Background:There are a variety of proposed motivations for sport specialization, such as improving sport skills to an elite level, making all-star or travel teams, or receiving a scholarship or professional contract. However, there has not been a quantitative examination of the attitudes and beliefs that may be contributing to the trend of sport specialization and year-round sport participation.Purpose:The primary aim was to describe the attitudes and beliefs of youth club sport athletes regarding sport specialization and sport participation. A secondary objective was to investigate whether an association exists between the level of sport specialization and the belief in receiving a college scholarship.Study Design:Cross-sectional study; Level of evidence, 3.Methods:A total of 974 youth athletes (578 female; mean age, 14.2 ± 1.6 years) completed an anonymous questionnaire that focused on attitudes and beliefs toward sport specialization and sport participation. Questions were developed utilizing the feedback of a panel of content area experts and the University of Wisconsin Survey Center. Data were summarized using frequencies, proportions (%), and means ± SDs.Results:Fewer than half of all athletes (45.8%) believed that specialization increased their chances of getting injured either “quite a bit” or “a great deal.” However, 91% of athletes believed that specialization increased their chances of getting better at their sport either “quite a bit” or “a great deal.” Similarly, the majority of athletes believed that specialization increased their chances of making their high school team (80.9%) or a college team (66.9%) either “quite a bit” or “a great deal.” Overall, 15.7% of athletes believed that they were either “very” or “extremely” likely to receive a college scholarship based on athletic performance. Highly specialized athletes were nearly twice as likely to have a high belief in receiving a college scholarship compared with low-specialization athletes (20.2% vs 10.2%, respectively; χ2 = 18.8; P = .001).Conclusion:Most youth athletes in this study believe that specialization increases their sport performance and ability to make not only a college team but also their high school team. Highly specialized athletes were more likely to believe that they will receive a college scholarship.

Background: Significant short-term improvements in function and pain after arthroscopic management of femoroacetabular impingement syndrome (FAIS) have been demonstrated regardless of mass index (BMI). No studies have reported the influence of obesity on mid- to long-term outcomes. Purpose: To evaluate the effect of BMI class on 5-year patient outcomes after arthroscopic treatment of FAIS. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of a prospective database was performed to identify patients who underwent arthroscopic treatment for FAIS. A matched-pair analysis for age and sex was performed in a 1:1:2:3 fashion for morbidly obese (BMI ≥35), obese (BMI = 30-34.9), overweight (BMI = 25-29.9), and normal weight (BMI = 18.5-24.9) patients, respectively. Patient characteristics, imaging, Hip Outcome Score Activities of Daily Living (HOS-ADL) and Sports Subscale (HOS-SS) scores, modified Harris Hip Score (mHHS), and pain scores were recorded preoperatively, with the same outcome scores recorded at 5 years postoperatively, along with satisfaction scores. Standardized modern hip arthroscopy, with labral repair, acetabuloplasty, femoroplasty, and capsular plication followed by formalized rehabilitation, was performed for all patients. Absolute outcomes along with change in outcomes were assessed between BMI groups. A between-group analysis was also conducted evaluating achievement of the minimal clinically important difference (MCID), patient acceptable symptomatic state (PASS), and substantial clinical benefit (SCB) for any outcome score. A multivariable analysis was additionally included to evaluate outcomes adjusting for known confounding variables. Results: A total of 140 patients with mean follow-up of 62.1 ± 6.5 months were identified: 20 morbidly obese, 20 obese, 40 overweight, and 60 normal weight. There were significant improvements for HOS-ADL, HOS-SS, and mHHS scores in the normal (all P < .0001) and overweight groups (all P < .0001), mHHS in the obese group ( P = .0275), and no significant improvement in functional scores in the morbidly obese group ( P > .05). Compared with normal controls, multivariable analysis, adjusting for confounders, showed similar improvement in HOS-ADL for patients in the overweight and obese groups, HOS-SS for patients in the overweight group, and mHHS for patients in the overweight and obese groups (all P > .05). All groups showed significant improvement in pain scores (all P < .01) that were not significantly different between groups in multivariable analysis (all P > .05). Obese BMI was associated with a 54.9-point decrease in 5-year HOS-SS, and morbidly obese BMI was associated with a 27.3, 35.0, and 23.7-point decrease in 5-year HOS-ADL, HOS-SS, and mHHS, respectively (all P < .05). Regarding surgical benefit in comparison with normal weight patients, patients in the overweight and obese groups were as likely to achieve MCID (reciprocal odds ratio [ROR]: 1.5 and 1.2, respectively, both P > .05), but patients in the morbidly obese group were not. All groups were significantly less likely than the normal weight group to achieve PASS (ROR: overweight 5.2, obese 14.1, morbidly obese 13.0; all P < .05) and SCB (ROR: overweight 3.9, obese 7.8, morbidly obese 20.3; all P < .05). Conclusion: There were significant improvements in at least 1 outcome score across all BMI groups with arthroscopic treatment of FAIS. While the normal weight patients demonstrated universal improvement in all patient-reported outcomes and significantly greater likelihood of achieving PASS and SCB, the higher BMI groups still demonstrated significant improvement in function and pain, except for the morbidly obese group. Patients with morbid obesity demonstrated long-term pain improvement, although they did not experience functional improvement.

Background: Impairments in squat depth have been reported in patients with femoroacetabular impingement syndrome (FAIS). However, little is known about single-leg squat (SLS) performance in these patients, despite this task being commonly used in the rehabilitation and training settings. Purpose/Hypothesis: The aims of this study were (1) to investigate whether patients with FAIS demonstrate differences in SLS performance compared with healthy controls and (2) to determine whether dynamic range of motion (ROM), muscle strength, hip morphologic measures, hip pain, and hip-specific function predict SLS performance in patients with FAIS. We hypothesized that patients with FAIS would demonstrate impaired SLS performance and that impaired hip biomechanics, muscle strength, and hip-specific function would predict squat performance in patients with FAIS. Study Design: Controlled laboratory study. Methods: Three-dimensional (3D) kinematic data were collected at 100 Hz using a 20-camera 3D motion capture system during 3 SLS trials in 34 patients with FAIS and 26 healthy controls. Isometric muscle strength was tested with a stationary handheld dynamometer in all participants. Squat performance was quantified by squat depth (in meters), and the biomechanical variables of dynamic ROM of the pelvis, the hip, the knee, and the ankle in all planes were calculated. In patients with FAIS, femoral and acetabular morphology were measured using radiographic alpha angles and lateral center-edge angles. Hip pain and hip-specific function were measured using the visual analog scale for pain and the Hip Outcome Score Activities of Daily Living subscale, respectively. Two-tailed independent-samples t tests were used to determine between-group differences for squat depth, dynamic ROM variables, and muscle strength. A hierarchical multiple linear regression (MLR) model was used to determine whether biomechanical variables, muscle strength, hip morphology measures, hip pain, and hip-specific function were predictors of squat depth. All statistical analyses were performed using SPSS Version 26. Results: There were no between-group differences in age (FAIS, 30.0 ± 7.0 years vs controls, 27.3 ± 7.0 years; P = .18) or body mass index (FAIS, 23.1 ± 2.8 vs controls, 22.6 ± 3.2; P = .51). Squat depth was less in patients with FAIS compared with healthy controls (FAIS, 0.24 ± 0.4 m vs controls, 0.29 ± 0.05 m; P < .001). In the sagittal plane, patients with FAIS demonstrated less dynamic ROM of the hip (FAIS, 67.8°± 12.4° vs controls, 79.2°± 12.5°; P = .001) and the knee (FAIS, 71.9°± 9.4° vs controls, 78.9°± 13.2°; P = .02) compared with controls. Patients with FAIS also demonstrated a less dynamic coronal plane pelvis ROM (FAIS, 11.3°± 5.0° vs controls, 14.4°± 6.7°; P = .044). Patients with FAIS had reduced hip muscle strength of the hip external rotator (FAIS, 1 ± 0.3 N/kg vs controls, 1.2 ± 0.3 N/kg; P = .034), hip internal rotator (FAIS, 0.8 ± 0.3 N/kg vs controls 1 ± 0.3 N/kg; P = .03), and hip flexor (FAIS, 4 ± 1.1 N/kg vs controls, 4.8 ± 1.2 N/kg; P = .013) muscle groups. The hierarchical MLR revealed that the dynamic ROM of the hip, the knee, and the pelvis, the hip external rotation muscle strength, and the femoral alpha angles were all significant predictors of squat performance, and the final MLR model explained 92.4% of the total variance in squat depth in patients with FAIS. Conclusion: Patients with FAIS demonstrate impaired SLS squat performance compared with healthy controls. This impaired squat performance is predominantly predicted by sagittal plane knee and hip biomechanics and hip external rotator strength, and less by frontal plane pelvic ROM and hip morphology in patients with FAIS. Clinical Relevance: Clinicians should focus treatment on improving dynamic ROM and hip external rotator muscle strength to improve squat performance; however, femoral morphology should also be considered in the treatment paradigm.

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