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Updated: Feb 4, 2026

A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
Relationship Between Sport Specialization and Short-Term Health-Related Quality of Life in Youth Athletes After
Daniel Stover1, Rajiv Verma2, Emily DeMaio3
1Ann and Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Background:
Researchers have examined associations between sport specialization and injury. However, no studies have investigated associations between sport specialization and health-related quality of life (HRQoL) after injury.
Hypothesis:
Among injured youth athletes, level of sport specialization is not associated with differences in HRQoL approximately 1 month after sport-related injury.
Study Design:
Cross-sectional study.
Level Of Evidence:
Level 4.
Methods:
A multicenter, cross-sectional study was performed at 3 primary care sports medicine clinics. Eligible 8- to 18-year-old athletes who presented for musculoskeletal injury or concussion were enrolled. At the initial clinic visit, patients completed the Player Development Survey (PDS) to determine sport specialization level. Approximately 1 month after enrollment, patients completed the Patient-Reported Outcomes Measurement Information System (PROMIS) to determine HRQoL measures.
Results:
Of 720 athletes invited to participate, 336 (age, 14.2 ± 2.4 years) completed the PDS and PROMIS surveys; 22% were highly specialized, 39% were moderately specialized, and 39% were low specialized athletes. Overall, there were no differences in HRQoL scores across the 3 levels of sport specialization. In subgroup analysis based on sex, female HRQoL scores were worse than male HRQoL scores irrespective of sport specialization level in 3 categories: pain interference (mean difference between female and male scores [± SEM] = 2.3 ± 1.1; P = 0.04), depression/sadness (2.9 ± 1.1; P = 0.01), and anxiety/fear (2.8 ± 1.2; P = 0.02).
Conclusion:
Higher level of sport specialization is not associated with worse HRQoL approximately 1 month after sport-related injury. Female athletes have worse short-term HRQoL after an injury irrespective of sport specialization level. While sex differences were statistically significant, the magnitude of differences was small.
Clinical Relevance:
Sport specialization is not associated with differences in HRQoL after injury. Injured female athletes may need closer monitoring due to possibly worse short-term HRQoL, but further investigation is needed.
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