2021 ISAKOS Biennial Congress Paper
High Specialization Among Female Youth Soccer Players Is Associated with an Increased Likelihood of Serious Injury: A Cross-Sectional Study Of Youth, College, and Professional Soccer Athletes
Michelle Xiao, BS, Stanford, CA UNITED STATES
Jacie L Lemos, BS, Stanford, CA UNITED STATES
Calvin E Hwang, MD, Stanford, CA UNITED STATES
Seth L. Sherman, MD, Redwood City, California UNITED STATES
Marc R. Safran, MD, Prof., Redwood City, CA UNITED STATES
Geoffrey D. Abrams, MD, Stanford, CA UNITED STATES
Stanford University, Stanford, California, UNITED STATES
FDA Status Not Applicable
Summary
High specialization in female youth soccer players is associated with an increased likelihood of sustaining a serious injury.
Abstract
Introduction
Sport specialization is increasingly common for youth athletes and can contribute to a higher likelihood of injury. Few studies have examined injuries as it relates to sport specialization in high-level female soccer players. The purpose of this study was to assess the associations between serious injury (> 3-month time loss) and level of specialization among high-level female soccer players and to compare the specialization and college commitment ages of female youth soccer players to Division I college and professional soccer athletes.
Methods
Youth, college, and professional female soccer players in the United States playing in the top league at each level were recruited to complete an anonymous online survey. The survey collected information about player demographics, soccer specialization and training patterns, history of serious injuries from soccer (defined as sidelining a player for three months or more), and perceptions surrounding soccer specialization. Descriptive summaries were presented for demographic data. Data from Division I and professional athletes were combined for analysis. Comparisons between groups were performed using 2-sample t-tests, chi-squared analyses, and binary logistic regression models controlling for differences in age. A p-value of less than 0.05 was set as significant.
Results
A total of 1,018 (767 youth, 251 college/professional) athletes completed the survey. Serious injuries affected 23.6% of youth and 51.4% of college/professional athletes. Anterior cruciate ligament (ACL) tears were the most common injury subgroup and were more prevalent in college/professional players compared to youth athletes (18.3% vs 4.0%; p < 0.001). Highly specialized youth athletes (66.5%) were more likely to have sustained a serious injury from soccer compared to athletes with low specialization (OR = 2.28 [1.38-3.92]; p=0.008) but not moderate specialization (OR = 1.37 [0.83-2.27]; p=0.43). Current youth soccer players started playing competitive soccer (7.4 + 2.2 vs 8.6 + 2.5 years; p < 0.001) and committed to play college soccer (15.3 + 1.6 vs 16.2 + 1.2 years; p < 0.001) at a younger age compared to college/professional athletes. A higher proportion of youth athletes specialized at a young age (< 10 years) compared to college/professional players (44.2% vs 25.9%; p < 0.001).
Conclusion
High specialization in female youth soccer players is associated with an increased likelihood of sustaining a serious injury. Current youth soccer players are specializing earlier and committing to play college soccer at a younger age compared to when current college and professional players did.