Differences in Overuse Injuries in Gender-Comparable Sports: A Nationally Representative Sample of High School Athletes.

Abstract

Participation in high school sports has physical, physiological, and social development benefits, while also increasing the risk of acute and overuse injuries. Risk of sport-related overuse injury differs between boys and girls. To investigate differences in overuse injuries among US high school athletes participating in the gender-comparable sports of soccer, basketball, and baseball/softball. Descriptive epidemiology study using a nationally representative sample from the High School Reporting Information Online (RIO) database. High schools. Athletes with overuse injuries during the 2006-2007 through 2018-2019 academic years. National estimates and rates of overuse injuries were extrapolated from weighted observed numbers with the following independent variables: sport, gender, academic year, class year, event type, body site, diagnosis, recurrence, activity, and position. Among an estimated 908 295 overuse injuries nationally, 43.9% (n = 398 419) occurred in boys' soccer, basketball, and baseball, whereas 56.1% (n = 509 876) occurred in girls' soccer, basketball, and softball. When comparing gender across sports, girls were more likely to sustain an overuse injury than boys (soccer, injury rate ratio [IRR]: 1.37, 95% CI = 1.20-1.57; basketball, IRR: 1.82, 95% CI = 1.56-2.14; baseball/softball, IRR: 1.21, 95% CI = 1.04-1.41). Most overuse injuries in soccer and basketball for both genders occurred to a lower extremity (soccer: 83.9% [175 369/209 071] for boys, 90.0% [243 879/271 092] for girls; basketball: 77.0% [59 239/76 884] for boys, 80.5% [81 826/101 709] for girls), whereas most overuse injuries in baseball and softball were to an upper extremity (72.5% [81 363/112 213] for boys, 53.7% [73 557/136 990] for girls). For boys' baseball, pitching (43.5% [47 007/107 984]) was the most common activity associated with an overuse injury, which differed from the most common activity of throwing (31.7% [39 921/126 104]) for girls' softball. Gender differences observed in this study can help guide future strategies that are more specific to gender and sport to reduce overuse injuries among high school athletes.