By Dev K. Mishra, M.D.
President, Sideline Sports Doc
Clinical Assistant Professor of Orthopedic Surgery, Stanford University
- A recently published study indicates that children from higher socioeconomic status (SES) households are more likely to sustain overuse injuries than children from lower SES households
- The authors found that the higher SES children were more likely to have single sport specialization, participated in more hours per week and months per year in that sport, and were less involved in unstructured free play
There are a number of factors that appear to be correlated with an increased risk of youth sports overuse injuries:
- Single sport specialization prior to the age of 14
- Playing that single sport more than eight months out of the year
- Practicing and playing a combined number of hours per week more than your age in years
Conversely it appears that free unstructured play rather than organized sport lowers a child’s risk of overuse injury. Appropriate periods of rest from sport as well as limitation in participation hours per week also appear to reduce injury risk. Is it possible that children from wealthier households are at higher risk of developing overuse injuries than children from poor households? One recently published study suggests that household wealth may be correlated with overuse injury risk.
This studywas recently published in the journal Sports Health. The authors of this study evaluated almost 1200 athletes aged seven through 18 and grouped them into lower versus higher socioeconomic status based upon their ZIP Code. They evaluated factors such as hours per week spent playing organized sports, number of months per year in their main sport, single versus multiple sport participation, and reporting of overuse injuries.
The authors found that higher socioeconomic status athletes had a statistically significant increase in the number of reported serious overuse injuries compared to lower socioeconomic status athletes. The authors hypothesized that this was potentially due to higher rates of sports specialization, more hours per week playing organized sports, less free unstructured play, and greater participation in individual sports for the higher socioeconomic status athletes.
This study provides an interesting perspective in the debate surrounding causes of overuse injuries amongst youth sport athletes. The authors of the study are highly credible individuals with considerable experience in sports injury epidemiology, however, there are some limitations in the study. First, usage of ZIP Codes may not be a fully reliable indicator of social economic status. Second, it’s possible that the percentage of injuries in the lower socioeconomic status group is underrepresented due to potentially limited access to medical care especially from specialist physicians. Finally, this study shows that factors possibly associated with higher socioeconomic status are correlated with overuse injuries, but this does not necessarily prove that those factors cause the overuse injury.
Overall this is an excellent study that adds to our knowledge base as we seek to reduce the numbers of overuse injuries in our young athletes.