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. 2024 May-Jun;16(3):327-332.
doi: 10.1177/19417381231171356. Epub 2023 May 3.

Results of a National Survey on Sport Specialization Behavior and Throwing Arm Injury in Youth Softball Players

Aaron Lear  1 , Anne Marie Zeller  2 , Suzy McNulty  3 , Brett Bentley  4 , Eric Post  5
Affiliations

Results of a National Survey on Sport Specialization Behavior and Throwing Arm Injury in Youth Softball Players

Aaron Lear et al. Sports Health. 2024 May-Jun.

Abstract

Background: There are few data on throwing arm and shoulder injury in youth softball athletes, and no data on the influence of sport specialization on injury in softball.

Hypothesis: We hypothesized that highly specialized athletes, and pitchers in particular, demonstrating various sport specialization behaviors would be more likely to report an upper extremity overuse injury in the previous 12 months.

Study design: Cross-sectional survey.

Level of evidence: Level 4.

Methods: An online, anonymous, cross-sectional survey was distributed to a national sample of female youth softball players between the ages of 12 and 18 years in fall 2021. Topics included were indicators of sport specialization and self-reported injuries to the throwing arm.

Results: A total of 1309 participants (mean age, 15.1 ± 1.7 years) completed the survey; 19.4% (N = 254) scored as highly specialized, 69.7% (N = 912) as moderately specialized, and 10.9% (N = 143) with low specialization. Of all participants, 27.3% (N = 357) pitched in the previous year. A minority of all players (43.7%; N = 572) reported arm injury in the previous 12 months, with 45.9% of pitchers (N = 164) reporting the same. Multivariate regression showed increased adjusted odds ratio (aOR) of injury history for athletes playing >30 games per year (aOR, 1.74; 95% CI, 1.26-2.40), participating on a club team (aOR, 3.36; 95% CI,1.85-6.07), and in pitchers participating on club teams (aOR, 2.97; 95% CI, 1.18-7.45). Decreased aOR of injury was noted in those participating in >8 months of softball per year (aOR, 0.25; 95% CI, 0.12-0.51) and in pitchers who were moderately specialized (aOR, 0.39; 95% CI, 0.17-0.92) and playing >8 months per year (aOR, 0.33; 95% CI, 0.11-0.96).

Conclusion: This sample provides a large proportion of athletes classified as high or moderately specialized in youth softball (89%). A large proportion (43.7%) of subjects reported arm injury in the past year, and insight into injury risk is provided. The results present conflicting data on the risk versus protective effect of specialization in youth softball athletes.

Clinical relevance: This project is a first step toward understanding sport specialization behavior and its influence on injury in youth softball.

Keywords: softball; sport specialization; throwing arm.

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Conflict of interest statement

The authors report no potential conflicts of interest in the development and publication of this article.The authors received grant support from the American Medical Society in Sports Medicine.

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