Context Sport specialization is a popular trend among youth athletes that has been associated with an increased risk for developing lower extremity overuse injuries. Early ice hockey specialization may contribute to the high rates of noncontact and overuse hip and groin injuries in collegiate ice hockey athletes. Objective To examine the effects of high, moderate, and low levels of sport specialization on subjective hip and groin dysfunction in collegiate ice hockey athletes. Design Retrospective cohort study. Setting Data were collected during the midseason of the 2018–2019 hockey season at a local ice hockey arena. Patients or Other Participants National Collegiate Athletic Association Division III and club ice hockey players from Midwestern college programs (n = 187; 81 women, 106 men). Main Outcome Measure(s) Participants were stratified into high-, moderate-, and low-specialization groups based on ice hockey participation before grade 9 of high school. The 6 subscales of the Hip and Groin Outcome Score questionnaire were used to assess current subjective hip and groin dysfunction. Results The high-specialization group had lower scores than the low-specialization group on the Symptoms (P = .001), Pain (P = .003), Activities of Daily Living (P = .001), Sport and Recreation (P = .014), and Quality of Life (P = .002) subscales. The moderate-specialization group had lower scores than the low-specialization group on the Symptoms (P = .015) and Activities of Daily Living (P = .006) subscales. Conclusions Collegiate ice hockey athletes who were highly specialized before high school reported greater current hip and groin pain, symptoms, and dysfunction during activities of daily living and sport and recreation and lower current hip- and groin-related quality of life compared with low-specialization ice hockey athletes. Early ice hockey specialization may be detrimental to hip and groin function in collegiate ice hockey athletes.

Background: Evidence suggests that shoulder and elbow injuries account for 31% to 37% of all National Collegiate Athletic Association (NCAA) baseball injuries, and up to 69% of NCAA baseball injuries are the result of noncontact and overuse mechanisms. Early sport specialization may contribute to the high rates of upper extremity injuries in college baseball players. Hypothesis: Higher specialization by age 13 years would be associated with worse subjective throwing arm function and a greater history of shoulder and elbow injury. Study Design: Cohort study. Level of Evidence: Level 2. Methods: Survey data were collected from college baseball players (N = 129) during midseason of the spring 2019 baseball season. Participants were stratified in low, moderate, and high specialization groups based on a 3-criteria sports specialization questionnaire. Participants’ throwing arm function was measured using the Functional Arm Scale for Throwers and the Kerlan-Jobe Orthopaedic Clinic shoulder and elbow questionnaires. Participants’ history of a shoulder or elbow injury that resulted in missing ≥2 weeks of baseball activity at any point in their baseball career was also collected. Results: The high specialization group reported worse subjective throwing arm function on the Functional Arm Scale for Throwers questionnaire than the low ( P = 0.03) and moderate ( P = 0.01) specialization groups. The high specialization group was over 5 times more likely to report a history of shoulder injury than the moderate (odds ratio [OR] = 5.42; 95% CI [1.71, 17.2]; P = 0.004) and low (OR = 5.20; 95% CI [1.87, 14.5]; P = 0.002) specialization groups, and over 3 times more likely to report a history of elbow injury than the moderate specialization group (OR = 3.77; 95% CI [1.05, 13.6]; P = 0.04). Conclusion: College baseball players that were highly specialized by age 13 years reported worse subjective throwing arm function and were more likely to have a history of upper extremity injury than players that were moderate or low specialization. Clinical Relevance: Early specialization in baseball may be detrimental to long-term upper extremity health in college baseball players.