High Specialization among Female Youth Soccer Players Is Associated with an Increased Likelihood of Serious Injury

Purpose This study aimed to assess the associations between serious injury (>= 3-month time loss) and level of specialization among high-level female soccer players and to compare the specialization and college commitment ages of female youth soccer players to Division I college and professional soccer athletes. Methods Youth, college, and professional female soccer players in the United States playing in the top league at each level were recruited to complete an anonymous online survey. The survey collected information about player demographics, soccer specialization and training patterns, history of serious injuries from soccer, and perceptions surrounding soccer specialization. Comparisons between groups were performed using two-sample t-tests, chi(2) analyses, and multiple logistic regression models controlling for differences in age. A P value of less than 0.05 was set as significant. Results A total of 1,018 (767 youth, 251 college/professional) athletes completed the survey. Serious injuries affected 23.6% of youth and 51.4% of college/professional athletes. Anterior cruciate ligament tears were more prevalent in college/professional players compared with youth athletes (18.3% vs 4.0%; P < 0.001). Highly specialized youth athletes (66.5%) were more likely to have sustained a serious injury from soccer compared with athletes with low specialization (odds ratio, 2.28 (1.38-3.92); P = 0.008) but not moderate specialization (odds ratio, 1.37 (0.83-2.27); P = 0.43). A higher proportion of youth athletes specialized at a young age (<= 10 yr) compared with college/professional players (44.2% vs 25.9%; P < 0.001). Conclusions High specialization in female youth soccer players is associated with an increased likelihood of sustaining a serious injury. Current youth soccer players are specializing earlier and committing to play college soccer at a younger age compared with when current college and professional players did.