Many parents unaware of sport specialization and increased injury frequency in youth baseball players

The Journal of Athletic Training (JAT), the National Athletic Trainers' Association's (NATA) scientific publication, released today Sport Specialization and Increased Injury Frequency in Youth Baseball Players: A Prospective Study as part of the special thematic issue on youth sport specialization. Baseball is an incredibly popular sport in the United States with 13 million-17 million athletes under the age of 18 participating at the club and high school levels. Despite evidence suggesting that sport specialization may be related to the development of overuse injuries and surgeries in youth athletes, youth specialization rates continue to rise in the United States. This study is the first to examine arm-injury incidence in youth baseball players while taking position into account.

We found it alarming that most athletes misclassified themselves as not specializing in sport when scientifically, they fell into the specialization category. This suggests not only a huge disconnect between community perceptions and scientific understanding of youth sport specialization, but the potential risks associated with specializing too soon. Parents should speak with a medical professional such as an athletic trainer to ensure their youth athlete is not putting their health at risk."

Amanda J. Arnold, PhD, DPT, OCS, CSCS, lead author

Key insights

• 31% of youth athletes self-classified as specialized in baseball, whereas the remaining 69% identified as non-specialized. When re-classified to scientific standards, the reality was that more than 83% of the cohort qualified as specialized and 17% qualified as not specialized.
• Athletes who specialized in baseball before age 13 demonstrated a higher frequency of arm injuries than those who did not specialize. Additionally, current research suggests that specialization does not correlate with an athlete's long-term success in the sport.
• Youth baseball players who also participated in additional position-specific training, particularly as pitchers, may also be at a higher risk for sustaining a shoulder or elbow injury.

A total of 159 asymptomatic, competitive youth baseball players were included in this study. Players underwent a baseline flexibility and strength assessment by the research team to determine the presence of any preexisting arm injuries or symptoms such as pain, tightness, or weakness that might limit sport participation. Players were then prospectively followed for a 6-month period. All players were male, ages 9 to 12 years, and participating in all baseball activities without restriction at the time of assessment.

Additional research on throwing athletes and youth sport specialization:

Sport Specialization and Overuse Injuries in Adolescent Throwing Athletes: A Narrative Review

Jason L. Zaremski, MD, CAQSM, FAAPMR, FACSM, Giorgio Zeppieri Jr, MPT, SCS, CSCS, Brady L. Tripp, PhD, ATC, LAT

• High levels of early sport specialization in baseball, independent of fatigue, age, and workload, place youth athletes at increased risk of injury and serious overuse injury.
• Youth pitchers are at two to five times greater risk of requiring shoulder or elbow surgery or ending their baseball career if they also played catcher, threw more than 80 pitches per game, threw more than 100 innings per year, or threw more than 8 months per year. The most perilous factor for these players, however, was regularly throwing with arm fatigue, which may place them 36 times more at risk of requiring surgery or ending their baseball career.
• Professional baseball players who specialized early reported significantly more serious injuries than those who did not.
• If an athlete sustains an overuse throwing injury, pursuing evidence-based training and rehabilitation programs can reduce the time lost as well as the likelihood of developing another throwing-related injury.