RehabAuthority Blog

Is single sport specialization harming our kids?

Published on February 10, 2017

Welcome to the initial blog post from RehabAuthority!! This has been a long time in the making and I’m super excited to kick this off.

I’m going to come right out of the gate full throttle with a topic that is very near and dear to my heart and that is youth sports. As a dad of two teenage boys I’ve been immersed in the culture of youth sports for the past 15 years. As a matter of fact this is my 15th year in a row of coaching basketball and football and I have had the opportunity to meet hundreds of great kids and parents. I also chair a nonprofit organization called Idaho Sports Foundation that helps to administer a fantastic sports program called Upward Sports. On a yearly basis, we have roughly 1,500-2,000 kids come through our Upward Sports programs, so when I say I am immersed in youth sports I am truly deep in it, the good but unfortunately also the bad.

Having been a part of this culture for so long I believe I am well qualified to say there are some things that are very broken in the culture of youth sports. In all the years I’ve coached kids, the #1 problem is always parents, not kids. Sure, I’ve had an occasional kid with an attitude issue or bad sportsmanship, but in those situations the coach player relationship is well defined and I have tools to handle these situations and it’s generally easy to resolve and truthfully a rare issue. The ugliest part of youth sports is parents who have win all at costs attitudes and who are completely out of control in their attitudes and expectations. Earlier this year I had to ask a parent to leave our football facilities because of his language and combative attitude towards other fans and our referees. This was in a first and second grade flag football game in which we don’t even keep score!!!

I could talk for hours about the heart to heart conversations I’ve had to have with dads and moms about their inappropriate behaviors on the sidelines. In 90% of the cases, after the dust has settled and we are having that conversation parents are completely embarrassed by their behavior and we hug it out and things are fine. Unfortunately, there is a small percentage of people that just have some bad wiring and no matter what is said or how things are explained their true character won’t change and they are just a cancer in every sports league they are in.

So, this leads me to the true heart of this discussion. In this part of the discussion I am speaking as a parent, a coach and a physical therapist. Over the last 15 years I have witnessed an incredible evolution in youth sports with club teams and year-round training. I have seen so many kids that are locked into one sport from grade school. I believe in the majority of these situations parents are driving this. Generally speaking, the reason given is pursuit of a college scholarship and the belief is if kids specialize early they will master their sport and scholarship opportunities will abound. There are certainly cases where this has worked out and the goal was attained. However, in the VAST MAJORITY of cases this does not happen and the ugly truth is there is an insurmountable amount of evidence that tells us single sport specialization is a horrible idea and is doing far more harm than good. Let me list some of the compelling evidence that is out there.

  • Children who specialize in a single sport account for 50% of overuse injuries in young athletes according to pediatric orthopedic specialists.
  • A study by Ohio State University found that children who specialized early in a single sport led to higher rates of adult physical inactivity. Those who commit to one sport at a young age are often the first to quit, and suffer a lifetime of consequences.
  • In a study of 1200 youth athletes, Dr Neeru Jayanthi of Loyola University found that early specialization in a single sport is one of the strongest predictors of injury. Athletes in the study who specialized were 70% to 93% more likely to be injured than children who played multiple sports!
  • Children who specialize early are at a far greater risk for burnout due to stress, decreased motivation and lack of enjoyment
  • Early sport specialization in female adolescents is associated with increased risk of anterior knee pain disorders including patella femoral disorder, Osgood Schlatter and Sinding Larsen-Johansson compared to multi-sport athletes, and may lead to higher rates of future ACL tears (added May 2014).
  • A study published in the Journal of Sports Sciences last year looked directly at the youth sports specialization issue. The study found that young athletes who competed in three sports at ages 11, 13, and 15 were significantly more likely to compete at an elite national level in their preferred sport than those who specialized in only one sport at the ages of 11, 13, and 15.
  • In another study, from 2012, also published in the Journal of Sports Sciences, young male athletes who participated in multiple sports were found to be more physically fit, have better gross motor coordination, more explosive strength, and better speed and agility than those who specialized in a single sport.
  • For most sports, there is no evidence that intense training and specialization before puberty are necessary to achieve elite status. Risks of early sports specialization include higher rates of injury, increased psychological stress, and quitting sports at a young age.
  • The American Medical Society for Sports Medicine (AMSSM) published results of a 2012 survey that found 88 percent of college athletes surveyed participated in more than one sport as a child.
  • Studies indicate that playing multiple sports actually results in longer playing careers, better confidence, motivation, motor control and athletic development, plus the ability to transfer these skills to other sports more easily.


1. DiFiori JP, Benjamin HJ, Brenner J, Gregory A, Jayanthi N, Landry GL, Luke A. Overuse Injuries and Burnout in Youth Sports: A Position Statement from the American Medical Society for Sports Medicine. Clin J Sports Med. 2014;24(1):3-20.

2. Abbott, A., Collins, D., Sowerby, K. & Martindale, R. (2007). Developing the Potential of Young People in Sport: A report for sportscotland by The University of Edinburgh, sportscotland: Edinburgh.

3. Fransen, J., Pion, J., Vandendriessche, J., Vandorpe, B., Vaeyens, R., Lenoir, M., & Philippaerts, RM. (2012). Differences in physical fitness and gross motor coordination in boys aged 6‐12 years specializing in one versus sampling more than one sport. Journal of Sport Sciences, 30, 379‐386.

4. Jayanthi, N., Pinkham, C., & Luke, A. (2011). The Risks of Sports Specialization and Rapid Growth in Young Athletes. 2011 Annual Meeting of the American Medical Society for Sports Medicine. April 30th-May4th, Salt Lake City, Utah.

5. American Medical Society for Sports Medicine (2013, April 23). Effectiveness of early sport specialization limited in most sports, sport diversification may be better approach at young ages. ScienceDaily. Retrieved from /releases/2013/04/130423172601.htm

6. Carlson, R. C. (1988). The socialization of elite tennis players in Sweden: An analysis of the players’ backgrounds and Development, Sociology of Sport Journal, 5, 241‐256;

7. Côté, J., Lidor, R., & Hackfort, D. (2009). ISSP position stand: To sample or to specialize? Seven postulates about youth sport activities that lead to continued participation and elite performance. International Journal of Sport and Exercise Psychology, 9, 7‐17.

8. Russell, W.D., & Limle, A.N. (2013). The relationship between youth sport specialization and involvement in sport and physical activity in young adulthood. Journal of Sport Behavior, 36, 82‐98.

9. Weirsma, L.D. (2000). Risks and benefits of youth sport specialization: Perspectives and recommendations. Pediatric Exercise Science, 12, 13-22.

10. Gould, D., Udry, E., Tuffey, S. and Loehr, J. (1996). Burnout in competitive junior tennis players: A quantitative psychological assessment. The Sport Psychologist, 10, 322-340.

11. Côté, J. & Fraser‐Thomas (2008). Play, practice, and athlete development. In Farrow, D., Baker, J., & MacMahon, C. (Eds.), Developing Sport Expertise (pp. 17‐28). New York: Taylor and Francis.;

12. Jayanthi, N. (December, 2012). Injury risks of sports specialization and training in junior tennis players: A clinical study. Paper presented at the Society for Tennis and Medicine Science North American Regional Conference, Atlanta, GA.;

13. Law, M., Côté, J. and Ericsson, K.A. (2007). Characteristics of expert development in rhythmic gymnastics: A retrospective study. International Journal of Exercise and Sport Psychology, 5, 82-103.

14. Joel S. Brenner. Pediatrics Jun 2007, 119 (6) 1242-1245; DOI: 10.1542/peds.2007-0887.

Are there different kinds of headaches?

Published on January 16, 2013

For our purposes we are going to try to simplify some of the discussion. The patients we see at RehabAuthority for headaches generally fall into 3 different categories.

Tension type headaches

Tension type headaches are by far the most common headache presentation. A recent study reported that many people will miss work 8.9 days per year due to tension type headaches (Schwartz). The most common symptom of tension type headaches is pain in the head. Unfortunately there are a lot of things that can cause pain in your head so tension type headaches are often not diagnosed correctly.

Tension type headaches typically have their origin in muscle problems in the neck. This can be caused by overuse, poor posture and work habits. Many people have been given advice to improve their posture but it is not that simple. Muscles adapt over time and can develop some significant problems that lead to chronic headache pain. They do not simply “return to normal” just because you sit up straight. As a matter of fact many people have developed a condition called “dysfunction” which means that their muscles and ligaments have adapted to poor posture and now it hurts worse when they try to sit up straight or improve their posture!

Many people with tension type headaches get some temporary relief of symptoms if they receive some treatment directly to the muscles of the neck. The key word is TEMPORARY. These patients are often stuck in an endless loop of massages, manipulations and hot packs to reduce their symptoms but within days their symptoms return. To eliminate tension type headaches requires a thorough examination of the muscles of the neck and a comprehensive treatment plan. There is no “one size fits all” approach.

Cervicogenic headaches

Cervicogenic headaches are less common than Tension type headaches. They are also sometime referred to as “mechanical” headaches. These are headaches that are generated by a mechanical problem in the neck (cervical spine). These types of headaches are often associated with trauma such as a whiplash injury. Certain joints in the neck (facets) as well as numerous nerves and even discs can cause headache pain.

There can be overlap in the symptoms and causes of headache pain. Some of the typical signs that help determine if a headache is Cervicogenic in origin is neck pain or stiffness combined with head pain. Cervicogenic headaches also don’t typically respond to headache medications because the ultimate source of the problem is mechanical in origin.

Migraine headaches

In very simple terms a migraine headache is a chemical and vascular problem. There is very exciting research into the area of migraine headaches but we are still a long way from “curing” this terrible problem. Migraine sufferers often describe intense pain, nausea, vomiting and visual auras. Migraines are absolutely devastating to people and often don’t respond to typical headache treatments. That is not to say Physical Therapy doesn’t have something to offer migraine sufferers.

Migraine headaches are common but are often under evaluated. Many people have been told they have migraine headaches and that is that, but in reality they have a mechanical problem in their neck, and their headaches are actually more tension type or Cervicogenic in origin. It has also been our experience with hundreds of patients that they do indeed have migraine headaches BUT the trigger that sets off their migraines is actually a mechanical problem in their neck! When we eliminate the neck problem their migraines happen much less frequently and the intensity is not nearly as severe. Instead of having 1 migraine per week many of these patients now have 1 or 2 per year!

Manual Therapy

Published on February 23, 2011

According to the Guide to Physical Therapy Practice the definition of manual therapy is: “a continuum of skilled passive movements to the joints and or related soft tissues that are applied at varying speeds and amplitudes, including a small velocity and high amplitude therapeutic movement.”

Put into plain English this means that Physical Therapist’s can move joints and soft tissue using varying techniques and speeds. This type of passive movement can range from slow rhythmic movements, all the way to fast movements that may cause an audible pop. While state laws differ, Idaho currently recognizes manipulations as part of physical therapy practice.

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