Early Sports Specialization Is Associated With Upper Extremity Injuries in Throwers and Fewer Games Played in Major League Baseball

Abstract

Background: Single-sport athletes who specialize in baseball at a young age may have a greater predisposition to overuse injury, burnout, and decreased career longevity when compared with multiple-sport athletes. The effect of sport specialization has not been studied in professional baseball players. Hypothesis: Major League Baseball (MLB) players who played multiple sports in high school would experience fewer injuries, spend less time on the disabled list, play more games, and have a longer career than athletes who played only baseball in high school. Study Design: Descriptive epidemiology study. Methods: First- and second-round MLB draft picks from 2008 to 2016 who played in at least 1 professional game were included in this study. Athletes who participated in 1 or more sports in addition to baseball during high school were considered multisport athletes, and athletes who participated in only baseball were considered single-sport athletes. For each athlete, participation in high school sports, injuries sustained in MLB and Minor League Baseball, number of days on the disabled list for each injury, number of games played in both leagues, and whether the athlete was still active were collected from publicly available records. Results: A total of 746 athletes were included in this study: 240 (32%) multisport and 506 (68%) single sport. Multisport athletes played in significantly more mean total games (362.8 vs 300.8; P < .01) as well as more mean MLB games (95.9 vs 71.6; P = .04) than single-sport athletes. There was no difference in the mean number of seasons played in the major leagues (1.8 vs 1.6; P = .15) or minor league (5.25 vs 5.20; P = .23) between multisport and single-sport athletes. Single-sport athletes had a significantly higher prevalence of upper extremity injuries compared with multisport athletes (136 [63%] vs 55 [50%]; P = .009). Single-sport pitchers also had a higher prevalence of shoulder and elbow injuries (86 vs 27; P = .008) and were more likely to have recurrent elbow injuries (33% vs 17% recurrence; P = .002) compared with multisport pitchers. Conclusion: Professional baseball players who participated in multiple sports in high school played in more major league games and experienced lower rates of upper and lower extremity injuries than players who played only baseball in high school.

High School Sport Specialization and Injury in Collegiate Club-Sport Athletes

“…13,14,16,26 Unlike our results, all of these studies found an association with O n l i n e F i r s t high school sport specialization and injuries in Division-I and professional athletes. 13,14,16,26 Confino et al and Rugg et al both found that athletes who were single-sport athletes in high school had more publicly reported major injuries during their professional careers than professional athletes who were multisport athletes in high school. 13,14 Another study by Buckley et al surveyed high school, collegiate, and professional athletes.…”

“…13,14,16,26 Confino et al and Rugg et al both found that athletes who were single-sport athletes in high school had more publicly reported major injuries during their professional careers than professional athletes who were multisport athletes in high school. 13,14 Another study by Buckley et al surveyed high school, collegiate, and professional athletes. 16 This study sought to crosssectionally evaluate sport specialization habits in current high school, collegiate, and professional athletes and to evaluate the association between reported injuries with sport specialization.…”

“…Two studies have demonstrated that professional athletes that were single sport athletes in high school had an increase in major injuries during their professional career as well as shorter professional sporting careers compared to professional athletes that were multisport athletes in high school. 13,14 These findings may be explained by the previous hypothesis that sport specialization has a long-term effect on movement patterns that increase the risk of sport-related O n l i n e F i r s t…”

Prevalence and Consequences of Sport Specialization Among Little League Baseball Players

“…4 Among professional baseball players, specialization during childhood was associated with greater prevalence of injuries during their professional career. 7,34 Participation in baseball for more than 8 months in a year was identified as a risk factor for shoulder or elbow injury among adolescent baseball pitchers. 21 In a magnetic resonance imaging study of 23 asymptomatic Little League players, year-round participation in baseball and single-sport participation were associated with abnormal shoulder magnetic resonance imaging findings.…”

Differences in Lower Extremity Movement Quality by Level of Sport Specialization in Cadets Entering a United States Service Academy

“…3,6 Increased youth sport specialization has been identified as an independent risk factor for lower extremity injury and overuse injuries. 5,8,17 Despite sport specialization being identified as an independent risk factor for injury, it remains unclear what underlying factors may contribute to this increased risk. Some authors have suggested that participation in multiple sports may be associated with improved decision-making during play and may have a positive influence on gross motor coordination, speed, endurance, and strength, because of enhanced movement quality.…”