Study: Single-Sport Athletes Injured More
November 3, 2016
A study conducted by the University of Wisconsin School of Medicine and Public Health and funded by the National Federation of State High School Associations (NFHS) Foundation revealed that high school athletes who specialize in a single sport sustain lower-extremity injuries at significantly higher rates than athletes who do not specialize in one sport.
The study was conducted throughout the 2015-16 school year at 29 high schools in Wisconsin involving more than 1,500 student-athletes equally divided between male and female participants. The schools involved in the study represented a mixture of rural (14), suburban (12) and urban (3) areas, and enrollments were equally diverse with 10 small schools (less than 500 students), 10 medium schools (501-1,000 students) and nine large schools (more than 1,000 students).
Athletes who specialized in one sport were twice as likely to report previously sustaining a lower-extremity injury while participating in sports (46%) than athletes who did not specialize (24%). In addition, specialized athletes sustained 60 percent more new lower-extremity injuries during the study than athletes who did not specialize. Lower-extremity injuries were defined as any acute, gradual, recurrent or repetitive-use injury to the lower musculoskeletal system.
“While we have long believed that sport specialization by high school athletes leads to an increased risk of overuse injury, this study confirms those beliefs about the potential risks of sport specialization,” said Bob Gardner, NFHS executive director. “Coaches, parents and student-athletes need to be aware of the injury risks involved with an overemphasis in a single sport.”
Among those who reported previously sustaining a lower-extremity injury, the areas of the body injured most often were the ankle (43%) and knee (23%). The most common types of previous injuries were ligament sprains (51%) and muscle/tendon strains (20%).
New injuries during the year-long study occurred most often to the ankle (34%), knee (25%) and upper leg (13%), with the most common injuries being ligament sprains (41%), muscle/tendon strains (25%) and tendonitis (20%).
In addition, specialized athletes were twice as likely to sustain a gradual onset/repetitive-use injury than athletes who did not specialize, and those who specialized were more likely to sustain an injury even when controlling for gender, grade, previous injury status and sport.
Thirty-four (34) percent of the student-athletes involved in the Wisconsin study specialized in one sport, with females (41%) more likely to specialize than males (28%). Soccer had the highest level of specialization for both males (45%) and females (49%). After soccer, the rate of specialization for females was highest for softball (45%), volleyball (43%) and basketball (37%). The top specialization sports for males after soccer were basketball (37%), tennis (33%) and wrestling (29%).
The study, which was directed by Timothy McGuine, Ph.D., ATC, of the University of Wisconsin, also documented the effects of concurrent sport participation (participating in an interscholastic sport while simultaneously participating in an out-of-school club sport), which indicated further risk of athletes sustaining lower-extremity injuries.
Almost 50 percent of the student-athletes involved in the survey indicated they participated on a club team outside the school setting, and 15 percent of those individuals did so while simultaneously competing in a different sport within the school. Seventeen (17) percent of the student-athletes indicated that they took part in 60 or more primary sport competitions (school and club) in a single year. Among those student-athletes in this group who sustained new lower-extremity injuries during the year, 27 percent were athletes who specialized in one sport.
The student-athletes involved in the study were deemed “specialized” if they answered “yes” to at least four of the following six questions: 1) Do you train more than 75 percent of the time in your primary sport?; 2) Do you train to improve skill and miss time with friends as a result?; 3) Have you quit another sport to focus on one sport?; 4) Do you consider your primary sport more important than your other sports?; 5) Do you regularly travel out of state for your primary sport?; 6) Do you train more than eight months a year in your primary sport?
Although some sports (field hockey, lacrosse) are not offered in Wisconsin and were not included in the study, the study concluded that since specialization increased the risk of lower-extremity injuries in sports involved in the survey it would also likely increase the risk of injuries in sports that were not a part of the study.
Rep Council Adjusts, Expands Out-of-State Competition Opportunities at Spring Meeting
By Geoff Kimmerly
MHSAA.com senior editor
May 12, 2023
Substantial changes to the rules governing out-of-state competition by Michigan High School Athletic Association member schools were among the most notable actions taken by the MHSAA’s Representative Council during its annual Spring Meeting, May 6-7 in Gaylord.
The Spring Meeting of the 19-member legislative body of the Association’s more than 1,500 member schools is generally the busiest of its sessions each year. The Council considered 31 committee proposals and dealt with a variety of eligibility rule, postseason tournament and operational issues.
The most far-reaching changes approved by the Council shifts the MHSAA rules regarding competitions against out-of-state opponents. Moving forward, MHSAA member schools may continue to compete against teams from Illinois, Indiana, Ohio, Minnesota, Wisconsin and Ontario – but also may compete against teams from elsewhere in the United States as long as those competitions take place in Michigan, one of those five contiguous states or Ontario. The Council voted to remove the allowance for MHSAA member schools to travel up to 300 miles to play an out-of-state opponent; MHSAA member schools still can compete against those opponents, but competition must take place in Michigan or one of the states/province listed above. Any event including schools from outside of Michigan or those contiguous states/province must receive approval by the MHSAA and each state high school association with a team involved in order for MHSAA member schools to be allowed to participate.
In an effort to strengthen the undue influence regulation, the Council approved a change making it a violation for coaches or their representatives to connect via social media with students from another high school or with a student prior to ninth grade who has not yet enrolled in a high school or participated in an athletic practice or competition as a high school student. Violations of this rule include connecting via social media with a “follow,” “friend request” or “direct message” to a student. The Council also expanded the portion of the undue influence regulation that doesn’t allow coaches and representatives to visit prospective athletes and their families at the families’ homes to not allow them to visit athletes and families at “other locations” as well.
The Council approved an expansion in the use of video to determine penalties when there is a bench-clearing situation or other incident where team members enter the area of competition during an altercation. MHSAA staff, based on video evidence, will be allowed to assess additional penalties including ejections and suspensions to team members, coaches and other staff who enter those areas to participate or engage in such an altercation.
Concerning specific sports, changes to three stand out from several adopted by the Council.
The Council approved three Bowling Committee recommendations affecting postseason competition in that sport. The first reorganizes Regional competition to eight sites, with each qualifying the top two teams and top seven singles for both girls and boys competitions to the Finals (instead of the previous six sites qualifying three teams and 10 singles for both girls and boys). The Council also approved a proposal to change the Team Finals match play to a head-to-head, best-of-five Baker game format. Finally, the Council approved a proposal to adopt the Phantom II oil pattern for all MHSAA Tournament competitions.
In girls volleyball, the Council approved a Volleyball Committee recommendation to begin seeding the top two teams in each District beginning with the 2024-25 school year. As is done currently with girls and boys basketball and girls and boys soccer, the top-two seeded teams in each District will be placed on opposite sides of the bracket, guaranteeing they will not play each other before the District Final. Seeding will be determined using the Michigan Power Rating (MPR) formula which takes into account regular-season success and strength of schedule. MPR is used to seed Districts in the same way in basketball and soccer.
In wrestling, the Council approved a Wrestling Committee recommendation adding two regular-season dual meets to the allowed number of wrestling contest dates. These must be dual meets and may not be converted into three-team (tri) or four-team (quad) meets. Teams and individuals now will be allowed 16 days of competition with no more than eight of those days allowed for tournament-type events where a wrestler competes more than twice.
Here is a summary of other notable actions taken by the Representative Council at the Spring Meeting, which will take effect during the 2023-24 school year unless noted:
• The Council approved a classification-related change for the MHSAA’s smallest member schools, allowing them to request participation of eighth and seventh-grade students, based on the high school’s enrollment. Schools with fewer than 125 students (instead of the previous 100) may request an MHSAA Executive Committee waiver to use eighth-grade students in all sports except football, ice hockey and wrestling. Schools with fewer than 75 students (instead of the previous 50) may make the same request to use seventh and eighth-grade students in all sports except those three. Schools requesting a waiver must show cause and rationale for those students’ participation.
• The Council approved a Sports Medicine Advisory Committee proposal requiring middle school head coaches to have valid, current CPR certification. Similar to the high school requirements for head coaches at all levels, this addition at the middle school level will ensure each team has at least one coach at each level present who is CPR-certified. This requirement will take effect with the 2024-25 school year, and schools will attest to its completion by the established deadline for each season.
• The Council approved an Officials Review Committee recommendation adjusting the minimum requirements for postseason consideration in wrestling, competitive cheer and soccer. In wrestling, officials must receive 75 coaches ratings (instead of the previous 100) to be considered for working a postseason meet. In girls competitive cheer, judges must be members in good standing of a Local Approved Association. In soccer, officials must work a minimum of five regular-season games (down from the previous 10) to be considered for the postseason.
• The Council also approved a Committee recommendation increasing the amount paid when an official arrives on site prior to a competition before receiving notice that competition has been canceled due to an “act of God” including weather that results in unplayable conditions. In these situations, officials will receive one-half of the contract fee (instead of the previous one-third).
• For baseball, the Council approved a change to when trophies will be awarded to Regional champions. Those trophies will be presented to both Regional champions after the Quarterfinal is concluded, as Regional Finals and the ensuing Quarterfinal are played at the same site on the same day and both Quarterfinal participants will have earned a Regional championship earlier that day.
• In addition to the Regional and Finals changes for bowling explained above, the Council also approved a Bowling Committee proposal seeking common start dates for practice and competition for Lower and Upper Peninsula teams. For the 2023-24 season, bowling teams in both peninsulas will begin practice Nov. 9 and competition Nov. 25. Previously, Upper Peninsula teams were allowed to begin their seasons slightly earlier – this past season four days sooner for practice and a week earlier for competition than their Lower Peninsula counterparts.
• The Council also approved a start date change in girls competitive cheer, proposed by the Competitive Cheer Committee, moving the practice start date to the second Monday before Thanksgiving. This shortens the season by one week, but also allows a more comfortable gap between the fall sideline cheer and winter competitive cheer seasons. This change will take effect with the 2024-25 school year.
• Also in cheer, the Council approved a Committee recommendation that adjusts the restricted period at the end of competitive cheer season to the Monday following Memorial Day, which will allow athletes to try out for sideline cheerleading for the upcoming season after the completion of the majority of spring-sport competitions.
• Additionally, the Council approved an exception to the MHSAA’s all-star regulation that will allow for individual competitive cheer and sideline cheer athletes to participate in an event that is “all-star” in name only as long as the selection components of the event comply with MHSAA regulations.
• In cross country and track & field, the Council approved Cross Country/Track & Field Committee recommendations to eliminate a pair of uniform-related rules adaptations designating the types of head attire that previously could be worn during cross country races and body adornments that previously were allowed to be worn during competitions in both sports.
• In golf, the Council approved a Golf Committee recommendation to require athletes to participate in at least four competitions for the high school team prior to representing that athlete’s school team in an MHSAA postseason golf competition. Those four regular-season competitions may be 9 or 18-hold events.
• A Council action in gymnastics will better define how athletes are assigned a division for the individual portion of the MHSAA Finals. Athletes are assigned either Division 1 or Division 2 based on past experience and skill level – Division 1 for those with the most – and the Council approved the allowance of the Xcel levels of Sapphire and Diamond to be part of the determining criteria. Athletes who have previously competed in a non-school event at either of these levels would be required to compete in the Division 1 level for MHSAA postseason competition.
• In tennis, the Council approved a Tennis Committee recommendation allowing in the Lower Peninsula for a No. 1 doubles pair from a non-qualifying team to advance from Regional to Finals competition if that pair finishes first or second at the Regional and the No. 1 singles player from that team also has qualified for the Finals individually by finishing first or second in Regional play. (Upper Peninsula tennis does not play a Regional.)
• The Council approved a Swimming & Diving Committee recommendation restructuring how qualifying times for Finals are determined in an effort to provide more entries in swimming events at the championship level. Moving forward, qualifying times will be determined based on the past five years of MHSAA race data, but also will account for past numbers of qualifiers in each swim race; qualifying times will be shifted to allow for more athletes to advance to the Finals in events where fields have not been full over the previous five seasons.
• The second swimming & diving recommendation approved by the Council assigned specific breaks during Finals competitions. During Friday preliminaries (swam in the Lower Peninsula only), 10-minute breaks will be placed between the 200-yard medley relay and 200 freestyle races, and between the 200 freestyle relay and 100 backstroke, with a 15-minute break between the 50 freestyle and 100 butterfly. The same 10-minute breaks will be mandated for Saturday Finals competitions, with a 15-minute break during Finals coming between the conclusion of diving and 100 butterfly races.
• For girls volleyball, the Council also approved a Volleyball Committee recommendation to permit the Michigan Interscholastic Volleyball Coaches Association (MIVCA) a 3-minute on-court presentation during the MHSAA Finals to recognize that season’s Miss Volleyball Award winner. The presentation will take place between the second and third sets of the Division 1 championship match.
Junior High/Middle School
• The Council voted to make permanent cross country and track & field competitions that have been conducted at a Regional level as part of a pilot program during the 2021-22 and 2022-23 school years. The Council also voted to expand the number of sites per Junior High/Middle School Regional to allow for large-school (Divisions 1 and 2) and small-school (Divisions 3 and 4) meets for each of the eight Zones. Each participating junior high and middle school will be classified for its Regional meet based on the enrollment of the high school with which the junior high/middle school is connected.
The Council also reviewed reports on membership, with 750 senior high schools and 767 junior high/middle schools in 2022-22 plus 63 elementary schools with 6th-grader participation; cooperative programs, with 376 high school programs for 692 teams during 2023-23; eligibility advancement applications, which totaled three; the use of Educational Transfer Forms, of which there were 127; school violations, attendance at athletic director in-service workshops and Coaches Advancement Program sessions; officials’ registrations, rules meetings attendance and officials reports submitted for the past three sports seasons. The Association’s $13.3 million budget for the 2023-24 school year also was approved.
The Representative Council is the 19-member legislative body of the MHSAA. All but five are elected by member schools. Four members are appointed by the Council to facilitate representation of females and minorities, and the 19th position is occupied by the Superintendent of Public Instruction or designee.
The MHSAA is a private, not-for-profit corporation of voluntary membership by more than 1,500 public and private senior high schools and junior high/middle schools which exists to develop common rules for athletic eligibility and competition. No government funds or tax dollars support the MHSAA, which was the first such association nationally to not accept membership dues or tournament entry fees from schools. Member schools which enforce these rules are permitted to participate in MHSAA tournaments, which attract more than 1.3 million spectators each year.