title: Sports Specialization, Part II: Alternative Solutions to Early Sport Specialization in Youth Athletes.
abstract: BACKGROUND
  Many coaches, parents, and children believe that the best way to develop elite athletes is for them to participate in only 1 sport from an early age and to play it year-round. However, emerging evidence to the contrary indicates that efforts to specialize in 1 sport may reduce opportunities for all children to participate in a diverse year-round sports season and can lead to lost development of lifetime sports skills. Early sports specialization may also reduce motor skill development and ongoing participation in games and sports as a lifestyle choice. The purpose of this review is to employ the current literature to provide evidence-based alternative strategies that may help to optimize opportunities for all aspiring young athletes to maximize their health, fitness, and sports performance.
  
  
  METHODS
  Nonsystematic review with critical appraisal of existing literature.
  
  
  METHODS
  Clinical review.
  
  
  METHODS
  Level 4.
  
  
  CONCLUSIONS
  Based on the current evidence, parents and educators should help provide opportunities for free unstructured play to improve motor skill development and youth should be encouraged to participate in a variety of sports during their growing years to influence the development of diverse motor skills. For those children who do choose to specialize in a single sport, periods of intense training and specialized sport activities should be closely monitored for indicators of burnout, overuse injury, or potential decrements in performance due to overtraining. Last, the evidence indicates that all youth should be involved in periodized strength and conditioning (eg, integrative neuromuscular training) to help them prepare for the demands of competitive sport participation, and youth who specialize in a single sport should plan periods of isolated and focused integrative neuromuscular training to enhance diverse motor skill development and reduce injury risk factors.
  B.
authors.affiliation: Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio The Sports Health and Performance Institute, OSU Sports Medicine, Ohio State University Medical Center, Columbus, Ohio The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts greg.myer@cchmc.org.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Myer
authors.affiliation: Department of Orthopaedics, Emory University, Atlanta, Georgia Department of Family Medicine, Emory University, Atlanta, Georgia.
authors.forename: Neeru
authors.initials: N
authors.lastname: Jayanthi
authors.affiliation: Division of Sports Medicine and Nonoperative Orthopaedics, Departments of Family Medicine and Orthopaedics, University of California, Los Angeles, California.
authors.forename: John P
authors.initials: JP
authors.lastname: DiFiori
authors.affiliation: The College of New Jersey, Ewing, New Jersey.
authors.forename: Avery D
authors.initials: AD
authors.lastname: Faigenbaum
authors.affiliation: Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio Center for Cognition, Action, and Perception, Department of Psychology, University of Cincinnati, Cincinnati, Ohio.
authors.forename: Adam W
authors.initials: AW
authors.lastname: Kiefer
authors.affiliation: Department of Physical Therapy, University of the Sciences, Philadelphia, Pennsylvania.
authors.forename: David
authors.initials: D
authors.lastname: Logerstedt
authors.affiliation: The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts Division of Sports Medicine, Department of Orthopaedics, Boston Children's Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts.
authors.forename: Lyle J
authors.initials: LJ
authors.lastname: Micheli
mesh_terms: D000293:Adolescent; D000367:Age Factors; D056352:Athletes; D001265:Athletic Injuries / Q000209:etiology / Q000517:prevention & control*; D054874:Athletic Performance; D002648:Child; D002675:Child, Preschool; D003163:Competitive Behavior; D012090:Cumulative Trauma Disorders / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D009048:Motor Skills; D010806:Physical Education and Training / Q000379:methods; D012307:Risk Factors; D013177:Sports; D013315:Stress, Psychological
keywords: athletic performance; injury prevention; neuromuscular training; youth sports