How to Reduce the Risk of Injury in Kids Related to Sports Specialization

New Recommendations: How to Reduce the Risk of Injury in Kids Related to Sports Specialization

One of my favorite movies growing up was The Sandlot. I still yell out, “YOU’RE KILLING ME SMALLS!” on a regular basis to my family, friends, and patients when they aren’t quite meeting expectations.  The movie depicts the bond developed by a group of pre-adolescent boys who meet regularly to play “pick-up games” of baseball and participate in other shenanigans. Unfortunately, this trend of children playing unorganized recreational sports without adult influence is becoming less and less common, while we are seeing a sharp increase in the number of children participating in intense specialization programs.


Sports specialization in kids is defined as intense year-round participation or training in a single sport for more than 8 months out of the year. Child and adolescent specialization programs were designed to produce elite-level athletes, and millions of kids, parents and coaches around the nation are drinking the Kool-Aid. However, the rigor of the schedule and the constant striving to be noticed by a scout or college comes at a high monetary, physical, mental and psychosocial cost. Current evidence reveals that around 70% of children drop out of organized sports by age 13 because of cost and burnout. There is also strong evidence showing an association between sports specialization and overuse injuries or even the need for surgery.


These evolving health and well-being issues have raised concerns among numerous health professionals. The National Athletic Trainer’s Association (NATA) recently released an official statement of recommendations to reduce the risk of injury related to sports specialization for young athletes. Their statement has been endorsed by professional football, hockey, soccer, basketball, and baseball athletic trainers and the NATA intercollegiate council for sports medicine. NATA supports the following recommendations:

  1. Delay specializing in a single sport for as long as possible.
  2. One organized sport per season.
  3. Avoid playing a single sport for more than 8 mos/year.
  4. Practice/play no more hours per week than age in years (ie…a 12 yr old should not participate in more than 12 hrs/week of organized sport).
  5. Two days a week of rest.
  6. Rest and recovery time from organized sport at the end of each competitive season.


– Athletes who participate in a variety of sports have fewer injuries and play sports longer than those who specialize before puberty.

-Almost 90% of 2018 NFL Draft picks were multisport athletes.

-The probability of a high school student athlete competing at the collegiate level and receiving any form of sports scholarship is <2%.

As a Sports Physical Therapist, I have seen an abundance of kids with overuse injuries come through the clinic. My goal is to help the young athlete, the parent, and the coach recognize that health is always a competitive advantage.  Unfortunately, many neglect the research and the recommendations at the expense of the young athlete, and I can only respond with, “YOU’RE KILLING ME SMALLS!

Sarah DoBroka Cooley PT, SCS, COMT, Cert DN has greater than 17 years of clinical experience and highly respected credentials including being a Board Certified Sports Clinical Specialist, a Certified Manual Therapist, and certifications in dry needling and instrument assisted manual therapy. She specializes in treating orthopedic injuries in athletes who compete on interscholastic, collegiate, Olympic, and professional levels. Locally, she has served as a PT consultant to Davidson College and was a member of the Motorsports Outreach Team for NASCAR. Contact her at

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