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Higher-Income Youth-Athletes Found More Likely to Suffer Overuse Injuries

Youth-athletes from higher-income families are 68 percent more likely to suffer serious overuse injuries compared to lower-income athletes, according to a new study presented last week at the American Medical Society for Sports Medicine's annual meeting in New Orleans.

The study examined 1,190 youth-athletes between the ages of 7-18 who were seen at primary-care and sports-medicine clinics at Loyola University Health System and the Ann & Robert H. Lurie Children's Hospital of Chicago. The researchers could determine the insurance status for all but 69 of the youth-athletes enrolled in the study (1,121 in total).

The researchers asked athletes to complete a survey about their volume of training and their degree of single-sport specification. If the athletes could pick a main sport, quit all other sports to focus on one sport, and spent more than eight months per year training and competing in a single sport, they were defined as having a high degree of sports specialization.

Thirty percent of privately insured athletes were highly specialized in one sport, while only 18 percent of publicly insured athletes could say the same. Likewise, 13 percent of privately insured athletes suffered serious overuse injuries, compared with only 8 percent of publicly insured athletes.

"Intense specialization in one sport can cost thousands of dollars a year in equipment, fees, transportation, private lessons, etc.," said Dr. Neeru Jayanthi, who presented the findings, in a statement. "Having the financial resources to afford such costs may provide increased opportunities for young athletes to participate in a single sport."

In other words: Wealthier families may be better positioned to have their children specialize in a single sport, which could be leading to a higher rate of injuries.

Last year, Jayanthi and his colleagues presented a study at the Society for Tennis Medicine and Science and United States Tennis Association-Tennis Medicine and Injury Conference suggesting that single-sport specialization and an increase in organized competition could lead to a higher rate of injuries for youth-athletes. The study suggested that more unorganized competition and "free play" (such as pick-up basketball games or touch football) could help protect against youth-athlete injuries.

This new study echoes those findings, as publicly insured athletes spent 7.1 hours per week in free play, compared to only 5.2 hours per week for privately insured athletes. Both publicly and privately insured athletes spent about 10 hours per week participating in organized sports.

Based on their findings, Jayanthi and his colleagues recommended increasing the amount of unstructured free play that youth-athletes engage in while limiting the time spent in organized sports. Youth-athletes should not spend more than twice as much time in organized sports as they do engaging in free play, they suggest. Additionally, youth-athletes should not spend more hours per week than their age participating in organized sports (i.e., a 12-year-old should spend no more than 12 hours per week in organized sports, etc.). They also recommend taking at least one day per week off from sports training, not participating in competitive sports year-round, and not specializing in a single sport until late adolescence.

Just last week, renowned sports surgeon James Andrews warned against youth pitchers participating in year-round baseball, blaming a never-ending competitive-sports schedule for the rise in Tommy John surgery. Earlier this year, Jayanthi and fellow members of the American Medical Society for Sports Medicine released a position statement on overuse injuries, which also suggested "early sport specialization may not lead to long-term success in sports and may increase risk for overuse injury and burnout." The statement recommended sport diversification for younger children, with the exception of "early-entry sports such as gymnastics, figure skating, and swimming/diving."

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