Introduction:
An athlete’s commitment to sports can involve more than one team, more than one training schedule, and more physical demands throughout the week. For youth athletes, these demands raise important questions about how training habits and sports participation relate to injury frequency. Sports-related injuries have been associated with declines in school functioning, physical functioning, and overall quality of life (Post et al., 2017; Brooks et al., 2021), making injury prevention an important concern beyond the playing field. However, the relationship between sports participation and injury frequency is worth examining more closely, particularly among athletes who participate in multiple sports compared with those who focus on one. This study examines whether weekly training hours and participation in multiple sports are associated with the frequency of bone and joint injuries among youth athletes ages 11–18. Understanding these relationships may help inform discussions about training habits and injury prevention.
Research Questions:
Are bone and joint injuries more commonly reported among youth athletes who participate in one sport compared with those who participate in multiple sports?
Methods:
This study used a survey-based design to examine the relationship between weekly training hours, multi-sports participation, and the frequency of sports-related bone and joint injuries among youth athletes. Data was collected through an anonymous Google Forms survey which received over 150 responses from athletes ages 11 to 18, grades 6 through 12. Participants were recruited primarily through in-person outreach at Summer Public School Athletic League (PSAL) practices, sports club, team practices, where athletes were approached and invited to complete the survey. The survey was also distributed through social media, messages, and personal contacts. Participants were asked to respond only if they were active athletes. A convenience sampling method was used, as participants were recruited based on their availability, and willingness to participate. Participants included student athletes on school teams, Summer Public School Athletic League, league teams, school clubs and other youth athletes in New York City.
Appendix A: Youth Athlete Injury Survey
The following survey was used to collect anonymous responses from youth athletes ages 11–18 about their sports participation, training habits, injury history, and awareness of injury prevention.
Section 1: Demographic Information
1. What is your gender?
- Female
- Male
- Other
- Prefer not to say
2. How old are you?
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
3. What grade are you currently in?
- 6th grade
- 7th grade
- 8th grade
- 9th grade
- 10th grade
- 11th grade
- 12th grade
Section 2: Sports Participation and Training
4. During the current school year, have you participated in an organized sport, such as a school team, club, or recreational league?
- Yes, a school team
- Yes, a club or recreational league
- Yes, both a school team and a club or recreational league
- No
5. Which sport or sports do you currently participate in? (Select all that apply.)
- Volleyball
- Soccer
- Track and field
- Softball
- Basketball
- Flag football
- Tennis
- Other
- I do not currently participate in organized sports
6. On average, how many hours per week do you spend practicing or training for your sport(s)?
- 1–3 hours
- 4–6 hours
- 7–9 hours
- 10 or more hours
- I do not currently practice or train
7. Which statement best describes your sports participation throughout the year?
- I participate in the same sport year-round.
- I participate in the same sport during one or more seasons, but not year-round.
- I participate in different sports during different seasons.
- I participate in multiple sports during overlapping seasons.
- I do not currently participate in organized sports.
Section 3: Warm-Up and Stretching Habits
8. How often do you complete a warm-up before practices or games?
- Always
- Often
- Sometimes
- Rarely
- Never
9. How often do you stretch before or after sports practices or games?
- Always
- Often
- Sometimes
- Rarely
- Never
10. When do you usually stretch during sports activities?
- Before activities only
- After activities only
- Both before and after activities
- I do not usually stretch
- Not sure
Section 4: Sports-Related Injury History
For the following questions, a sports-related injury means an injury that occurred during sports practice, training, or competition.
11. Have you ever experienced a sports-related injury?
- Yes
- No
- Not sure
12. In the past 12 months, how many sports-related injuries have you experienced?
- 0
- 1
- 2
- 3
- 4
- 5 or more
- Not sure
13. What type or types of sports-related injuries have you experienced? (Select all that apply.)
- Sprain
- Muscle strain
- Knee injury
- Ankle injury
- Concussion
- Fracture (broken bone)
- Other
- I have never had a sports-related injury
- Not sure what type of injury I experienced
14. Did a sports-related injury cause you to miss practices, games, or competitions?
- Yes
- No
- I have never had a sports-related injury
- Not sure
Section 5: Injury Prevention Awareness
15. Do you think completing an appropriate warm-up before sports activities can help reduce the risk of sports-related injuries?
- Yes
- No
- Not sure
16. How interested are you in learning more about preventing sports-related injuries?
- Very interested
- Somewhat interested
- Slightly interested
- Not interested
Results
A total of 152 youth athletes ages 11–18 participated in the study, consisting of 75 single-sport athletes and 77 multi-sport athletes. Among single-sport athletes, 5 (7%) reported bone injuries and 7 (9%) reported joint injuries. Among multi-sport athletes, 33 (43%) reported bone injuries and 28 (36%) reported joint injuries. Multi-sport athletes reported a range of injuries, including knee injuries, posterior cruciate ligament (PCL) and medial collateral ligament (MCL) tears, broken knee and ankle sprains, ankle and wrist fractures, muscle strains, shoulder injuries, dislocations, concussions, and other ankle and foot injuries.
When comparing weekly training hours, the training hours differed between single-sport and multi-sport athletes. Among single-sport athletes, 42 of 75 (56%) reported training 1–3 hours per week, compared with 7 of 77 (9%) multi-sport athletes. In contrast, 47 of 77 multi-sport athletes (61%) reported training 7 or more hours per week, compared with 23 of 75 single-sport athletes (31%). Additionally, 14 multi-sport athletes (18%) reported training 10 or more hours per week, compared with 3 single-sport athletes (4%). Overall, multi-sport athletes in this sample were more concentrated in the higher weekly training-hour categories.
The number of injuries reported also differed between the two groups. Among single-sport athletes, 43% reported no injuries, 28% reported one injury, 14% reported two injuries, and 15% reported three or more injuries. Among multi-sport athletes, 27% reported no injuries, 32% reported one injury, 26% reported two injuries, and 15% reported three or more injuries. Multi-sport athletes had a lower percentage of athletes reporting no injuries and a higher percentage reporting two injuries. However, the percentage reporting three or more injuries was the same in both groups.
The sport-specific analysis showed that basketball and volleyball had the highest percentages of athletes reporting bone injuries, at 52.4% and 50.0%, respectively. Soccer had the highest percentage of athletes reporting joint injuries (50.0%), followed by ice hockey (43.8%). No athletes who reported playing badminton or tennis reported bone injuries in this sample.
The analysis of missed practices or games also showed a difference between the two participation groups. Among the 12 injured single-sport athletes, 5 (41.7%) reported missing a practice or game, while 7 (58.3%) did not. Among the 61 injured multi-sport athletes, 59 (96.7%) reported missing a practice or game, while 2 (3.3%) did not.
Overall, multi-sport athletes in this sample reported more bone and joint injuries than single-sport athletes, and athletes reporting injuries also reported higher weekly training hours. A greater proportion of injured multi-sport athletes also reported missing practices or games. These findings describe patterns within the surveyed group; they do not establish that participating in multiple sports or training more hours caused injuries or increased their severity.
Discussion
This study examined whether youth athletes who participate in multiple sports report more bone and joint injuries than athletes who participate in only one sport. The results showed a noticeable difference between the two groups. Among single-sport athletes, 7% reported bone injuries and 9% reported joint injuries. Among multi-sport athletes, 43% reported bone injuries and 36% reported joint injuries. These findings suggest that injuries were reported more frequently among multi-sport athletes in this sample. However, this does not necessarily mean that playing multiple sports causes more injuries.
One possible reason for this difference is that athletes who play multiple sports may have more practices, games, and physical demands to manage throughout the week. In my survey, 61% of multi-sport athletes reported training 7 or more hours per week, compared with about 31% of single-sport athletes. They may also use the same muscles and joints repeatedly across different sports, especially if their schedules leave little time for rest. This could put additional stress on their bodies. However, the survey did not measure how much rest athletes received or identify which sport caused each injury, so these are possible explanations rather than confirmed reasons for the results. Additionally, 18% of multi-sport athletes reported training 10 or more hours per week, compared with only 4% of single-sport athletes, while 56% of single-sport athletes reported training only 1–3 hours per week, compared with 9% of multi-sport athletes.
The results also varied by sport. Basketball and volleyball had the highest percentages of reported bone injuries, while soccer had the highest percentage of reported joint injuries, followed by ice hockey. These differences could be related to the movements involved in each sport, such as jumping, landing, changing direction quickly, and physical contact. However, the survey did not directly measure these factors or confirm which sport an athlete was playing when an injury occurred. Some participants also played multiple sports, so their injury reports may overlap. For these reasons, the results show differences within this sample but do not prove that certain sports are more likely to cause injuries.
Another finding was the difference in missed practices or games between injured single-sport and multi-sport athletes. Among the injured single-sport athletes, 41.7% reported missing a practice or game. In comparison, 96.7% of injured multi-sport athletes reported missing one. This is a substantial difference in the responses. One possible explanation is that an injury could affect an athlete’s ability to participate in activities across multiple teams. However, the survey did not measure injury severity or recovery time. More information would be needed to understand why the difference was so large.
The number of injuries reported also differed between the two groups. Among single-sport athletes, 43% reported no injuries, 28% reported one injury, 14% reported two injuries, and 15% reported three or more injuries. Among multi-sport athletes, 27% reported no injuries, 32% reported one injury, 26% reported two injuries, and 15% reported three or more injuries. This suggests that multi-sport athletes in this sample were less likely to report no injuries and more likely to report two injuries. However, both groups had the same percentage of athletes reporting three or more injuries, showing that the difference was not consistent across every injury-count category.
There are several limitations to this study. The responses were self-reported, meaning that injuries were not verified through medical records. The number of athletes surveyed was different for each sport, which may affect the percentages. In addition, some athletes played multiple sports or reported more than one type of injury, so the categories were not necessarily separate. The survey also did not establish when injuries occurred in relation to training hours, how much recovery time athletes received. These limitations mean that the results can show patterns and relationships, but they cannot establish cause and effect.
Future research could build on this study by collecting more detailed information about when injuries occurred, which sport athletes were playing at the time, their weekly training schedules, and how long they needed to recover. It would also be helpful to examine rest periods between practices and competitions and whether athletes had experienced previous injuries. A larger sample and more detailed responses could help provide a clearer understanding of the relationship between sports participation, training demands, and injuries among young athletes.
Overall, the findings showed that multi-sport athletes reported higher percentages of bone and joint injuries than single-sport athletes. Athletes who reported injuries also tended to train more hours per week, and a greater percentage of injured multi-sport athletes reported missing practices or games. These findings raise important questions about the training demands placed on young athletes and the role of recovery in injury prevention. Although the study cannot determine what caused the reported injuries, it provides a starting point for further research into how young athletes can stay active while protecting their long-term health.