Specializing in a sport may sound appealing to ambitious young athletes and parents, but the future risks to physical and mental health are significant, based on new data from approximately 1000 individuals presented at the American Academy of Orthopaedic Surgeons 2026 Annual Meeting.

Young athletes are often under pressure to specialize in a single sport at an early age, lead author Michael C. Willey, MD, an orthopedic surgeon at the University of Iowa in Iowa City, Iowa, told Medscape Medical News. “In our Young Adult Hip Clinic at the University of Iowa, we often see teenagers with hip problems, including hip impingement and hip dysplasia,” he said. These injuries may occur from excessive participation in sports involving power motion (such as weight lifting or football), cutting motion (such as basketball or soccer), or high hip motion (such as dance or gymnastics), he explained. 

“For this study, we wanted to assess the impact of sports specialization during hip development (age, 8-14 years) on future hip injury and need for treatment,” Willey said. 

The researchers surveyed 1018 college students (73.6% female) aged 18-22 years from five different universities. The participants answered questions about their sports participation and specialization between the ages of 8 and 14 years, as well as about their injuries. The International Hip Outcome Tool (iHOT) was used to assess hip pain and function.

More than one third of participants reported specializing in a single sport between the ages of 8 and 14 years. The most common single sports were baseball/softball, basketball, soccer, track/cross country, and volleyball.

The researchers found that hip and groin pain were significantly more common in early specializers than in those who did not focus on a single sport (62.7% vs 53.3%; P = .0035). Of those who reported hip or groin pain, surgery for hip treatment was significantly more likely in the early specializers (21.3% vs 12.4%; P = .0328), and 39 participants reported hip arthroscopy. In addition, a significantly greater proportion of early specializers reported quitting their primary sport because of injury (68.0% vs 55.4%; P < .0001).

When the researchers analyzed the results by sex, females had higher rates of hip or groin pain than males (58.6% vs 49.8%) and higher rates of both nonsurgical and surgical treatment for hip conditions (57.5% vs 44.7% and 6.1% vs 2.0%, respectively).

Although early specialization was significantly associated with lower iHOT scores that indicated worse hip pain and function (P = .0005), it was not associated with non-hip orthopedic surgeries or lower mental health ratings.

The study results highlight the need to encourage parents and children to explore multiple sports and avoid participation in a single sport year-round, especially during the rapid growth phase of hip development, Willey told Medscape Medical News. More research is needed in the form of imaging studies to identify which sports and levels of participation are associated with hip impingement and hip instability, Willey said.

When Specialization Is Counterproductive

“Early sports specialization is often driven by the belief that focusing on a single sport from a young age improves performance later in life,” said Alvin Su, MD, PhD, Chief of Sports Medicine at Nemours Children’s Health, Delaware Valley. “However, if early specialization is associated with a higher risk of injury, it may ultimately be counterproductive to that goal, exposing young athletes to unnecessary health risks without providing a meaningful performance advantage,” said Su, who was not involved in the study.

A key message for clinical practice is the growing evidence that cross-training across multiple sports is beneficial, not only for reducing injury risk but also for improving overall athletic development and performance, said Su. “Adequate rest and proper training instruction are also critical; overuse combined with poor technique is one of the most harmful combinations for young athletes,” he emphasized.

For young athletes pursuing higher-level competition, the involvement of trained professionals, such as athletic trainers or physical therapists, during periods of intense training can be valuable for injury prevention and performance optimization, Su noted.

“For primary care clinicians, the practical takeaway is to encourage participation in more than one sport during childhood,” Su told Medscape Medical News. “Equally important is emphasizing that youth sports should be enjoyable,” he added. Looking ahead, more research is needed to develop sport-specific injury prevention programs and training protocols, as well as more evidence to guide return-to-play strategies tailored to the demands of individual sports, Su said.

The study received no outside funding. The research group disclosed receiving general support from Medacta, which has developed patient-specific tools used to treat hip dysplasia in young adults. Su had no financial conflicts to disclose.