By Dr. Jason Klein, orthopedic surgeon

It’s a common theme in youth sports these days: a child shows interest in a sport, plays it, enjoys it, and winds up being pretty good at it. Parents and coaches see potential, so they put a plan in motion, one that will surely create success for their child: private lessons, specialized camps, summer teams, traveling teams, workout regimes, and whatever else it takes to make the child a standout in that sport. Visions of playing on an elite team, getting a college scholarship, and signing a professional sports contract dance in their heads.

Youth sports participation has changed through the years. Once a recreational pastime that involved learning fundamental skills, teamwork, how to win and lose, and having fun, has evolved into a highly structured, deliberate training focused on developing dominating, sport-specific skills.

Participating in youth sports has many benefits. It helps develop socialization, gross motor skills, strength, endurance and self-esteem. But intense training in just one sport can potentially cause an overuse injury, burnout or both.

What is “sport specialization?”

A 2016 study conducted by the University of Wisconsin School of Medicine and Public Health* defined a sport specialized athlete as one who answered yes to at least four of the following:

  1. Do you train more than 75 percent of the time in your primary sport?
  2. Do you train to improve skill and miss time with friends as a result?
  3. Have you quit another sport to focus on one sport?
  4. Do you consider your primary sport more important than your other sports?
  5. Do you regularly travel out of state for your primary sport?
  6. Do you train more than eight months a year in your primary sport?

There are other slightly different definitions, but they all revolve around the same theme: an intense focus and training on one sport.

What’s so bad about “sport specialization?”

A higher susceptibility to injury is a major issue associated with sport specialization. In fact:

  • In a study of 1200 youth athletes, a doctor at Loyola University found that early specialization in a single sport is one of the strongest predictors of injury.**
  • Athletes in that same study who specialized were 70% to 93% more likely to be injured than children who played multiple sports.
  • According to the National Youth Sports Health & Safety Institute, approximately half of all injuries evaluated in pediatric sports medicine clinics are associated with overuse.

Causes of Overuse Injuries

When an activity is repeated over and over, as is done in one sport specific activity, a young athlete uses the same muscle groups and applies pressure to the same areas in the body. Overtraining and/or inadequate rest in between training or playing only makes things worse. Overuse injuries can happen in any sport, but some injuries are unique to certain sports, like shoulder injuries in swimmers and elbow injuries in baseball pitchers.

Children are still growing, and unevenly at that. Bones grow first, which create tight tendons and muscles. To continue to stress those areas over and over could cause any one of those entities to fall victim to an overuse injury. If an injury does occur, it could even have an adverse effect to normal growth and development.


Coaches and parents should be aware of the stages of overuse and the signs of an overuse injury. The four stages are:

  • Pain in the affected area after physical activity
  • Pain during physical activity, not restricting performance
  • Pain during physical activity, restricting performance
  • Chronic, persistent pain, even at rest

Signs of overuse include:

  • Pain that cannot be tied to an acute injury
  • Pain that increases with activity
  • Swelling
  • Changes in form or technique
  • Decreased interest in practice

If your child shows signs of overuse, request an appointment with any one of the orthopedic surgeons at OSMS.


Overuse injuries can easily be prevented. The first, and most important step to prevention is awareness of single sport injury dangers. The American Academy of Orthopaedic Surgeons (AAOS) has put together a single sport awareness campaign, complete with injury prevention tips and resources for both parents and coaches. We encourage you to go to to take advantage of those resources.

Dr. Jason Klein is an orthopedic surgeon at OSMS and sees patients in Green Bay and Marinette.