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Sports Specialization, Volume, and Injury Risk….Who’s to Blame?

“ACL surgeries in 6-to-18- year-olds are up 60 percent during the past 20 years, and more than 57 percent of all “Tommy John Surgeries” are being performed on 15-19 year olds. Dr. James Andrews, world renowned orthopedic surgeon, recently said that more than 40 percent of his surgical practice is on kids” (John 2018).

How is this possible? Aren’t kids supposed to be invincible and resilient because of their “youth”? Well yes, our kids are these things, but there is a limit- especially if total volume exceeds their capacity.

Within our Made 2 Move ACL Performance Lab, we are always diving into current research on injury risk and associations, specifically among youth athletes. Last January, we published a blog on sport specialization, in which we talked about the importance of diversifying sport involvement in our youth athletes (ie: playing multiple sports and not specializing in one at an early age, as this has been shown to decrease the risk for injury.)

While this still holds true, new research suggests another point- perhaps it is the volume rather than the single sport that is the issue here. In reality, we know it is a combination of many factors that leads to injury and can’t be attributed to one singular variable. However, volume is one of these variables: what does the research say about training volume and injury?

Let’s Talk About Volume…

Volume refers to the total amount of work you’re doing and can be measured in a lot of different units. For youth athletes- it’s the combined hours at practice and games in a given week. For our Made 2 Move runners- it may be your mileage per week. For your average or elite weightlifter or Crossfitter, the concept of volume is likely very familiar to you- it’s measured in both a singular training session- (ie how many squats are on your program for that day), as well as the total number of these training sessions you have in a week.

Recently touched on in our sports specialization blog, (Jayanthi et al. 2013) revealed a heightened risk of injury when youth participated in more hours of sports practice per week than their number of years in age, or whereby the ratio of organized sports to free play time was in excess of 2:1. This excess of 2:1 is an excess of total training volume.

While the above 2013 study dived more into the consequences of sport specilization, this 2019 study dove into the consequences of too much volume. Researchers reported, “Similar to Jayanthi et al 213 we observed that total hours per week engaged in vigorous activity was a robust predictor of risk” (Field et. al 2019).

What’s more? This new research is applicable to a lot of the adult athletes we see at Made 2 Move, not just our youth athletes. People love to demonize specific forms of physical activity- running, crossfit, weightlifting, etc. and blame these activities for injury. But what if it was more of a volume and preparedness issue- running is not bad, playing soccer is not bad, Crossfit is not bad- the volume was just simply too high. Your body just wasn’t prepared for the load and volume that was demanded of it- so it responded by sending you pain signals and/or injury as an alarm to let you know- “hey this more than I can tolerate right now.”

Too much Volume…What’s the Solution?

That’s what we’re here for at Made 2 move- increasing your preparedness, building your tissue’s capacity, resilience, and threshold. What does this mean? Rather than telling you to stop running, doing Crossfit, or playing year round soccer, we like to build up the capacity of your tissues, tendons, muscles body to be able to do the activities you love to do. This may look like rest and recovery in the early stages of rehab and scaling back on overall training volume if that was what led to injury in the first place.

We encourage our athletes to:

  • Move in different planes.

  • Try different sports and activities.

  • Be disciplined and consistent in their recovery- this includes sleep, nutrition, and yes: Rest days.

Developing an Off Season Plan:

Field and his researchers summed it up perfectly:

“Our results suggest more than simply recommending that youth engage in more than 1 sport or do not engage in 1 sport for multiple seasons. We also need a cultural change on the norms of physical activity in our society: We need fewer hours of practice for young athletes overall” (Field et. al 2019).

So what do our PTs at Made 2 Move recommend for our youth athletes? The first recommendation is that they play multiple sports or at least take time off from their primary sport- not spend 11 out of 12 months of the year playing soccer. If your child has no interest in a sport besides soccer or football, our Made 2 Move PTs can give them a program to complement their sport and build them up during the offseason. This is what we do with our youth soccer girls- an off season and in season strength training program adapted weekly to account for games, tournaments, and practices.

“Despite popular belief, early sports specialization has not been validly linked to professional athletic success and, in fact, it has been shown that late adolescent (compared with childhood) specialization and broader training in childhood are linked to more elite achievement” (McLellan et. al 2022).

This applies to our adult athletes at Made 2 Move as well. Newsflash: playing year round sports or going 110% in every Crossfit WOD or running at your race pace for every run is a surefire way to incur an injury. I’ll say it again for those in the back: you have to give your body time to recover. Program this recovery time just as diligently as your program in your workouts. For some, rest days and recovery requires just as much discipline as the physical workouts.

Take time off from seasons- this is where playing multiple sports comes in. Kids love sports- we don’t want to take that away from them. Maybe they swim part of the year and play soccer the other half. This involves different planes of movement, varied movement patterns, and improves overall motor coordination. When playing one sport, the same movements are happening over and over- putting stress on the same body parts. Playing multiple sports changes up the way you move!

Let’s look at the big picture.

To our Made 2 Move athletes- some questions to ask yourself (or your child):

Are you enjoying it? Is your body prepared? Are you fueling properly? Are you recovering enough?

Let’s think past just this season or getting our kids to play sports in college or the next race/competition: how can we prepare our youth for their future? We want them to carry this love of movement into adulthood, and if they’re burnt out or severely injured at 16, it’s unlikely they will be motivated to move in the same way in the future. And to our Made 2 Move adult athletes- the same applies. We are in this for the long haul- let’s give our body the longevity it deserves!

Looking for a PT that understands your love for sport and wants to see you succeed? At Made 2 Move we are a group of active Yogis, Crossfitters, Runners- you name it, some of whom also grew up playing sports! So we understand the enthusiasm for sport, and we are here to help you find balance in your overall training volume. Reach out to today to set up a consultation with one of our PTs!


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