Specialization in one sport increases the risk of injury, find researchers

Gifted young athletes are under increasing pressure to play only one sport year round.

But a new Loyola University Health System study of 519 junior tennis players has found that such specialization increases the risk of injury. Researchers who analyzed 3,366 matches in United States Tennis Association junior competition found that players who specialized in only tennis were more likely to withdraw from tournaments for medical reasons, typically injuries.

Also, players who had experienced an injury or tennis-related illness during the past year were 5.4 times more likely to withdraw from a tournament for medical reasons.

"Parents, coaches and players should exercise caution if there is a history of prior injury," said Dr. Neeru Jayanthi, lead author of the study. "And parents should consider enrolling their children in multiple sports."

Jayanthi reported results at the international Society for Tennis Medicine and Science World Congress in Valencia, Spain.

Jayanthi is medical director of primary care sports medicine and an assistant professor in the departments of Family Medicine and Orthopaedic Surgery and Rehabilitation at Loyola University Chicago Stritch School of Medicine.

Players in the study began playing tennis at an average age of 6, began competing at age 9 and began to specialize at age 10. Players practiced a median of 16 to 20 hours per week, and 93 percent said they competed at least ten months per year.

The study is the latest in a series of studies Jayanthi and colleagues have conducted on injuries in young tennis players. Earlier studies found that:

• Junior players are more likely to withdraw for medical reasons if they play five or more matches in a single tournament. Counting singles matches, doubles matches, consolation matches, etc. a player can compete in as many as 10 matches in a tournament. "The heavy match volume takes its toll as the tournament progresses, and a relatively high number of these young tennis players not only sustain injury but are unable to compete any further," Jayanthi said.

• Boys are more likely to withdraw for medical reasons than girls, and older teenagers are more likely to withdraw than younger adolescents.

• Medical withdrawal rates are significantly higher in consolation and singles matches. In some cases, players withdraw for medical reasons -- even when they are not hurt -- in order to save their rankings or because they have lost interest in playing in consolation matches.

Injuries in young tennis players typically include muscle strains, ankle sprains, hip injuries, knee cap instability, stress fractures in the spine and tendonitis of the wrist and rotator cuff. "But one injury you rarely see in kids is tennis elbow," Jayanthi said. "That's because they learn to hit the ball correctly."