Context: Sport specialization during adolescence may affect future injury risk. This association has been demonstrated in some professional sports athletes.

Objective: Determine the association between adolescent sport specialization levels in high school and injuries sustained during collegiate club sports.

Design: Cross-sectional study.

Setting: Paper and online surveys.

Patients: Collegiate club sport athletes.

Intervention: An anonymous survey was administered from September 2019–May 2020. The survey included sport specialization classification via commonly used 3-point scale (Low, Moderate, High) for each high school year (9th–12th), high school sports participation, and collegiate club sport injury history. The number of years an individual was highly specialized in high school was calculated (0–4 years). Individuals who participated in the same sport in high school and college were compared to individuals who were playing a different sport in college than their high school sports.

Main Outcome Measures: An injury related to sport club activities and classified as arising from a contact, non-contact, or overuse mechanism that required the individual to seek medical treatment or diagnosis. Injuries were classified into overuse and acute injury mechanisms for the upper and lower extremity, (UE and LE respectively) and head/neck.

Results: Single sport participation or number of years highly specialized in high school sport were not associated with college club sport injuries (p>0.1). Individuals who played a different collegiate club sport than their high school sports were more likely to report a LE and head/neck acute injury compared to athletes who played the same collegiate and high school sport (LE=20% vs 8%, χ2=7.4 p=0.006; head/neck=16% vs 3%, χ2=19.4 p<0.001).

Conclusions: Adolescent sport specialization was not associated with reported club sport injuries in collegiate club sport athletes. Collegiate club sport athletic trainers should be aware that incoming students exploring a new sport may be at risk for LE and head/neck acute injuries.

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