Background: There is little data evaluating the risk for serious overuse injury in young athletes focusing on a single-sport or during growth spurts, in a clinical-based population. Objective: To determine whether sports specialization, weekly training volumes, and growth rates are associated with increased risk for injury and serious overuse injury in young athletes. Design: Case-control study. Setting: Injured young athletes ages (7-18yr) were recruited from sports medicine clinics and compared to healthy controls from primary care clinics presenting for sports physicals in 2 medical centers. Participants: There were 1206 participants (50.7% male) who were evaluated at baseline while longitudinal follow up data collection for up to 3 years is ongoing at time of submission. Risk factor assessment: Independent variables included hours/week of organized sports, free play, gym, sports specialization, and growth rate.Main outcome measurements Dependent variables included total injuries, acute injuries, overuse injuries, and serious overuse injuries. Results: Injured athletes were older than uninjured athletes (14.1 +/-2.1 vs. 12.9 y/o +/-2.6, P<.001) and reported a higher avg. hrs/wk playing organized sports (11.3+/-6.9 vs. 9.4 +/-8.2 hr, P<.001). Picking a main sport to focus on one sport was an independent risk factor for injury even after adjusting for hrs/week in total sports activity and age (OR 1.48 P<.05). Young athletes participating in more sports hrs/wk than their age (P<.05) and participating in>2 times organized sports:free play were more likely to have a serious overuse injury (P=.001). Annual calculated growth rates did not impact injury status (4.76 vs 4.79 cm/yr,injured vs. uninjured respectively). Conclusions: Injured young athletes are older, spend more time in organized sports, and specialize. Our data support the need for counseling young specialized athletes as to the risks for overuse injury.
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