RICHMOND, Va. (March 11, 2026) - In one of the first prospective studies of youth soccer athletes, ECNL Chief Medical Advisor Dr. Drew Watson recently published research surrounding sports specialization and injury risk. In this study, Watson did not find any statistical significance in regards to injury risk between those athletes who specialize in soccer and those who play multiple sports.
"Perhaps no topic in youth sports has received more attention in the last decade than specialization," Watson said. "Understanding how specialization is related to health outcomes has important implications for athletes and families as they attempt to navigate the youth sports landscape. To date, soccer-specific information about specialization and injury risk has been lacking, making it hard for families to balance the powerful physical and mental health benefits of sports against any potential risks to their young players. Our hope is that this work will help provide additional information for players and families when making decisions about how to pursue their goals within youth soccer."
The study followed 80 U13 to U18 female athletes from a single club during two competitive seasons, collecting preseason fitness testing data, daily training load and recording any time-loss injuries throughout the study period. The study then compared the injury incidence between athletes who only participated in soccer (specialized) to those who participated in other sports during other parts of the year (not specialized), while controlling for in-season training load.
The study found no differences between the groups with respect to preseason fitness or in-season training load. It found no difference in the proportion of the specialized and not specialized athletes that had an injury during the study, and after adjusting for training load, it found no difference in injury incidence between the two groups. While this is a relatively small study, it suggests that if there is an association between specialization and injury among youth soccer players, it is not sufficiently strong to result in a detectable difference among multiple girls age groups during two consecutive years.
The relationship between specialization and injury is likely different for different sports and this is one of the few studies of specialization and soccer specifically. Prior research has typically aggregated multiple sports together, making it difficult to know how it applies to different sports and genders. In addition, prior research has primarily found that specialization increases the risk of chronic, lower extremity overuse injuries, which were only a small subset of the injuries identified in this study. This may be due to the fact that movement patterns in soccer are very heterogeneous and may not lead to the same repetitive stresses that are thought to at least partly explain the association between specialization and overuse injuries in sports more broadly. Further sport-specific, well-controlled, prospective research is needed to better define the impacts of specialization for young athletes.
"Decisions about sport participation are complex, highly individualized and based on a lot of different circumstances and factors," Watson said. "The impact of specialization is just one of those factors to be considered as athletes and families figure out how to best access the powerful benefits of sports."
The ECNL Center for Athlete Health and Performance launched in March 2025 to identify, develop and share best practices in long-term youth athlete health, development and performance. The ECNL Center for Athlete Health and Performance provides compilations of the most applicable research from around the world on topics relevant to youth athletes, as well as evidence derived from research projects within the ECNL conducted in collaboration with Dr. Watson's Human Performance Laboratory at the University of Wisconsin.
The CAHP will continue to conduct research, disseminate evidence, and offer recommendations on a wide range of high-yield topics relevant to youth athletes, coaches, and families, including mental health, injury and illness risk and prevention, load management, pediatric exercise physiology, sport nutrition, and more.
For more information regarding the ECNL Center for Athlete Health and Performance, click here.
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About the ECNL:
The ECNL is the nation's leading youth soccer development platform for America's top soccer players. The ECNL mission to provide the best youth sports experience in the world drives constant innovations in competitions and experiences for players, parents, families, coaches, referees, and partners. The ECNL has questioned convention and challenged the status quo of youth sport since 2009, pushing boundaries and striving for unmatched excellence. Together with its clubs and club leaders, the ECNL creates unforgettable memories and supports the development of youth players into college stars, professionals, world champions, and leaders.
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