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Engagement in athletic participation is critical for the physical and emotional well-being of pediatric and adolescent youth. Yet, changing patterns of sports participation have created multiple consequences for those involved. A trend toward single sport specialization and club sports at the expense of unstructured, recreational play has led to these changes. Youth are subject to increased injury risk as well as compromised mental health. Furthermore, disparities in access to sports are created for many who cannot afford to play, leaving many communities without access to physical activity. This drive toward sports specialization (and privatization) has been driven by the fallacy that it will lead to subsequent athletic success at the collegiate and professional level, a notion that health care providers must help to dispel.