Abstract
BACKGROUND: Associations of youth sport participation patterns, health, and social-environmental factors with subsequent participation in the National Basketball Association (NBA) have not been investigated systematically. Prior studies suggest that high-performing athletes who achieve the world-class level of adult sport engaged in less organized training in their primary sport, participated in more multisport practice and competition, and incurred fewer injuries as youths compared with lower-performing adult national-class athletes. HYPOTHESIS: Players who sign an NBA player contract engaged in less organized basketball, demonstrated more multisport practice, and incurred fewer injuries as youth athletes compared with non-NBA peers. STUDY DESIGN: Cross-sectional study. LEVEL OF EVIDENCE: Level 4. METHODS: Top-ranked male high school basketball players (n = 627, 16.6 ± 1.3 years old) attending invitational events in the United States in 2018 and 2019 completed a questionnaire regarding participation in coach-led and nonorganized basketball and other sports, injuries, academic progress, residence relocation, and scholarship or funding. Of this sample, 40 (6%) signed an NBA player contract by age 22 years. These 40 players were matched by age, birth month, playing position, and national youth player ranking with 40 peers who did not reach the NBA. Matched-pairs analyses included χ(2), unpaired t tests, U tests, and binary-logistic regression (BLR). RESULTS: Youth athletes who later became NBA players reported more organized participation in sports other than basketball until age 14 years (90.0% vs 52.5%), began playing on select teams and focusing exclusively on basketball at older ages (10.7 ± 2.4 vs 9.1 ± 2.5 and 12.9 ± 2.2 vs 9.6 ± 2.5 years), and spent less time in organized and nonorganized basketball than matched non-NBA peers. NBA players also reported fewer severe injuries at ≥14 years (25.0% vs 47.5%) and were less likely to stay back in school, relocate residence, and receive scholarships/funding, respectively. BLR correctly classified 85.0% of NBA and non-NBA players. CONCLUSION: Participation in approximately 2 other sports, later specialization, less coach-led and nonorganized basketball, fewer injuries, and less disruption to academic and home life were characteristic of top-ranked youth players who later played in the NBA. CLINICAL RELEVANCE: This is the first study to investigate youth basketball participation patterns associated with reaching the NBA among top-ranked U.S. high school basketball players.