Journal
JOURNAL OF SPORT REHABILITATION
Volume 24, Issue 1, Pages 31-35Publisher
HUMAN KINETICS PUBL INC
DOI: 10.1123/jsr.2013-0101
Keywords
knee injury; patellofemoral pain; sport injury
Categories
Funding
- National Institutes of Health [R01-AR049735, R01-AR055563, R21-AR065068]
- NFL Charities
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Objectives: To determine if sport specialization increases the risk of anterior knee pain in adolescent female athletes. Design: Retrospective cohort epidemiology study. Methods: Female basketball, soccer, and volleyball players (N = 546) were recruited from a single county public school district in Kentucky consisting of 5 middle schools and 4 high schools. A total of 357 multisport and 189 single-sport (66 basketball, 57 soccer, and 66 volleyball) athlete subjects were included due to their diagnosis of patellofemoral pain (PFP) on physical exam. Testing consisted of a standardized history and physician-administered physical examination to determine the presence of PFP. This study compared self-reported multisport athletes with sport-specialized athletes participating in only 1 sport. The sports-participation data were normalized by sport season, with each sport accounting for 1 season of exposure. Incidence rate ratios and 95% confidence intervals (CI) were calculated and used to determine significant differences between athletes who specialized in sport in early youth and multisport athletes. Results: Specialization in a single sport increased the relative risk of PFP incidence 1.5-fold (95% CI 1.0-2.2, P = .038) for cumulative PFP diagnoses. Specific diagnoses such as Sinding Larsen Johansson/patellar tendinopathy (95% CI 1.5-10.1, P =.005) and Osgood Schlatter disease (95% CI 1.5-10.1, P =.005) demonstrated a 4-fold greater relative risk in single-sport compared with multisport athletes. Incidence of other specific PFP diagnoses such as fat pad, plica, trauma, pes anserine bursitis, and iliotibial-band tendonitis was not different between single-sport and multisport participants (P>.05). Conclusion: Early sport specialization in female adolescents is associated with increased risk of anterior knee-pain disorders including PFP, Osgood Schlatter, Sinding Larsen-Johansson compared with multisport athletes.
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