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.

Lacrosse Finals Move to U-M Among Headlines as Spring Sports Ramp Up

By Geoff Kimmerly
MHSAA.com senior editor

April 9, 2024

The Girls & Boys Lacrosse Finals will be played at University of Michigan Lacrosse Stadium for the first time, one of the most notable changes for this season as sports ramp up for more than 100,000 athletes anticipated to participate this spring for Michigan High School Athletic Association member schools.

The MHSAA sponsors postseason competition each spring in baseball, girls and boys lacrosse, girls soccer, softball, girls and boys track & field, boys golf (Lower and Upper Peninsula) and girls golf (UP), and girls (LP) and boys (UP) tennis.

The U-M Lacrosse Stadium opened for competition in 2018 and seats 2,000 spectators. The Girls Lacrosse Finals will be played Friday, June 7, with Division 1 at 4 p.m. and Division 2 at 7 p.m. The Boys Lacrosse Finals will be played the following day, June 8, with Division 2 at 11 a.m. and Division 1 at 2 p.m.

Girls lacrosse also has a significant format adjustment this season, as games will be played with four 12-minutes quarters instead of the previous two halves, in part to allow coaches more opportunities to provide direct instruction during a game. Two more rules changes are expected to improve flow of play – players awarded a free position outside of the critical scoring area no longer must come to a stop and settled stance before self-starting, and false start penalties outside the critical scoring area have been eliminated.

Several more rules changes will be noticeable this spring:

In boys lacrosse, a change was made to enhance player safety. Play will stop immediately any time a player’s helmet comes off, and that player may not return until the next dead ball after play continues.

Fair and legal starts are a continued emphasis for track & field, and a rule change will allow for movement before the start of the race as long as a competitor does not leave their mark with a hand or a foot after the “set” command, or make forward motion before the starting device is activated.

A significant rule change in softball alters pitch delivery mechanics. The pitcher may now have both feet off the ground at the same time when releasing the ball as long as both feet remain within the 24-inch width of a pitching plate and the pitcher does not replant the pivot foot before delivering the pitch.

Another change in softball requires that a playbook/playcard be worn on the wrist or kept in a back pocket to reduce distractions. If worn by the pitcher, the equipment must be worn on the non-pitching arm. Similarly in baseball, a wristband with plays or instructions will be permitted but must be a single, solid color, and for pitchers may not contain the colors white or gray or be otherwise distracting. Baseball players must wear this wristband on the wrist or forearm, and pitchers may wear one only on their non-pitching arm.

Also in baseball, a rule change allows for one-way communication devices worn by the catcher to receive instructions from the dugout while on defense, for the purpose of calling pitches. The coach must be inside the dugout/bench area to use the communication device.

Golfers now are required to participate in at least four competitions for the high school team prior to representing that school team in an MHSAA Regional or Final. Those four regular-season competitions may be 9 or 18-hole events.

In tennis, for the first time in Lower Peninsula play, a No. 1 doubles flight from a non-qualifying team will be able to advance from its Regional to Finals competition. To do so, that No. 1 doubles flight must finish first or second at its Regional, and the No. 1 singles player from that team also must have qualified for the Finals individually by finishing first or second in Regional play.

On the soccer pitch, two officiating-related changes will be especially noticeable. Officials now may stop the clock to check on an injured player without that player being required to leave the match – previously that player would have to sub out. Also, categories for fouls have been redefined: careless (which is a foul but does not receive a card), reckless (a foul with a yellow card) and excessive force (foul with red card). 

The 2023-24 Spring campaign culminates with postseason tournaments, as the championship schedule begins with the Upper Peninsula Girls & Boys Golf and Boys Tennis Finals during the week of May 27 and wraps up with Girls Soccer, Baseball and Softball Finals on June 15. Here is a complete list of winter tournament dates:

Baseball
Districts – May 23-June 1
Regional Semifinals – June 5
Regional Finals, Quarterfinals – June 8
Semifinals – June 13-14
Finals – June 15

Golf
LP Boys Regionals – May 28-June 1
UP Girls & Boys Finals – May 29, 30, 31 or June 1
LP Boys Finals – June 7-8

Boys Lacrosse
Pre-Regionals – May 10-15
Regionals – May 16-29
Quarterfinals – May 31 or June 1
Semifinals – June 5
Finals – June 8

Girls Lacrosse
Pre-Regionals – May 16-18, or May 20
Regionals – May 22-June 1
Semifinals – June 5
Finals – June 7

Girls Soccer
Districts – May 22-June 1
Regionals – June 4-8
Semifinals – June 11-12
Finals – June 14-15

Softball
Districts – May 23-June 1
Regionals – June 8
Quarterfinals – June 11
Semifinals – June 13-14
Finals – June 15

Tennis
LP Girls Regionals – May 15-18
UP Boys Finals – May 29, 30, 31 or June 1
LP Girls Finals – May 31-June 1

Track & Field
Regionals – May 16-18
Finals – June 1