Original research| Volume 23, ISSUE 2, P139-144, February 2020

The associations of early specialisation and sport volume with musculoskeletal injury in New Zealand children

Published:September 10, 2019DOI:



      To investigate associations of early specialisation (highly specialised before age 13 years) and sport participation volume with injury history in New Zealand children.


      Cross-sectional survey study.


      Children attending a national sports competition were invited to complete a questionnaire capturing specialisation level (high, moderate or low), participation volume and injury history. Multiple logistic regression was used to investigate associations between variables.


      Nine hundred and fourteen children (538 female) completed the questionnaire. After adjusting for age, sex and hours of weekly sport participation, the odds of reporting an injury history were not significantly higher for early specialised children compared to children categorised as low specialisation (OR = 0.88; CI = 0.59–1.31; p = 0.53). Participating in more hours of sport per week than age in years (OR = 2.42; CI = 1.27–4.62; p = 0.02), playing one sport for more than 8 months of the year (OR = 1.60; CI = 1.07–2.36; p = 0.02), or exceeding a 2:1 weekly ratio of organised sport to recreational free-play hours (OR = 1.52; CI = 1.08–2.15; p = 0.02), increased the odds of reporting a ‘gradual onset injury’.


      Early specialisation in one sport did not increase the odds of reporting a history of injury. Exceeding currently recommended sport participation volumes was associated with increased odds of reporting a history of gradual onset injury.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Science and Medicine in Sport
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bergeron M.F.
        The young athlete: challenges of growth, development, and society.
        Curr Sports Med Rep. 2010; 9: 356-358
        • Sam M.
        Sport policy in Aotearoa/New Zealand, Chapter 12.
        Sport in Aotearoa/ New Zealand Society. 2nd ed. Cengage Learning, Melbourne, Australia2007
        • Buckley P.S.
        • Bishop M.
        • Kane P.
        • et al.
        Early single-sport specialization: a survey of 3090 high school, collegiate, and professional athletes.
        Orthop J Sports Med. 2017; 5: 1-7
        • Smith M.
        Early sport specialization: a historical perspective.
        Kinesiol Rev. 2015; 4: 220-229
        • Sugimoto D.
        • Stracciolini A.
        • Dawkins C.I.
        • et al.
        Implications for training in youth: is specialization benefiting kids?.
        Strength Cond J. 2017; 39: 77-81
        • Jayanthi N.
        • Labella C.
        • Fischer D.
        • et al.
        Sports-specialized intensive training and the risk of injury in young athletes: a clinical case-control study.
        Am J Sports Med. 2015; 43: 794-801
        • LaPrade R.F.
        • Agel J.
        • Baker J.
        • et al.
        AOSSM early sport specialization consensus statement.
        Orthop J Sports Med. 2016; 4: 1-8
        • Côté J.
        • Vierimaa M.
        The developmental model of sport participation: 15 years after its first conceptualization.
        SciSport. 2014; 29: S63-S69
        • McGuine T.A.
        • Post E.G.
        • Hetzel S.J.
        • et al.
        A prospective study on the effect of sport specialization on lower extremity injury rates in high school athletes.
        Am J Sports Med. 2017; 45: 2706-2712
        • Post E.G.
        • Trigsted S.M.
        • Riekena J.W.
        • et al.
        The association of sport specialization and training volume with injury history in youth athletes.
        Am J Sports Med. 2017; 45: 18
        • DiFiori J.
        • Benjamin H.J.
        • Brenner J.S.
        • et al.
        Overuse injuries and burnout in youth sports: a position statement from the American medical society for sports medicine.
        Clin J Sport Med. 2014; 24: 3-20
        • Zwick E.B.
        • Kocher R.
        Growth dynamics in the context of pediatric sports injuries and overuse.
        Semin Musculoskelet Radiol. 2014; 18: 465-468
        • Hosseinzadeh P.
        • Milbrandt T.
        Histology of physeal injuries.
        Curr Orthop Pract. 2011; 22: 130-134
        • Bowerman E.
        • Whatman C.
        • Harris N.
        • et al.
        Are maturation, growth and lower extremity alignment associated with overuse injury in elite adolescent ballet dancers?.
        Phys Ther Sport. 2014; 15: 234-241
        • Brenner J.S.
        • LaBella C.R.
        • Brooks M.A.
        • et al.
        Sports specialization and intensive training in young athletes.
        Pediatrics. 2016; 138e20162148
        • Bell D.R.
        • Post E.G.
        • Trigsted S.M.
        • et al.
        Prevalence of sport specialization in high school athletics: a 1-year observational study.
        Am J Sports Med. 2016; 44: 1469-1474
        • Denscombe M.
        The good research guide: for small-scale social research projects.
        4th ed. Open University Press, Maidenhead, England2010
        • Lavrakas P.
        Encyclopedia of survey research methods.
        (Availible from:) Sage Publications, Thousand Oaks, CA2008
        • Powell M.A.
        • Smith A.B.
        Ethical guidelines for research with children: a review of current research ethics documentation in New Zealand.
        Kotuitui. 2006; 1: 125-128
        • Bahr R.
        No injuries, but plenty of pain? On the methodology for recording overuse symptoms in sports.
        Br J Sports Med. 2009; 43: 966-972
        • Post E.G.
        • Bell D.R.
        • Trigsted S.M.
        • et al.
        Association of competition volume, club sports, and sport specialization with sex and lower extremity injury history in high school athletes.
        Sports Health. 2017; 9: 518-523
        • Pasulka J.
        • Jayanthi N.
        • McCann A.
        • et al.
        Specialization patterns across various youth sports and relationship to injury risk.
        Phys Sportsmed. 2017; 45: 1-9
        • Sanders J.O.
        • Qiu X.
        • Lu X.
        • et al.
        The uniform pattern of growth and skeletal maturation during the human adolescent growth spurt.
        Sci Rep. 2017; 7: 1-9
        • Silder A.
        • Thompson J.A.
        • Delp S.L.
        • et al.
        Biomechanical effects of an injury prevention program in preadolescent female soccer athletes.
        Am J Sports Med. 2017; 45: 294-301
        • Olsen S.J.
        • Fleisig G.S.
        • Dun S.
        • et al.
        Risk factors for shoulder and elbow injuries in adolescent baseball pitchers.
        Am J Sports Med. 2006; 34: 905-912
        • McLeod T.C.V.
        • Decoster L.C.
        • Loud K.J.
        • et al.
        National athletic trainers’ association position statement: prevention of pediatric overuse injuries.
        J Athl Train. 2011; 46: 206-220
        • Purnell M.
        • Shirley D.
        • Nicholson L.
        • et al.
        Acrobatic gymnastics injury: occurrence, site and training risk factors.
        Phys Ther Sport. 2010; 11: 40-46
        • Rose M.S.
        • Emery C.A.
        • Meeuwisse W.H.
        Sociodemographic predictors of sport injury in adolescents.
        Med Sci Sports Exerc. 2008; 40: 444-450
        • Barreiro J.A.
        • Howard R.
        Incorporating unstructured free play into organized sports.
        Strength Cond J. 2017; 39: 11-19
        • Duncan S.
        • McPhee J.
        State of play. Executive report.
        2015 (Available at: [Accessed 18 April 2018].)