Early Specialization in Sport

Dr. Sprouse joined Brandon Bates on WBIR's Mornings with Fox 43 to discuss how kids (and their parents and coaches) should approach specializing in a single sport.  Click on the image above to watch their chat.  Below, Dr. Sprouse has written an article on the topic.

Dr. Sprouse joined Brandon Bates on WBIR's Mornings with Fox 43 to discuss how kids (and their parents and coaches) should approach specializing in a single sport.  Click on the image above to watch their chat.  Below, Dr. Sprouse has written an article on the topic.


Early Specialization

As a parent of young children, I have been very aware of the pressures for them to specialize in sports early.  With over 60 million children participating in organized sports each year in the US, there are more parents and coaches working to help athletes stand out.  Even at the ages of 6 and 7, we see kids who are participating in year-round traveling programs for baseball, soccer, swimming, and other sports.  This idea of “Early Specialization” has seen a lot of media attention in the past few years, and the sports medicine community is devoting much research to this topic…rightfully so.  Most parents are well-intentioned when allowing (or perhaps “nudging”) their kids to pick a single sport at an early age, but is there evidence to show this is beneficial?  More importantly, is there evidence that shows it is harmful?

Numerous medical specialty groups have now published position statements on this topic.  From 2016 to 2018, the American Medical Society for Sports Medicine, the American Academy of Pediatrics, and the American Orthopedic Society for Sports Medicine all issued fairly similar recommendations based on the current literature.

Before delving into the evidence and recommendations, let’s first lay out some definitions.

Specialization - This process is defined as participation and intensive training / competition in organized sport for 8 or more months out of the year.  This participation is in a single sport, to the exclusion of other sports and general “free play”.

Early Specialization - This specialization process is considered to be “early” when the child engaging in specialization is pre-pubertal.  In the US, we now see this routinely in kids 6-12 years old.

Late Specialization - Late specialization is a process in which athletes may begin playing sports early in life, but they do not begin to specialize until the onset of puberty (generally 14-16 years old).

Many parents and coaches argue that Early Specialization leads to better athlete development and skill acquisition, which results in greater sporting success.  Some point to the “10,000 Hour Rule”, as proposed by Ericsson.  However, it has been shown that this rule does not apply to athletic endeavors, and there is some question as to the validity of the “rule” for other pursuits as well.  In fact, research repeatedly shows that there is not a clear link between Early Specialization and athletic success in most sports.  For a few specific sports though, Early Specialization can be useful.  Gymnastics, swimming, diving, and figure skating are often used as examples of sports in which Early Specialization does seem to be helpful.

Those sports seem to be the exception to the rule though.  For the vast majority of sports, those athletes who specialize later in childhood tend to be more successful.  This association likely occurs for multiple reasons.

Injury - Early Specialization is associated with a significantly higher incidence of injury in children.  These injuries can lead to missed practices and games, and it also can lead to a child abandoning sports and an active lifestyle in general.

Burnout - Children who specialize in a specific sport early in life have a higher rate of burnout.  Despite perceived promise of success, they lose the desire to train and compete.  Obviously, this is not conducive to long-term success nor is it a way to promote lifelong healthy activity.

Psychological - Early Specialization has been associated with higher levels of anxiety and depression.

Social Isolation - A few studies have show that Early Specialization limits a child’s opportunities for social interaction with multiple groups, arguing that this is detrimental to their social development.

Lifelong Fitness - Children who specialize early in a specific sport are less likely to be active adults.  This is part of the “burnout” that has been repeatedly demonstrated in studies, but it is an important point.  Most athletes, even if they specialize early, will not receive a college scholarship nor will they play professional sports.  As parents, our goal for our children is that they have a healthy and happy life…not just a successful high school sporting career.  It is becoming evident that Early Specialization does not promote this goal.

This academic stuff is all well and good, but what are the successful athletes doing?  And what do coaches look for?  It’s one thing to see what a bunch of doctors think is best, but perhaps what plays out in “real life” is quite different.

  • Of the 253 players drafted in the NFL in 2017, nearly 90% played multiple sports in high school.
  • A German study showed that most elite athletes specialized in their primary sport later in life.
  • NCAA Division 1 athletes are more likely to have played multiple sports in high school.
  • There were 322 athletes invited to the 2015 NFL Combine.  A mere 13% of them played only football in high school.
  • Pete Carroll, collegiate and NFL coach, has been quoted as saying, “The first questions I’ll ask about a kid are, ‘What other sports does he play? What does he do? What are his positions? Is he a big hitter in baseball? Is he a pitcher? Does he play hoops?’ All of those things are important to me. I hate that kids don’t play three sports in high school.”
  • Basketball players who delay specialization until after the age of 12 score higher on tests of athleticism and have been shown to progress their basketball skill faster than those who specialize early.
  • Many professional athletes have been vocal in their support of late specialization, and many point to their own childhoods playing many sports.

Despite evidence demonstrating the benefits of Late Specialization and the detriment of Early Specialization, there are still numerous “Sports Enhancement” Programs for young kids.  These programs teach sport technique and work on specific conditioning, but none of these have been shown to lead to a greater chance of long-term success, despite the time and money invested.

When reviewing the current evidence and the recommendation of medical societies and top coaches, a program of Late Specialization is the way to proceed.  There are a few such programs described, and they all tend to follow similar trajectories.

6 - 10 years old: Have fun!  Learn to love sports while developing a wide array of movement skills and overall athleticism.

10 - 14 years old: Start to learn basic skills of a specific sports.  Some paradigms refer to this as “Training to Train”.  This is not overly specialized.  The goal is to start to learn what skilled practice looks like.

14 - 18 years old: Introduce an emphasis on competition.  Learn the strategy of the sport, and institute training that focuses on competitive success.

18+ years old: Tailor the athletes skills to a level of high performance, if appropriate.  For those unlikely to continue at a highly competitive level, transition to a lifetime of activity.

Such a progression has been shown to maximize an athlete’s chances for success, limit their exposure to injury, and increase the likelihood of an adult life full of activity and health.  As parents and coaches (and doctors!), that should be our ultimate goal.  Every person will get something different out of sports.  We should set them up for success, whatever that looks like.

How Does Our Elite Concierge Package Work?

Our Concierge packages offer you the best guidance to pursue your optimal health and performance.  Many people wonder how they work, so we laid out this information to show you how a year of services could be laid out.

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Of course, it's your package of services, and you can use it however you like!  But the above arrangement allows you to make the most of all you have to take advantage of.  If you are interested in our Concierge offerings, make an appointment for a FREE consultation to discuss the options.  Enrollment is limited, so call today!

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WBIR / Fox43 Mornings: How to Simplify Your Fitness Goals

This morning, in honor of the New Year, Dr. Sprouse joined Abby Ham to talk about simplifying your fitness goals in 2018.  It's not about strict diets or specialized workout plans.  Lifestyle change is needed, and focusing on the "high yield" changes makes the most sense.  Watch their discussion to learn how to be successful in achieving your New Year's goals.

Individualized Nutrition Advice for your Health and Performance

Have you ever wondered what type of diet would work best for you, your goals, and your physiology?  One size does not fit all, though there are many basics which must be applied.  At Podium Sports Medicine, we are able to use a number of tools to help you determine what will work best for you.

  • Blood tests - looking at measure of blood sugar, insulin, cholesterol (with particle size measurement), and nutrient levels, we can see how your current diet is impacting your physiology, for better or worse.
  • Continuous Glucose Monitor - for many patients, we can apply a 24/7 blood sugar monitor that will tell you how your body responds to certain meals, exercise regimens, or a night of poor sleep.  Using this information, we can help you better tailor and time your meal intake.
  • Food Logs - it's simple, but keeping track of 3-4 days of intake can be eye-opening, especially when coupled with software that allows you to get a bigger picture of what you are truly eating and how it is supporting your activity levels.
  • Physiologic Testing - For some patients, it makes sense to look at how many grams of carbohydrate and fat they burn at given intensities.  This is called "substrate utilization".  INSCYD testing allows us to gather this information and help you determine how to fuel for different efforts and goals (performance, weight loss, "fat adaptation", etc.).

While it's nice to have all these tools, it's unlikely that many people need to make use of all of them.  Often, with just one or two of these, we can help you make significant progress toward individualizing your diet and improving your results!