Sport Specialization, Club Sport Participation, Quality of Life, and Injury History Among High School Athletes

J Athl Train. 2019 Oct;54(10):1061-1066. doi: 10.4085/1062-6050-361-18.


Context: Many factors can affect the injury risk and quality of life among high school athletes. Early sport specialization and club sport participation may be components to consider when assessing the injury risk and quality of life.

Objective: To investigate patient-reported quality-of-life and injury-history measures among adolescent athletes at different sport-specialization levels and to compare these measures between those who did and those who did not report participating in club sports.

Design: Cross-sectional study.

Setting: High school athletic facility.

Patients or other participants: High school student athletes 13 to 18 years of age were recruited and tested during their annual preseason athletic physical examinations.

Main outcome measure(s): Our primary grouping variables were sport-specialization level (classified as low, moderate, or high) and club sport participation (organized sport outside of traditional school athletics). Our outcome variables were the Patient-Reported Outcome Measurement Information System Pediatric Profile-37 rating, Severity Measure for Depression-Child score, and injury history.

Results: A total of 97 individuals participated (mean age = 15.2 ± 1.1 years; 38% female). Relatively similar proportions of individuals reported participating at each level of sport specialization (low = 34%, moderate = 40%, high = 26%). Forty-six (48%) participants stated they participated in club sports. No differences were evident in quality of life (P values = .15-.92 across domains), depression (P = .60), or injury history (P > .70) among the specialization groups. Those who described participating in club sports had a higher proportion of time-loss musculoskeletal injuries (63% versus 29%; P = .002) and of injuries requiring imaging, injection, a cast, a brace, or crutches (72% versus 46%; P = .013) than those who did not.

Conclusions: Although no injury-history differences were found among the sport-specialization groups, a higher proportion of club sport athletes than nonclub sport athletes reported a history of injury. Club sports are generally seen as more competitive, and the higher number of injuries seen in this setting could be related to a higher level of play among club sport athletes.

Keywords: PROMIS; musculoskeletal injury; pediatric sports medicine; youth sports.

MeSH terms

  • Adolescent
  • Athletes* / psychology
  • Athletes* / statistics & numerical data
  • Athletic Injuries* / epidemiology
  • Athletic Injuries* / prevention & control
  • Athletic Injuries* / psychology
  • Cross-Sectional Studies
  • Depression* / etiology
  • Depression* / physiopathology
  • Depression* / prevention & control
  • Female
  • Humans
  • Male
  • Patient Reported Outcome Measures
  • Quality of Life*
  • Risk Assessment
  • Risk Factors
  • Specialization*
  • Students* / psychology
  • Students* / statistics & numerical data
  • United States