On the surface, the concept of having young people specialize in one sport makes sense. “The earlier I put my kid into one sport, and the more they work on that one sport, the better they will get at it, and the better chance they have of excelling at it.” That’s a reasonable conclusion for parents to make.

Unfortunately, this thinking doesn’t take into consideration the many other factors that contribute to athletic prowess: developmental stage, the variability of movement, adaptability of movement, mental flexibility and resilience, and, last but certainly not least, health.

That last factor, health, was made crystal clear to me during my first rotation in Tucson, Arizona. A 15-year-old, elite soccer player—we’ll call him Ryan—walked into the clinic for a “Return to Sport” assessment. He had played soccer his entire life and from the age of four played only soccer year-round. That’s known as “early sport specialization.”

For the last few years he had dealt with some nagging injuries, and as he was ramping up his conditioning over the summer, his achilles tendon (that cord-like structure on the back of your foot) became too painful for him to play.

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After getting his full injury history, he laid down on the table and I started my initial examination.

I gently brushed his achilles tendon, and he nearly jumped off the table. I started pressing around his ankle and into his shin, and his hands were digging into the table. My clinical instructor and I looked at each other instantly worried. We brought out a tuning fork (an instrument that sends vibrations through bone and can detect stress fractures with good reliability), and let’s just say Ryan wasn’t happy.

These were all huge red flags. We referred him for x-rays on the ankle and shin, revealing stress fractures throughout his ankle and shin.

He’d be out for at least eight weeks.

I remember his next visit vividly. It was an inflection point for my own interests in youth athletics. Ryan came in with a boot and crutches and sat down on the table. We were discussing his rehab plan and timeline, at which point he interrupted, looked at his mom and asked, “So I won’t be able to play this Saturday? It’s the opener.” She shook her head and the realization set in. He broke down crying, his shoulders falling under the weight of the news. “All the hard work I put in every day…they told me to just keep pushing through…” and his voice trailed off.

This kid had been playing through severe Achilles pain and stress fractures for weeks, and no one said a thing until one coach suggested in passing that he get it checked out. It all thoroughly pissed me off, but it also made me wonder. He had played one sport all his life, doing the same movement over and over. Is there any connection between playing only one sport and injuries?. Boy was there ever.

A growing amount of research is showing that an increase in early, single-sport specialization has led a spike in youth athletes getting hurt. That number sits at over 3.5 million athletes under the age of 14 receiving medical treatment each year and an estimated 2.5 million high-school athletes getting injured each year.

There are three main reasons:

1 – Playing the same sport results in repeating the same movements over and over. This constant stress on the same spots of the body means constant stress on the same muscles, ligaments, joints etc. without reprieve. That’s the classic recipe for disaster—like constantly bending and twisting a paperclip until it finally snaps.

2 – Single sport specialization has led to young people playing year-round, and the growing popularity of club and travel teams has added to their overall workload. They’re having more practices, more games, and training more than ever before. They’re completely overloaded.

3 – With the club teams and the increased focus on competition/excelling in the sport, kids are playing at a higher intensity and under more scrutiny, constantly pushed by their parents and coaches—many of whom are investing thousands of dollars and time with their kids. Kids are being overtaxed, both physically and mentally, another recipe for disaster. The most common thing I hear from young people is “I’m just tired all the time. My body is tired, and I just feel like I’m in a fog.”

Here’s a list that encapsulates the most common risk factors for overuse injury in youth athletes:

Further, there are significant mental and social costs that can come from specializing in one sport. It can create a negative sports experience and one-dimensional self-concept where the kid’s entire identity is wrapped up in one sport and leads to an outcome-oriented mindset that is devastated by failure. The time and energy requirement can create an imbalanced lifestyle that ignores building social and mental skills that are needed on and off the field.

A time when kids are supposed to be experiencing and developing many different aspects of their worldview becomes dominated by a single sport. They have less control over their schedules or lives, leading to burnout, which can manifest with symptoms such as depression, chronic fatigue and eating disorders.

A paper by Novak in 1976 summed up the imbalance of striving for unreasonable perfection in youth sports when it described the situation as “the progressive loss of freedom in exchange for increased excellence and precision.”

A famous cautionary tale is Todd Marinovich, who was pushed daily by his father Marv to try and perfect his quarterbacking. Although Todd was a star athlete in high school and college at USC, he began to show some serious cracks when he was suspended for skipping class and arrested for cocaine possession. But he still went on to be drafted in the first round of the NFL Draft by the Raiders—probably the worst place for him given his associations in Southern California. His drug problems persisted and worsened under the pressure of the NFL, where he only played four years before his drug addiction resulted in multiple arrests.

Marinovich is certainly an extreme example, but his story shows what can happen when a young person has to deal with constant pressure and stress.

The other thing I learned through my research is that early sport specialization (outside of a few sports like gymnastics and figure skating, which require complex movements early on) has not been shown to improve long-term performance at that sport.

Allowing young people to sample different sports prior to adolescence and eventually choose the one or two sports they’re most comfortable playing has been linked to a longer sports career that promotes a positive view of sports, creates a self-reinforcing foundation of intrinsic motivation through enjoyment of activities and builds a range of motor and cognitive experiences that can eventually be applied to whichever sport(s) the kid chooses.

To quote my GSC colleague Anthony Varriano:

“Basketball serves as a means to improve football players’ catch radius by making them more familiar with the apex of their vertical jump and wingspan. It also improves footwork and overall positioning so players can better leverage their mass to create separation from defenders to receive a pass. Tennis can help basketball and baseball players improve defensive footwork, quickness, and hand-eye coordination. The patience required to play golf and singles tennis can make just about any athlete better by testing their competitive resolve and emotional restraint. Soccer and cross country can improve athletes’ endurance for basketball and football.”

He continues: “I have a high school friend who ran cross country at 240 pounds who went on to play rugby in college and said he wouldn’t have had the endurance to do so otherwise. The best pitcher on our Babe Ruth baseball team was also the best tennis player on our high school team, and I think the tennis serve did a lot to strengthen his throwing arm but, more importantly, improve flexibility of the wrist, which allowed him to increase the spin rate of his pitches, resulting in more movement.”

There are numerous examples of elite players who were multi-sport athletes, most notably Bo Jackson, who can do anything, including archery. Randy Moss and Tony Gonzalez both could have been professional basketball players. These players may simply be chalked up as outliers but we know that creating physical literacy and exposing young people to multiple sports builds better movement patterns and better decision-making skills, because they’re involved in a wide variety and range of activities that challenge them in multiple ways cognitively and physically.

There are programs like Strength Lab: superheroes—created by Simon Brundish and his wife in the United Kingdom—that are being implemented in elementary schools worldwide to engage young people in a wide range of movement patterns that are also the basis for strength training.

The bare reality is that outside of a few sports, the entire premise for having kids choose one sport earlier, become so-called experts earlier and go on to perform better is patently false.

So what can we do? Education, education, education. Education for parents and coaches really is the crux of solving this problem. Many parents and coaches don’t understand the increased risks that come with earlier and earlier single-sport specialization. The focus needs to be on long-term development and understanding the appropriate stages for sports specialization.

A Canadian organization called the Sport for Life Society has been at the forefront of this education, creating the long-term athletic development (LTAD) framework. This framework breaks down youth athletic development in seven separate stages and parses out the appropriate training for each stage based on many of the factors I mentioned above.

This framework is now supported by some of the most credible organizations in sport, including the National Strength and Conditioning Association (NSCA) and International Olympic Committee (IOC).

Parents and especially coaches are at the frontlines with youth sports, so they are the primary power brokers who can champion this model. Personally, the LTAD is what I’ve modeled my own youth athletic development and performance program around, and it’s what I champion to any coach or parent who is willing to listen.

This piece may seem like I’m putting all the blame on parents or coaches, but I truly do empathize with their position. For the parents and coaches who do understand the risks, it’s a catch-22: the parents want their “Ryan” to get the exposure needed to gain the attention of the people plugged into the pipelines for high school and college scholarships, and the coaches are trying to get plugged into higher-paying jobs—so both play the game.

Unfortunately, it leads to reinforcing a constant cycle of specialization that is becoming more and more embedded in youth sports, especially as the amount of money invested continues to increase. AAU in America is a prime example.

Whether you’re directly or indirectly involved in youth sports, the message has to get out or the story I shared about “Ryan” will increasingly become the norm. We’re forcing kids into adult constructs that are mismatched with their developmental stages and hindering them in multiple ways—whether that’s becoming a high-performance athlete who loves the sport or simply a well-rounded individual with multiple interests and outlets.

We have to get this right, do it the right way, and frameworks like the LTAD exist just for that purpose. There’s no taking a mulligan when it comes to children’s development.