Injury Risk Factors Related to Sport Specialization in High School Basketball: A Prospective Study

Context: Research that has examined the association between specialization and injury in basketball has been limited to cross-sectional or retrospective studies.

Objective: To determine whether specialization is a risk factor for injury among high school basketball athletes.

Design: Prospective cohort study.

Setting: Basketball players from 12 high schools participating in the National Athletic Treatment, Injury, and Outcomes Network Surveillance Program (NATION-SP) were recruited before the 2022-2023 interscholastic basketball season.

Patients or other participants: One-hundred thirty athletes (mean age ± SD = 15.6 ± 1.3; girls' basketball: n = 68 [52.3%]).

Main outcome measure(s): Before the start of the school basketball season, participants completed a questionnaire that had questions regarding participation in various specialized sport behaviors. During the basketball season, the school's athletic trainer reported all athlete-exposures and injuries (regardless of time loss) for participating athletes into NATION-SP. Injury incidence and incidence rate ratios (IRRs) with 95% CIs were calculated for the specialized sport behaviors previously described.

Results: No difference in injury risk between highly specialized and low specialized athletes was found (IRR [95% CI] = 1.9 [0.9, 3.7]). Players who participated in basketball year round were twice as likely to sustain an injury than those who did not play year round (IRR [95% CI] = 2.1 [1.1, 3.6]). Similarly, players who reported participating in basketball skills camps were at increased risk of injury compared with athletes who did not participate in basketball skill camps (IRR [95% CI] = 2.5 [1.2, 5.7]).

Conclusions: Injury risk related to sport specialization in basketball may be specific to certain behaviors such as year-round play and participation in skills camps. Validated measures of comprehensive sport activity are needed to better measure specialization in youth sports to better determine injury risk related to sport specialization and develop injury prevention programs for basketball athletes.