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Impact of youth sports specialisation on career and task-specific athletic performance: a systematic review following the American Medical Society for Sports Medicine (AMSSM) Collaborative Research Network’s 2019 Youth Early Sport Specialisation Summit
  1. Stephanie A Kliethermes1,
  2. Kyle Nagle2,
  3. Jean Côté3,
  4. Robert M Malina4,
  5. Avery Faigenbaum5,
  6. Andrew Watson6,
  7. Brian Feeley7,
  8. Stephen William Marshall8,
  9. Cynthia R LaBella9,10,
  10. Daniel C Herman11,
  11. Adam Tenforde12,
  12. Anthony I Beutler13,
  13. Neeru Jayanthi14
  1. 1 Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, USA
  2. 2 Department of Pediatrics, University of Washington, Seattle, Washington, USA
  3. 3 School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
  4. 4 Department of Kinesiology and Health Education, University of Texas, Austin, Texas, USA
  5. 5 Department of Health and Exercise Science, The College of New Jersey, Ewing, New Jersey, USA
  6. 6 Department of Orthopedics and Rehabilitation, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
  7. 7 Department of Orthopedic Surgery, University of California San Francisco, San Francisco, California, USA
  8. 8 Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  9. 9 Pediatrics, Northwestern University, Chicago, Illinois, USA
  10. 10 Pediatric Orthopedics and Sports Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
  11. 11 Department of Orthopaedics and Rehabilitation, University of Florida, College of Medicine, Gainesville, Florida, USA
  12. 12 Department of Physical Medicine and Rehabilitation, Harvard University, Boston, Massachusetts, USA
  13. 13 Family Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA
  14. 14 Orthopaedics and Family Medicine, Emory Sports Medicine Center, Johns Creek, Georgia, USA
  1. Correspondence to Dr Stephanie A Kliethermes, Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI 53706, USA; kliethermes{at}


Objective The impact, positive or negative, of youth sport specialisation (YSS) on short-term and long-term performance is not fully understood; however, the desire to maximise performance goals is generally considered the primary reason children and adolescents specialise at a young age. We performed a systematic review of original research to establish the association of YSS and task-focused or career-focused performance outcomes.

Design Systematic review.

Data sources Databases searched include PubMed, EMBASE, Cochrane, CINAHL and SPORTDiscus.

Eligibility criteria We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify peer-reviewed research articles published in English between 1 January 1990 and 31 December 2018 that reported original findings on the association of YSS and performance outcomes. Studies without an explicit measure of sport specialisation, for example, volume measures without measuring sport specialisation, were excluded.

Results Twenty-two articles were included in the final review; 15 addressed career performance outcomes and 7 considered task performance outcomes. All identified studies were cross-sectional or retrospective in design. The proportion of elite athletes who specialised early ranged between 7% and 85%, depending on sport and definition of specialisation. Elite athletes often specialised between the ages of 14 and 15 compared with their non-elite or semi-elite peers who typically specialised prior to 13 years. In addition, neuromuscular control, anterior reach asymmetry and physical task outcomes did not differ by specialisation status.

Conclusion The volume and methodological rigour of published research in this field are limited. Our review suggests that YSS is not required to achieve success at elite levels. YSS also does not appear to improve task-related performance (eg, anterior reach, neuromuscular control) outcomes for specialised athletes when compared with non-specialised athletes during childhood and adolescence.

  • sports
  • elite performance

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  • Contributors All authors contributed to the conception or design of the work. SAK and KN contributed to the data search and data abstraction. SAK, KN and NJ drafted the manuscript, and all authors critically reviewed it and agreed on final version. All authors agree to be accountable for all aspects of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any fundingagency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.