58% of Pro Table Tennis Players Report Hip Pain: French Institute Study Reveals a Hidden Cost of Elite Play

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Table tennis is marketed as one of the safest sports you can play. At the recreational level, the data backs that up: table tennis accounted for just 4.2% of nearly 800,000 racket-sport emergency department visits in the United States over 23 years, the lowest share of any racket sport (American Journal of Emergency Medicine, 2026). But a new study from France shows that at the professional level, a different injury picture emerges, and it centers on a body part most players never think about: the hip.

What the Researchers Found

Physicians and researchers at INSEP, the French National Institute of Sport, Expertise and Performance in Paris, the training home of many of France’s top athletes, examined 19 professional table tennis players: 13 men and 6 women, average age about 25 (Clinical Journal of Sport Medicine, 2026).

The team, led by Dr. Camille Rose, collected training histories, administered the UCLA activity score, and documented each player’s hip pathologies and pain. What they found surprised even the players themselves.

Eleven of the nineteen players, 58%, reported hip pain. Imaging and clinical assessment showed 8 players (42%) had femoroacetabular impingement, commonly called FAI, a condition where the ball of the hip joint does not fit perfectly into the socket, causing the bones to pinch against each other during movement. Over time, that pinching damages the cartilage that cushions the joint.

The damage was rarely isolated. Among the players with FAI, 6 also had chondropathy (cartilage damage), 5 had hip dysplasia (a shallower-than-normal socket), and 3 had coxarthrosis, early osteoarthritis of the hip. Five players, 26% of the squad, eventually required surgery: either a femoroplasty to reshape the hip bone or, in the most severe cases, a total hip replacement. Every single one returned to professional play afterward.

Why Table Tennis Players’ Hips Take a Beating

A table tennis stroke looks gentle compared to a tennis serve, but the loading pattern is relentless. The sport demands thousands of repetitive pivots, lunges, and weight transfers, almost always biased toward the dominant side. Forehand-dominant players rotate through the same hip hundreds of times per training session, day after day, year after year.

FAI is often described as a “morphology meets movement” problem. Many people are born with subtly cam-shaped femoral heads or deeper sockets and never notice, because their daily movement never pushes the hip into the pinching range. Elite table tennis does exactly that, repeatedly driving the hip into deep flexion with internal rotation during lunges and pivot strokes.

The players themselves underestimated the risk. Before turning professional, 8 of the 19 thought high-level play could cause joint pain somewhere in the body, but not one predicted the hip specifically. After living the life, 15 of them said hip pain is simply common among elite players. Expectations caught up with reality.

Context From Other Research

This is not the first sign that table tennis has a structured injury pattern at the elite level. A 17-year retrospective study of 139 high-level young players, published in Annals of Medicine and Surgery in 2026, found an overall injury rate of 1.2 per 1,000 hours of play, with 82.6% of injuries being overuse injuries rather than acute trauma. The most common sites were the knee (Osgood-Schlatter and Sinding-Larsen conditions in growing athletes), the heel (Sever’s disease, 13.7%), and the shoulder (tendinopathy, 11.6%).

The hip data from INSEP fills in the adult end of that timeline. The picture that emerges is consistent: recreational table tennis is exceptionally safe, but professional-level training volume produces predictable overuse patterns, first in the growing skeleton, later in the hip joint.

The contrast with the emergency-department data is striking. The American study found falls and cardiac events drove hospital admissions in racket sports, mostly among older adults, and that table tennis was the smallest contributor. None of the French professionals’ hip problems would ever show up in emergency statistics. They accumulate slowly, off the radar, in athletes in their twenties.

What This Means for Players and Coaches

For professionals and serious amateurs, the study authors make a clear recommendation: anticipate hip problems and build prevention into training. Practical takeaways follow from the mechanism:

Screen early if you train hard. FAI is detectable before it becomes arthritis. Players logging 20-plus hours a week with any groin, hip, or deep buttock pain, especially pinching at the bottom of a lunge, warrant a clinical assessment rather than rest-and-return.

Balance the load. The dominant-side bias of table tennis is structural to the sport, but strength programs that train both legs symmetrically, and mobility work that avoids repeatedly forcing the hip into impingement ranges, can reduce cumulative damage.

Take hip pain seriously, not stoically. Five of these athletes needed surgery, but all five returned to professional play. The outcomes in this cohort argue for early intervention, not avoidance of care. Waiting until the joint shows coxarthrosis narrows the options considerably.

Know the odds you actually face. If you play a few times a week, your injury risk from table tennis is among the lowest in all of sport. The hip findings apply to the professional volume threshold, thousands of loaded rotations per week, sustained for years. That is a dose problem, not a sport problem.

The Bottom Line

The INSEP study is small, 19 players at one national institute, and the authors frame it as a case series rather than a prevalence survey of the sport worldwide. But it is one of the first systematic looks at hip health in professional table tennis, and the signal is hard to ignore: 58% hip pain prevalence, 42% FAI, and a 26% surgery rate in athletes barely into their twenties.

For a sport aiming to grow its professional base, the study reads as a checklist item: add hip screening and prevention programs to elite training, the way tennis did for shoulders and knees a generation ago. And for the rest of us, it is a reminder that the safest sport in the rack still has a physical cost at the top end.

Sources

1. Rose C, Denis S, Le Garrec S, Ramos-Pascual S, van Rooij F, Saffarini M, Nogier A. Case Study: Prevalence of Hip Pain and Femoroacetabular Impingement in Professional Table Tennis Players. Clinical Journal of Sport Medicine. 2026;36(2):139-144. PMID 41489689.
2. Bonhomme C, Menu P, Grondin J, Hirardot T, Dauty M, Fouasson-Chailloux A. Table tennis musculoskeletal injuries in young high-level players: a 17-year retrospective cohort study. Annals of Medicine and Surgery. 2026;88(8):4828-4835. PMID 42583567.
3. Ferguson K, Badeti J, Zhu M, Yang J, Xiang H, Smith GA. Racket and paddle sports-related injuries treated in United States emergency departments, 2000-2023. American Journal of Emergency Medicine. 2026;109:58-68. PMID 42372568.