the athlete changing their biomechanics to compensate. These overuse injuries can have long-term implications.

One rule of thumb is that no child should spend more hours in a week participating in their sport than their age. For example, a 10-year-old should not participate more then 10 hours per week. This is especially true for younger athletes. In addition, athletes should have at least one or two days off from their sport each week and two to three months off throughout the year. This time off can be spread throughout the year in one-month increments, and the athlete should remain physically active during that time.

There has been progress to help limit overuse injuries in youth sports. Some organizations have implemented rules limiting the number of practice hours and repetitive movements like pitch counts in baseball. But, it is also very important for the parents to listen to their kids if they tell them something hurts. Many times this is ignored, and by the time a parent realizes there may be something wrong, damage has occurred. Communication is definitely a key component in reducing overuse injuries.

With so many kids solely focusing on one sport, an athlete who wants to participate in other sports may feel they will fall behind when it comes to their primary sport. Because of this, there is an increasing percentage of kids playing two sports at the same time. This can also put them at high risk of overuse injuries. Taking time to play a sport different from an athlete’s primary sport is beneficial as it recruits the use of new muscles while giving others a much-needed rest, but this only works if they stop playing their primary sport during this time. Parents should limit their children to playing only one sport at a time.

Ultimately, it is the health and well-being of young athletes that we need to focus on. Advising parents to help ensure their kids slow down a bit is important. Sports participation is a positive thing for all children, so preventing injuries that may force them to withdraw from sports altogether is of utmost importance.


  1. Brenner JS; American Academy of Pediatrics, Council on Sports Medicine and Fitness. Sports Specialization and Intensive Training in Young Athletes. Pediatrics published online: August 29, 2016 (doi:10.1542/peds.2016-2148).
  2. Brenner JS; American Academy of Pediatrics, Council on Sports Medicine and Fitness. Overuse injuries, overtraining, and burnout in child and adolescent athletes. Pediatrics. 2007;119(6):1242–1245. Reaffirmed June 2014
  3. DiFiori JP, Benjamin HJ, Brenner JS, et al. Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine. Br J Sports Med. 2014;48(4):287–288
  4. LaPrade R, Agel J, Baker J, Brenner J, et al. Early Sport Specialization Consensus Statement from American Orthopaedic Society for Sports Medicine, Orthopaedic Journal of Sports Medicine. April 2016; 4 (4). Published April 28, 2016, doi:10.1177/2325967116644241.

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About CHKD Sports Medicine  CHKD's sports medicine program offers the most comprehensive care for your young athlete. From diagnosis and treatment to customized rehabilitation plans, we specialize in physical therapy and injury prevention programs for active children and teens. Our team is composed of pediatric orthopedic surgeons, sports medicine specialists, physician assistants, certified athletic trainers and pediatric sports medicine physical therapists.