Sport Specialization and Increased Injury Frequency in Youth Baseball Players: A Prospective Study

Context: Sport specialization is thought to be a primary contributor to the throwing-related injury risk in youth baseball players. Objective: To (1) establish arm-injury incidence in a cohort of male youth (9-12 years old) baseball players and (2) examine sport specialization and the frequency of arm injuries in the same cohort. Design: Cohort study. Setting: Greenville, South Carolina, youth baseball programs and tournaments. Patients or Other Participants: A total of 159 asymptomatic youth baseball players (age = 11.1 +/- 1.1 years) were physically assessed and then were prospectively followed for 6.7 +/- 1.5 months. Main Outcome Measure(s): Athlete demographics and playing and injury histories were initially recorded. Athlete-exposures and presence of arm injury were prospectively tracked. All injuries were physically confirmed by a licensed physical therapist. Results: Youth players demonstrated an arm-injury incidence rate of 2.22 per 1000 athlete-exposures. Parents and players underestimated sport-specialization status based on the standard research definition (self versus research based: 31% versus 83%, respectively; P = .001). The frequency of arm injuries was higher in specialized players (100%) than in nonspecialized players (80%, P= .03) but did not differ between pitchers and position players (13.2% each, P= 1.00). Conclusions: Sport specialization was associated with throwing-related arm injuries in a small cohort of youth baseball players. It is concerning that 57.9% of parents and specialized players were unaware of the athletes' status. Larger studies with longer follow-up periods are needed to further evaluate injury-risk profiles in physically developing youth populations.