Overuse injuries, sports specialization rates seen more often in athletes of high socioeconomic status

During a media webcast from the American Academy of Orthopaedic Surgeons and the American Orthopaedic Society for Sports Medicine, a presenter discussed the impact of socioeconomic status on sports specialization and risk of injury in young athletes from the Chicago metropolitan area.

“We feel this is the first study to report in young Chicagoland athletes that as socioeconomic status increases, the likelihood of sport specialization increases and [they are] more likely to do individual sports but also to have more serious overuse injuries,” Neeru A. Jayanthi, MD, said during his presentation. “However, it’s interesting those of lower economic status, those kids have more physical activity and, as a result, more free play. So perhaps, free play is protective of overuse injury and may play a vital role in a young athlete’s life.”

High vs low socioeconomic status

According to their study published in Sports Health, Jayanthi and colleagues evaluated 1,200 young athletes from two academic health systems. Athletes completed a survey on training patterns. Investigators collected injury data from electronic medical records. Date included ZIP codes, race and health insurance type. Socioeconomic status was determined from ZIP codes, and athletes were stratified as low, medium or high socioeconomic status. Association among risk factors and injuries was determined with analysis of variance and multivariate regression.

Difference in free play

Athletes with public health insurance tended to start competitive sports later and their training patterns demonstrated that they had more physical activity and free play which resulted in a higher sports-training ratio.

“When we look at this a bit more closely, when we look at insurance type and socioeconomic status, we find that lower socioeconomic-status kids actually have more physical activity, about 20 hours a week, vs. those of higher socioeconomic status,” Jayanthi said. “Where does that difference come from? It comes from free play, from not having other coachers or parents tell you where to play and how to play it.”

Jayanthi said athletes with the highest socioeconomic status had the highest rate of sports specialization compared to athletes with the lowest socioeconomic status, who had the lowest rate of sports specialization. Athletes with high socioeconomic status trained more for competitive organized sports, at a mean of 8 to 10 months, compared to those with low economic status. Greater rates of overuse injuries were seen in athletes with higher socioeconomic status.

As the socioeconomic status increased, the proportion of athletes with greater than a 2 to 1 ratio of weekly hours of organized sport to free play increased.

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Jayanthi said those of lower socioeconomic status should be allowed more access to sports, as this could lead to safer training patterns.

“Sports are meant to be fun and so if we can do more things to encourage kids to have more fun in sports, I think we will have more success in getting all kids to be physically active and also involved in sports,” Jayanthi said. – by Monica Jaramillo

References:

Jayanthi N A . The fall forecast – Settling the youth sport safety score: From gender differences to sports specialization and what parents, coaches and athletes need to know. Webcasted on July 24, 2018.

Jayanthi NA, et al. Sports Health. 2018;doi:10.1177/1941738118778510.

orthoinfo.aaos.org/en/staying-healthy/onesportinjury/

Disclosure: Jayanthi reports no relevant financial disclosures.