Wealthier Athletes Get More Overuse Injuries

More money, more problems

Children from wealthier families might get the short end of the lacrosse stick when it comes to overuse injuries.     Photo: Paul Vasarhelyi/Thinkstock

Young athletes who comes from higher-income families are more likely to suffer from overuse injuries, according to new research from the Loyola University Medical Center. The same athletes are also twice as likely to specialize in one sport.

The study explains this link using health insurance data. Athletes ranging from ages seven to 18 whose families have private health insurance suffer from serious overuse injuries (defined as ailments that force them to the sidelines for six months or longer) 68 percent more often than their lower-income counterparts who are covered by Medicaid.

"Intense specialization in one sport can cost thousands of dollars a year," said Neeru Jayanthi, one of the study's authors. "Having the financial resources to afford such costs may provide increased opportunities for young athletes to participate in a single sport."

Previous research has linked specialization to higher rates of overuse injury, but the new study confirms the economic aspect.

"Young athletes with this type of training appear to be at greater risk for serious overuse injuries than those who have fewer financial resources," said Lara Dugas, another study author.

Publicly and privately insured athletes alike spend about 10 hours per week playing organized sports, but 30 percent of privately insured athletes are highly specialized in a single sport, compared to 18 percent of publicly insured athletes. Only 8 percent of publicly insured athletes surveyed suffered serious overuse injuries; 13 percent of privately insured athletes suffered the same type of injuries.

The study's authors think time spent doing unstructured physical activities—such as pickup basketball games—could have something to do with it. Publicly insured athletes spent 7.1 hours per week doing such activities, compared to about 5.2 hours per week among privately insured athletes. The study's authors say more unstructured physical activity could reduce the risk of overuse injuries but caution that further research is needed to confirm that hypothesis.

For now, young athletes should consider Jayanthi's evidence-based advice to reduce the risk of overuse injuries:

  • Participate in as much unstructured free play as possible, and avoid spending more than twice as much time playing organized sports as unstructured ones.
  • Use age as a rule of thumb when determining how many hours to play sports per week. A 10-year-old should spend a maximum of 10 hours per week playing sports, while a 12-year-old could play sports two hours more per week, and so on.
  • Take a day off every week from training, and take one to three months off per year.
  • Avoid specializing in a single sport until late adolescence.

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