Set on Specializing?
Consider these Injury-Mitigating Strategies
Alexandra Abbott, MD
If you are set on a single sport or activity (despite that the professionals were sport samplers and despite that injury and burnout risk will increase), it’s a good idea to at least consider waiting until later adolescence to specialize. The later the better, but between 13-16 years may be optimal. In addition to timing of specialization, there are also some evidence-based strategies to reduce the risk for injury associated with specialized sport participation.
“Rules of Thumb” for Training and Competition Volume:
One day off per week (two is better) from the primary sport. These do not have to be “couch potato” days, but should be days where any activity is light, unstructured, participation rather than performance focused, and restorative in general. Participating in another sport altogether may also be considered. For example, perhaps there is no soccer practice but you decide to go for a run, play tennis instead, practice juggling for 30 minutes or less, engage in a mobility or pre-hab (injury prevention) session, or take a complete rest day from activity to restore and recover.
Hours per week of the primary sport should be less than a youth athlete’s age in years. For example, an 8 year old with four practice sessions each lasting 2 hours is more likely to require injury management than one who has shorter and/or fewer training sessions during the week. Most commonly, volume metrics are reasonable until a tournament or competition week adds significant volume suddenly. During a week like this, injury risk is significantly increased.
Year-round participation— program an “off-season” or rest from the primary sport:
Scheduling an “off-season” into the calendar, which looks like 3 months of the year where performance is not emphasized, can benefit athletes by reducing their risk for injury. During an off-season or “de-load” period, athletes are not trying to set new records or emphasize competition. Instead, they may be focusing on fundamentals, pre-hab, and/or strength and conditioning, participating in another sport or activity altogether, participating in unstructured activities, and/or resting altogether.
Professional and Olympic athletes commonly program off-seasons/deload periods explicitly, in order to minimize injury risk and to promote peak performance occurring during competition periods of the year. For young athletes, 3 months of the year may look like nonconsecutive weeks of rest from structured activities (quarterly vacation periods?), consecutive or nonconsecutive rehab/pre-hab periods, periods of cross-training, sampling other sports, and/or focusing on mobility and fundamentals.
Progressing Volume Over Time
Increasing volume (i.e. duration, frequency, intensity) is often crucial for improving performance. However, increased volume week-to-week can be associated with increased risk for injury. Consider these tools to increase volume without becoming injury-prone.
10% rule: Week-to-week progression of exercise volume exceeding 10% has been associated with injury risk in athletes. Most commonly applied to runners, this would be represented by a running 10 miles per week and adding just 1 mile per week to progress with optimal injury mitigation (10% increase). Most often, however, progression is dictated by external influences:
An athlete might enjoy a period of decreased activity without intentional gradual progression before a new sport season starts.
A spontaneous decision to sign up for a race might pressure a runner’s progression schedule.
A coach’s “boot camp” model might emphasize significant volume above the athletes’ baselines.
Non-runners may choose to quantify their volume and intentionally progress it by 10% weekly with metrics such as minutes or hours per week, instead of weekly miles.
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ACWR: The acute-to-chronic-work-ratio (ACWR) functions similarly to the 10% rule. Acute workload (work performed in the past week) is measured against the chronic workload (work performed in the past month). Ratios over 1.2 (high acute compared to chronic/baseline) result in increased injury risk. Ratios under 0.8 may indicate relative under-training, and if not intentionally in an off-season, this may promote injury if returning to baseline too quickly later.
Finally, sports should be pain-free, full stop. “No pain, no gain,” “pain is weakness leaving the body,” “no days off,” sound so intense that they must be true, right? Yikes. Pain is your tissues’ way of telling you that damage is occurring. Its true that muscular growth, bone density increases, and other tissue adaptations cannot occur without this stress and microdamage. However, pushing through strain or playing through an injury is a quick way to make a strain turn into an injury or to make an injury worse.
Use common sense, and when that is not precise enough, consider these tools to improve your longevity in sport.
Austin Reaves enjoys more relaxed training, cross training, as well as actual rest throughout the year, separately from the NBA season.
