The prevalence of high school multi-sport participation in elite national football league athletes.

: Early youth specialization is increasingly being researched and identified as a risk factor for overuse injuries and burnout. This study aimed to characterize high school sport specialization in top National Football League (NFL) athletes and determine whether associations exist between single-sport specialization and future injury risk, performance, and longevity.: For NFL first-round draft picks from 2008-2017, data on the number of games played in the NFL, overuse injuries causing athletes to miss one or more regular season games, Pro Bowl selections, and current status in the NFL were collected using publicly available information.: A total of 318 athletes were analyzed. Multi-sport athletes were highly prevalent (88%, n = 280), while only 12% (n = 38) of athletes were classified as single-sport. No difference between multi-sport and single-sport athletes was found regarding games missed to upper (p = 0.93) or lower extremity injuries (p = 0.49), total games played (p = 0.57), or NFL longevity (p = 0.97). There was no significant difference in the proportions of athletes reaching at least 1 Pro Bowl.: The majority of NFL first-round draft picks were multi-sport athletes in high school. Single-sport football participation in high school does not appear to aid athletes in reaching or succeeding in the NFL.