Early Sport Specialization Impact on Rates of Injury in Collegiate and Professional Sport Participation: A Systematic Review and Meta-analysis

Early sport specialization (ESS) is common among adolescent athletes due to desire of reaching elite status; however, the long-term impact of ESS on sports injury (SI) rates is not fully understood. We performed a systematic review and meta-analysis of the literature to evaluate the effect of ESS on SI rates during elite sport participation. Search included PubMed, Web of Science, SPORTDiscus, EMBASE, Cochrane, CINAHL, ERIC, and Medline databases. Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) guidelines were followed to identify published peer-reviewed articles from inception to 23 March 2023. Eligible studies reported numbers of elite athletes in collegiate, national, and professional teams in ESS and their counterpart category, as well as the portion of each group with at least one SI. Studies on concussion or non-contact injuries, or without explicit injury reports during elite sprot participation were excluded. Five articles were included in the review; 3 reported SIs on collegiate and 2 reported on professional athletes. A total of 3087 athletes were included (ESS = 45%). The overall effect was not significant and demonstrated that ESS athletes had a lower odd (OR=0.7) of a SI during elite sport participation. Articles with clear reports are scarce, and thus limit the impact of the findings in this study. High heterogeneity was evident in this analysis, largely due to lack of standardized terminology, evaluation, and data representation. Prospective studies that consider diverse athlete population of the same sport are warranted.