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.
Representative Council Approves Expansion of Personal Branding Activities for Student-Athletes
By
Geoff Kimmerly
MHSAA.com senior editor
January 27, 2026
The Representative Council of the Michigan High School Athletic Association has approved an expansion of personal branding activities (PBA) – also commonly referred to as Name-Image-Likeness (NIL) – allowing student-athletes at MHSAA member schools, effective immediately, to potentially benefit from such opportunities.
The MHSAA previously allowed some PBA opportunities, including the abilities for student-athletes to conducts camps, clinics and private lessons. The expanded policy allows student-athletes to capitalize on PBA through several more options as long as those activities are individual opportunities for individual students – while not disrupting competitive equity that would result from the creations of group activities including collectives and other pay-for-play opportunities now the norm at the collegiate level.
The topic of PBA/NIL had been discussed at length with membership over the last three years during MHSAA Update meetings and various other conferences with schools and their administrators. The Council had debated the possibility of these rule changes since the Michigan Legislature proposed amending state law to allow for student-athletes’ use of NIL in 2023, and also after closely monitoring similar developments in surrounding states.
“We have said from the start of this conversation that the MHSAA could be comfortable with a policy that provides individual branding opportunities for individual student-athletes, and this rule change provides those while excluding the possibility of collectives, and boosters and school people getting involved in those activities,” MHSAA Executive Director Mark Uyl said. “This is the essence of what NIL was supposed to allow in the first place, and we’re confident we’ve crafted language that allows true NIL opportunities without affecting competitive equity among our member schools.”
Additional activities allowed by the new PBA policy include social media endorsements and promotions, personal appearances, photo sessions or autograph signings; modeling, advertising, merchandise, sports cards or apparel sales; and the use of a student’s name, image or likeness in marketing materials.
PBA activities must be consistent with MHSAA rules and school policies. A student-athlete may not capitalize on PBA based on athletic performances, awards/recognition, team participation or competition outcomes. A student-athlete also may not involve school names, logos, mascots, trademarks or other obvious identifiers, uniforms or other intellectual property, and PBA activity may not occur during school attendance or any MHSAA event (including practice) and cannot take place on school property or be promoted on school media channels.
Schools, including coaches and other employees, are not allowed to solicit, arrange, negotiate or promote PBA activities on behalf of their student-athletes. Doing so may put that school’s MHSAA membership in jeopardy, in addition to rendering that student-athlete ineligible for MHSAA athletics.
“The MHSAA will guard the competitive equity we have promoted for more than 100 years, and take with the utmost seriousness any attempts to break or blur this rule,” Uyl said. “We have provided clear language and sufficient guidance on what is allowed to assist our schools as they navigate this ever-changing landscape.”
PBA associated with products, services, individuals, companies or industries deemed inappropriate, unsafe or inconsistent with the values and goals of interscholastic athletics, as determined by the MHSAA – for example gaming or gambling, alcoholic beverages and banned substances – are also prohibited.
All PBA activities must be disclosed to the MHSAA within seven days of an opportunity or contract for disclosure and approval. Schools may choose to have stricter rules regarding PBA if they choose to do so.
For more details on what is and what is not allowed, and frequently asked questions about PBA in regards to MHSAA regulations, visit the MHSAA Name, Image, Likeness page.
The Representative Council is the legislative body of the MHSAA. All but five members 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 1.4 million spectators each year.