Good morning, unfortunately I'm not a doctor yet, but hopefully to join your ranks soon. So my name is David Lee, I'm a fourth year medical student at Western Michigan and a former research fellow at the Rothman Institute. I'd like to thank all of you for giving us the opportunity to present our findings. These are disclosures per the academy website, none relevant to this talk. So youth participation in athletic activities has increased over the past several decades and a subset of these athletes are choosing to specialize in sports at an earlier age. There's a lot of potential motivation cited for this among both athletes and parents believing that it gives them a competitive advantage and they're pursuing future career opportunities. So what does this mean? These kids are committing to intense training regimens in a specific sport and attempt to compete at a higher level and they're doing so earlier and earlier. And a lot of people have raised concerns regarding this, regarding specific high intensity programs related to one sport or one joint and there's been prior work published looking at high school athletes across a single season and specialized athletes were more likely to have suffered from lower extremity injuries. There's specific sport data looking at arm injuries in youth baseball like we saw earlier today and hip and groin injuries in hockey players. So our study was hoping to look at the sport specialization rates among high school athletes and compare these specialization rates to injuries in the longitudinal fashion. So our study looked at three high schools in a single district in the southern New Jersey area. Enrollment began in August of 2016. Following that these athletes were followed throughout their entire high school careers. Our last class was enrolled in 2019-2020 academic year so data collection is still ongoing. So these athletes were administered two types of surveys at the start of every one of their seasons every year they were administered a preseason survey collecting demographic data and at the end of each individual season they were asked to report on injuries. This injury data was corroborated with athletic trainer reported injury data and our own medical records to verify and for the purposes of our analysis sport specialization was defined as participation in a single sport for six or more months out of the year. So these are all the athletes we've collected from our study. We had 925 total athletes collected and they've so far engaged in 1724 years academic years of competitive play. There were slightly more males and females in our study and as you can see although 26.8% of athletes reported being specialized throughout their career at some point in their career in any individual season 15% were specialized. When looking at the injury data they reported by anatomic location the vast majority were in ankle knee and the head and neck. And when looking at specific injuries by diagnoses ankle sprains and concussions were by far the most common although you can see on the far right here that there's a plurality of other injuries that were less than five and did not fit on this graph. So this is looking at injury results across all their competitive years so individual seasons. Specialized athletes were more likely to be male much more likely to report an injury And when looking at specific injury severity types those in the zero to one week and two to four week were more likely to occur in specialized athletes. This is looking at our class of 2020 which is our first group that had four years of longitudinal data collected. In freshman year they started out with 300 athletes 9.4% of whom were specialized. By the time they reached senior year only 85 athletes 27.1% of whom were specialized. When looking at injury results for this class athletes were specialized at any point throughout their four years were much more likely to report an injury and by severity they're likely to report injuries in the zero to one two to four and four more week type. When looking more granularly at the specialized athletes in that class athletes who came in as specialized athletes as freshmen suffered no different injury rates than those who specialized later on in their careers and athletes who spent 50% of their career or greater specialized suffered no different injury rates than those who spent less than 50% of their career specialized. So some of our takeaways are our sports specialization rates can change and vary throughout an individual's high school career. Overall these athletes were more likely to report an injury and specifically in the one week two to four week or four more week types and there was no association that we found between the timing and degree of specialization longitudinally over the course of career although there is other data out there showing that the specific degree of specialization within an individual season can matter. Some of the limitations if a student went to an outside provider and the data was not reported by either them or one of our trainers the injury would have been missed. We didn't provide the survey in multiple languages so potentially non-English speaking patients would not have participated in this. The study wasn't controlled for the level of competition so for JV versus varsity degree of playing time so if they're a starter if they're not which matters more at the varsity level than the JV level or their degree of off-season activity we did ask about if they participated in club sports or something like that but weren't able to capture exactly how many hours per week and how many months of the year they were spending on these. And this captures results from a single public district in one region of the United States. Participation in sports can vary in different parts of the country different sports are offered at different times of the year and obviously this misses students at sports specific academies where they're playing you know basketball or football or some sport year round. Here are our citations and thank you for your time.

youth specialization

sports

injury rates

ankle sprains

concussions