your child should specialize in one sport 👦


"Well that's just like your opinion, man."
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-The Big Lebowski


Early in my career, I treated a 12-year-old baseball pitcher with shoulder pain.
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The diagnosis? A stress reaction in the humerus and a rotator cuff tear.
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An injury typically seen in older adults was present in a young, growing child.

In talking with the patient's mother, it became clear how crucial it was for their child to return to pitching ASAP. What should have been an honest moment of self-reflection instead focused on the urgency to get a pre-teen back for an upcoming showcase tournament.

If you work in a sports clinic, you see countless examples like my patient.

​​Sugimoto​ defines sports specialization as,

"Intentional and focused participation in a single sport for a majority of the year that restricts opportunities for engagement in other sports and activities."

Over the last decade, it has been common for researchers, podcasters, and social media personalities to preach the need for movement variability and the importance of diversity in athletic endeavors.

Runners are now advised that participating in sports like soccer and basketball can lead to stronger, denser skeletons that are less likely to break, as shown in the following studies.

You can improve bone strength and health at any age, but there's less of a return on investment once you graduate high school.

A theoretical "window of opportunity" during pre- and early-puberty exists where bones adapt to mechanical stimuli, highlighted by how tennis players' dominant arms adapt depending on when they participated in the sport ⬇️.

There is an assumption made in these studies: that we still have an opportunity to change a patient's athletic choices.

It's rare for me to treat a patient younger than high school, meaning the biggest opportunity to improve their bone health is almost closed. I can still get them lifting, jumping, and optimizing their nutrition, but the biggest chance for improved bone health is closing.
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This research is informative, but may lack a bit of practicality with when we typically engage with adolescent athletes.

The cost of a million activities

Encouraging movement variety is a good idea for any human at any age, but we often fail to acknowledge that adding more can tip the scales in the wrong direction.

Playing multiple sports means more money, time, and energy to athletic endeavors.

The athlete who plays competitive soccer and runs on a year-round track team may be benefiting from a movement perspective while also being overbooked, underfueled, and having their life viewed through the lens of athletic potential versus simply being a kid.

Outside of sports, many high school athletes I consult have high academic loads, are involved in school, church, or community programs, and still have a social life.
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Most kids already have too much on their plate.

Parents are the real problem

If the parents don't get caught in the specialization trap, they get snagged by the optimization trap that was hiding in the bushes.

I've met many parents who were a positive influence on their child's athletic experience, with just as many who were a massive roadblock in their child's development.

Years ago, I was consulting a young, gifted runner whose parents wanted them to lift with me. They had a successful start to their high school career and had aspirations of a professional running career. Here was their schedule when they booked their assessment.

  • Running for their high school coach
  • Additional running from an online coach
  • Three sessions of pilates a week
  • Five hours a week of dance
  • Attending high school
  • Growing into an adult human

Every one of those bullets is a "positive" thing to include. But where is there space to add in lifting? And where is there space for a life outside of all of this? And how on earth is a high school kid going to be able to eat enough food to cover that energy expenditure?

This is a typical schedule I see when consulting high school runners every week.

The real solution

If a young athlete (and their family) have the time, energy, and resources to play another sport or get in the weight room, they should do it. But often what young athletes need is the opposite of what their parents, peers, and social feed tell them.

They need "nothing". Every week should have a block for "nothing". Most kids would benefit from more space, boredom, and time allocated to nothing productive.

99% of adolescent athletes will not play their sport past high school. Let's not destroy their relationship with movement and life in the process.

NEW LIVE COURSE 👇

For the first time, Chris Johnson and I are teaming up with Becca McConville for a two-day course in Kansas City.

The weekend will focus on the practical aspects of evaluating and treating runners, with Becca providing the essentials on nutrition, bloodwork, and the health aspects of patient care.

To learn more about the course, click HERE.

Have a question about the course?
Reply to this email.

Ethiopia Roast by
​Elixr Coffee​

Thanks for spending a few minutes with me.
Have a great rest of your weekend.

-Nathan Carlson PT, DPT


600 1st Ave, Ste 330 PMB 92768, Seattle, WA 98104-2246
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Nathan Carlson PT, DPT

I share helpful tips on treating running injuries and growing a niche practice.

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