Military cadets who focus on one sport are more likely to be injured, study finds

U.S. Military Academy cadets who have focused on one sport are more likely to be injured in their first year of service, potentially impacting military readiness, according to a first-of-its kind study being presented at the National Athletic Trainers' Association (NATA) 70th Clinical Symposia & AT Expo.

The study of United States Military Academy (USMA) cadets at West Point found that those who had highly specialized in sports before entering college – focusing only on one sport and playing it more than eight months a year – were 51% more likely to sustain a lower-body injury during their first year at the academy than those who had moderately specialized in sports. The study is the first to assess how prior sport specialization is associated with injury risk during the first year of military service.

The majority of injuries sustained were due to participation in sports and physical training. All cadets are required to participate in athletics while at the academy, whether at the intramural, club or National College Athletic Association (NCAA) level.

Our research adds to the growing body of literature that suggests high levels of sports specialization in adolescence and childhood increases injury risk. As athletic trainers, we recommend that parents encourage their children to participate in a variety of sports, which may decrease the likelihood that they'll be injured."

Kenneth L. Cameron, PhD, MPH, ATC, FNATA, senior author of the study and director of Orthopaedic and Sports Medicine Research, Keller Army Hospital, USMA at West Point

Researchers completed assessments of the 892 cadets in the West Point class of 2021 before their first year at the academy began. They used a three-question tool to classify each cadet's level of sports participation prior to entering military service:

  1. Did you choose a main sport?
  2. Did you quit other sports to focus on a main sport?
  3. Did you train for more than eight months a year for that sport?

Each "yes" was scored as 1 point and each "no" was scored as 0 points. Those who scored 3 were considered highly sports-specialized, 2 were moderate and 0-1 were low. Overall, 165 (18.5%) reported a high level of sports specialization, 337 (37.8%) reported a moderate level and 390 (43.7%) reported a low level.

Those who were highly sport specialized upon entry to the academy were most likely to be inured in their first year and those with moderate levels were least likely to be injured. After one year, 47% of the high, 30% of the moderate and 33% of the low sports specialized cadets had suffered a lower-extremity injury, such as an ankle sprain or lower leg stress fracture. Those who were highly specialized were 51% more likely to sustain a lower-body injury than those who were moderately specialized and 35% more likely than those whose sport specialization was low. Those whose sport specialization was low were 12% more likely to sustain a lower-body injury than those who were moderately specialized, but this difference was not statistically significant. Some experts believe those who are low or moderately specialized may be at lower risk for injury due to improved gross motor coordination, speed, endurance and strength.

"Lower-extremity musculoskeletal injuries significantly impact military readiness," said Dr. Cameron. "These injuries lead to significant time loss from training and limit soldiers' ability to be deployed."

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