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.
Rate of MHSAA High Schools Charging Participation Fees Falls to Lowest in 22 Years
By
Geoff Kimmerly
MHSAA.com senior editor
August 5, 2026
The annual Michigan High School Athletic Association participation fee survey completed for the 2025-26 school year continued to confirm the positive direction that has emerged this decade as the rate of member high schools charging student-athletes to play sports fell to its lowest in more than two decades.
Of the 703 MHSAA member schools (93 percent of membership) which responded to the most recent survey, only 38 percent (270 schools) charged participation fees in 2025-26 – a drop of two percent from the year prior and the lowest percentage since 34.5 percent of member schools reported charging a fee for the 2004-05 school year. Over the two decades between, the rate of high schools charging participation fees reached a high of 57 percent in 2013-14. Rates consistently have measured in the low 40s after the COVID-19 pandemic.
The MHSAA began conducting the participation fee survey with the 2003-04 school year. For the purposes of the survey, a participation fee is anything $20 or more regardless of what the school called the charge – registration fee, athletic fee, etc.
All four school-size classifications also saw rate decreases, with Class A schools leading the way with 46 percent charging fees – which was still a reduction of seven percent from 2024-25. Class B was down slightly to 39 percent charging for participation, while Class C schools were down six points to 28 percent charging and Class D schools were down four points also to 28 percent.
A standardized fee for each team on which a student-athlete participates – regardless of the number of teams – has remained the norm over the history of the MHSAA’s survey, and for the second-straight year 43 percent of schools charging a fee did so in this way during 2025-26. That was followed by 33 percent of responding schools charging a one-time standardized fee and 13 percent assessing fees based on tiers of the number of sports a student-athlete plays (for example, charging a larger fee for the first team and less for additional sports).
For 2025-26, the median maximum amount a school charged per student-athlete for the school year was $150, and the median annual maximum charged per family was $350. For schools charging student-athletes a one-time fee to cover all sports played, the median was $125. For schools charging a fee per sport, the median was $80 for each team.
The survey for 2025-26 and surveys from previous years can be found on the Pay-To-Play Survey page (direct link to this year’s results).
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.