Editor's note - this is part three of a three-part release from the Pennsylvania Medical Society.

The start of a new school year in the Keystone State means a new PIAA fall sports season is here.

With plenty of energy after a summer of training, student-athletes and coaches are eager to hit the fields and courts for official practices, while fans start to make plans for Friday Night Lights.

The fall months are an exciting time for those who enjoy sports whether you're a football, soccer, tennis, golf, volleyball, or cross country student-athlete, parent, or fan. There's so much to look forward to.

Of course, there are always concerns too. Concussions happen. Bones break. ACLs tear. And on a very rare occasion an athlete has an issue with their heart.

To help ease some of these concerns, Pennsylvania state law strongly supported by Pennsylvania physicians requires all high school coaches pass tests related to concussion management and sudden cardiac arrest. And leading up to each season – fall, winter, and spring – coaches across Pennsylvania prepare themselves for the worst through mandatory online education on these subjects.

ACL injuries

Physicians are quick to point out that within the sports world, there are many types of injuries that can occur, and state laws aren't able to cover them all. Trainers, coaches, players, and parents need to pay close attention on the field to other potential health risks.

One such area of growing concern in recent years is anterior cruciate ligament (ACL) injuries.

According to an April 2014 study published in Pediatrics, the official journal of the American Academy of Pediatrics, the number of ACL injuries reported in athletes under the age of 18 has been increasing during the past two decades. One reason for this increase is because of intensive sports training at an earlier age.

"Because of hyper specialization, more children are becoming focused on a single sport at an earlier age," says Josh Williamson, MD, FAAP, a pediatrician and sports medicine physician of the Pennsylvania Chapter of the American Academy of Pediatrics. "That's not good for the overall development of the child."

Dr. Williamson says that parents sometimes believe their child will have a better shot at getting a full-ride to college on an athletic scholarship and thus believe they must specialize at a very early age. But, he adds, that concept doesn't hold true and they may be doing more harm than good.

"It's best to diversify your child's sports," says Dr. Williamson. "They need overall development, and early specialization actually may lead to injuries and burnout."

Reports from the American Medical Society for Sports Medicine support Dr. Williamson's point. In a UCLA sports specialization study, 88 percent of NCAA Division I athletes at the school played two or three sports as children. The majority of those athletes did not specialize until after age 12.

Other studies point out that those who specialize too young may increase their risk to injuries.

With ACL injuries becoming more common, athletes playing certain sports may be at greater risk.

Pediatrics, quoting data from the National High School Sports-related Injury Surveillance Study, says the sports with the highest rate of ACL injuries for high school athletes are girls soccer, boys football, girls basketball, girls gymnastics, and boys lacrosse.

"The top two high school sports for ACL injuries – girls soccer and boys football – are fall sports in Pennsylvania," says Dr. Williamson, who practices in Pottstown. "Research shows that neuromuscular training may help prevent some ACL injuries, so coaches and athletes should incorporate that type of training into their preseason and season drills."

Press release provided by Pennsylvania Medical Society