Abstract
BackgroundAcute and overuse injuries affect millions of high school athletes annually and a better understanding of differences between these injuries is needed to help guide prevention, treatment, and rehabilitation strategies. This study compares acute and overuse injuries using a nationally representative sample of high school athletes.MethodsInjuries among United States high school athletes participating in 5 boys’ sports (football, soccer, basketball, wrestling, baseball) and 4 girls’ sports (soccer, volleyball, basketball, softball) reported in the High School RIO™ surveillance system during the 2006-07 through 2018-19 school years were classified as acute or overuse. National estimates and injury rates were calculated.ResultsOf 17 434 646 estimated injuries, 92.0 % were acute and 8.0 % were overuse. The acute injury rate was higher than the overuse injury rate among both male (Rate Ratio [RR] 16.38, 95 % CI: 15.70–17.10) and female (RR 8.14, 95 % CI: 7.71–8.60) athletes. The overuse injury rate per 10,000 athlete exposures among female athletes (1.8) was slightly higher than among males (1.4). The rate of acute injury compared with the rate of overuse injury was higher during competition (RR 32.00, 95 % CI: 29.93–34.22) than practice (RR 7.19, 95 % CI: 6.91–7.47). Boys’ football contributed the most acute (42.1 %) and overuse (23.7 %) injuries among the 9 sports. Among female sports, girls’ soccer contributed the most acute (15.6 % of all acute injuries) and overuse (19.4 % of all overuse injuries) injuries. The lower extremity was most commonly injured in acute (48.9 %) and overuse (65.9 %) injuries. Ligament sprain (31.7 %) and concussion (21.0 %) were the most common acute injury diagnoses, while muscle strain (23.3 %) and tendonitis (23.2 %) were the most common overuse injury diagnoses. Compared with acute injuries, overuse injuries were more likely to result in time loss from sports participation of < 1 week among both boys and girls and across most sports. Acute injuries were more likely than overuse injuries to cause a time loss of 1–3 weeks or medical disqualification from sports participation.ConclusionsAcute and overuse injuries display many differences that provide opportunities for data-informed athlete preparation, treatment, and rehabilitation, which may reduce injuries and improve injury outcomes in high school athletics.
Highlights
Acute and overuse injuries affect millions of high school athletes annually and a better understanding of differences between these injuries is needed to help guide prevention, treatment, and rehabilitation strategies
Injury Frequency and National Estimates From the 2006-07 through 2018-19 school year, 52 285 injuries were reported, which represent an estimated 17 434 646 injuries among high school athletes nationally, who participated in the 9 sports included in this study (Table 1)
Acute injuries were less likely to result in time loss from sports participation of < 1 week overall (IPR: 0.70, 95 % Confidence Interval (CI): 0.68–0.74)
Summary
Acute and overuse injuries affect millions of high school athletes annually and a better understanding of differences between these injuries is needed to help guide prevention, treatment, and rehabilitation strategies. This study compares acute and overuse injuries using a nationally representative sample of high school athletes. Using data collected from various injury reporting systems, existing studies have analyzed sports-related injuries at individual universities, groups of high schools, or within specific cohorts of athletes, which limit their ability to establish patterns that can be generalized across larger populations (Cuff et al 2010; Liller et al 2019; Lundberg Zachrisson et al 2020; Yang et al 2012). High School Reporting Information Online (RIOTM) is currently the largest sportsrelated injury surveillance system that uses a nationally representative sample of United States (US) high school athletes. While it has been used in many peerreviewed publications, few have studied overuse injuries (Cuff et al 2010; Kerr et al 2018; Rechel et al 2008; Schroeder et al 2015). To-date, no studies have directly compared characteristics of acute and overuse injuries using a nationally representative database
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