Prevalence and Consequences of Sport Specialization Among Little League Baseball Players

Abstract

Background: Baseball is one of the most popular boy’s youth sports, and there has been a rise in the rates of certain overuse injuries among players. Specialization has been identified as a risk factor for overuse injury in high school athlete populations, but there is little understanding of the prevalence or consequences of sport specialization in Little League baseball players. Hypothesis: Sport specialization will be highly prevalent among Little League baseball players and specialization will be associated with worse throwing arm health. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: A total of 246 Little League baseball players (male; N = 241; age, 9.5 ± 1.6 years) between 7 and 12 years old completed an anonymous, online questionnaire with their parent’s assistance. The questionnaire consisted of participant demographics and baseball participation information, including sport specialization status and the Youth Throwing Score (YTS), a valid and reliable patient-reported outcome measure for youth baseball players. Results: Only 29 (11.8%) players met the criteria for high specialization. Approximately one-third of all players (n = 77; 31.3%) reported participating in baseball year-round or receiving private coaching outside of their league (n = 81; 32.9%). Highly specialized athletes demonstrated worse scores on the YTS on average compared with low-specialization athletes (mean [SE]: 56.9 [1.6] vs 61.1 [1.2]; P = 0.01). Similarly, pitching in the previous year ( P < 0.01) or traveling overnight regularly for showcases ( P = 0.01) were associated with a worse score on the YTS. Conclusion: While the prevalence of high sport specialization was low among Little League baseball players, other behaviors associated with specialization such as year-round play and the receiving of private coaching were more common. Highly specialized Little League players demonstrated worse throwing arm health compared with low-specialization players. Clinical Relevance: Little League players and their parents may represent a potential target audience for dissemination campaigns regarding sport specialization.

Age of Early Specialization, Competitive Volume, Injury, and Sleep Habits in Youth Sport: A Preliminary Study of US Youth Basketball

“…Moreover, the findings are contrary to several studies which demonstrated associations between specialization and injury. 32,37 Girls specialized earlier than boys, which was consistent with findings from a recent study of NCAA (National Collegiate Athletic Association) athletes. 38 A larger sample size, with a larger percentage of girls and a broader range of competitive levels will provide a better assessment of the impact of early specialization on these relationships and potentially illuminate the motivating factors behind these trends.…”

“…Moreover, the findings are contrary to several studies which demonstrated associations between specialization and injury. 32 , 37 …”

Proposed Musculoskeletal Examination of Youth and Adolescent Baseball Players

“…Croci et al (14) identified those college baseball players who had highly specialized by 13 years were more likely to have a history of upper extremity injury than players who were low/moderate specialization and reported worse subjective throwing arm function. This has been observed in the Little League population and high school population, as well as with players of high sport specialization demonstrating worse throwing arm health compared with low-specialization players (15,16).…”

“…A number of studies have looked at factors related to injury in the youth baseball population over the past year ranging in topics from; early sport specialization (ESS) (12)(13)(14)(15)(16), pitch counts (17)(18)(19)(20)(21)(22)(23), prethrowing protocols (24,25), imaging findings (26), to body region-specific inquiries (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43) in search for opportunities to reduce the risk of injury in this population. We will review a wide range of articles and their relevance to injury risk in this population.…”

Early Sport Specialization and Long-term Throwing Arm Health in College Baseball Players

“…25 Research has indicated that high-level specialization in Little League baseball players is relatively low; however, year-round play and receiving private coaching were more common. 22 The increased exposure and stress can contribute to both chronic and acute injuries. Most literature has focused on evaluating relationships between specialization and injury at a single time point.…”