Context: Studies have illustrated that overuse injuries occur in adolescent athletes more often than previously reported. The general purpose of this study was to provide a thorough report of secondary school athletic trainers encounters, practices, and perceptions of overuse injury in adolescent athletes. Design: Cross-sectional. Methods: An anonymous online questionnaire was distributed via email to athletic trainers in the secondary school setting. The questionnaire was sent to participants during the summer of 2021 and 430 participants (highest educational degree earned: master’s degree = 66%) completed the survey. Various survey methods were used to evaluate athletic trainers (1) demographics, (2) estimations about what percentage of injuries evaluated and treated were classified as overuse, (3) methods for treating overuse injuries, (4) confidence in treating overuse injuries and the complete implementation of their treatment plan, (5) perceptions of various barriers to treating overuse injuries, and (6) perception as to why patients did not want to reduce activity to treat their overuse injuries. Results: Participants reported that about half of all evaluations and treatments in a year were overuse injuries and they were “fairly” or “completely” confident (90%) in their ability to treat these injuries. The most common treatments cited were stretching (91%) and reducing activity (90%). Only 61% of participants were “fairly” or “completely” confident in the complete implementation of their treatment plan. Participants believed that patients’ reluctance to reduce sport activities (82% “moderate” or “extreme” barrier) was the most significant barrier to treatment. Participants cited athletes’ avoidance of missing games as the most common reason athletes were reluctant to reduce sporting activity. Conclusions: Participants felt confident in treating overuse injuries yet faced significant barriers in treating these injuries. Clinicians should be prepared to have conversations about the importance of reducing sporting activity to allow proper healing for overuse injuries in adolescent athletes.

Context Sport specialization has been assumed to have psychosocial ramifications for athletes, including on autonomous motivation which has been linked with continued sport participation. Sport dropout is common in youth athletes, yet it is unknown how sport specialization may affect this population psychosocially. Objective To determine the association of sport specialization with sport autonomous and controlled motivation and amotivation in middle school-aged athletes. Study Design Cross-sectional. Setting An anonymous online questionnaire was distributed to athletes via schools, club sports, and social media. Patients or Other Participants A total of 178 athletes (Male=59%, private school=51%, grade: 6th=20%, 7th=32%, 8th=48%) completed the questionnaire. Main Outcome Measures The questionnaire assessed sport participation, motivation using the Youth Behavioral Regulation in Sport Questionnaire, and demographics. Sport specialization was defined using a modified 3-point scale (low, moderate, and high) and multisport versus single-sport athletes. Non-parametric tests were used to analyze the differences between the types of motivation and specialization levels and multisport versus single sport athletes. Results Sport specialization categories were not significantly associated with autonomous motivation, controlled motivation, or amotivation. There were no statistically significant associations between multisport or single sport athletes with any type of motivation. However, exploratory analysis revealed multisport athletes had significantly higher scores for intrinsic motivation, a subscale of autonomous motivation, compared to single sport athletes (single sport: median=5.00 25th–75th quartile=4.50–5.00; multisport: median=5.00 25th–75th quartile=5.00–5.00; p=0.04). Conclusions Sport motivation did not differ between sport specialization groups in middle school athletes. Dropout of sport is common in middle school-aged athletes but is multifactorial in nature. Lack of sport motivation could be a factor for some athletes, but all specialization groups appeared to have similar outcomes. Out exploratory analysis suggests that clinicians may consider having an open dialogue with single-sport athletes, their parents/guardians, and coaches to ensure athletes are enjoying their sport.

Attitudes and beliefs of parents about sport specialization may indicate why youth athletes decide to specialize. The purpose of this study was to determine the association between sport specialization level, ice hockey position, and the parent/guardians’ attitudes and beliefs on sport specialization. Our results demonstrate that goalies were the most likely to specialize, and parents of specialized ice hockey players tend to believe that sport specialization helps their child achieve future sporting aspirations. Increased sport specialization may put ice hockey goalies at an increased risk for overuse injuries, and parents’ beliefs about sport specialization may impact their child’s sporting behaviors.