High School Sports Injury Research Articles

Characteristics Of Traumatic, Catastrophic Injuries In High School And College Sports In The United States: A Decade In Review

Characteristics Of Traumatic, Catastrophic Injuries In High School And College Sports In The United States: A Decade In Review

Comparative Analysis of the Six-Strand Hamstring and Peroneus Longus in Sports Medicine and Rehabilitation

The anterior cruciate ligament (ACL) is crucial for knee stability and is often injured in sports, leading to significant issues like degenerative changes and meniscal tears. ACL tears are prevalent in high-school sports injuries, accounting for 50% of knee injuries in the U.S. Surgical reconstruction, often involving bone-patellar tendon-bone (BPTB) or hamstring autografts, is common, with varying success rates and complications. Emerging alternatives like the peroneus longus tendon show promise but require further comparative studies. This prospective and multicentric study included 110 patients who underwent ACL reconstruction from 2020 to 2022. Fifty-five patients received hamstring tendon autografts (Group H) and fifty-five received peroneus longus tendon autografts (Group P). Surgeries were performed by experienced surgeons using standardized techniques. Patients were evaluated using clinical tests and functional scores including the Lysholm Knee Questionnaire and IKDC-2000 at various postoperative intervals up to 24 months. Data were analyzed using SPSS with a significance level set at p < 0.05. Group H showed superior knee function preoperatively and at 24 months postoperatively compared to Group P. Group H had higher Lysholm and IKDC scores consistently throughout the study period. The anterior drawer and Lachman’s tests indicated better knee stability for Group H. Complications were comparable between groups, with specific issues related to donor site morbidity and muscle weakness observed in each. The six-strand hamstring tendon autograft (Group H) demonstrated superior functional outcomes and knee stability compared to the peroneus longus tendon autograft (Group P) for ACL reconstruction. Despite some donor site morbidity, the hamstring tendon showed better long-term recovery and fewer complications. Future studies should explore larger, multicentric cohorts and integrate regenerative medicine techniques to further enhance ACL reconstruction outcomes.

Youth sport participation, injury history, and current physical activity among young adults

Objective: To examine the interaction between high school (HS) sports participation and injury history with current moderate-to-vigorous physical activity (MVPA) among young adults. Participants: Participants (N = 236) were 18–25 years old, not currently injured, and reported no physical activity limitations. Methods: Participants completed online demographic, injury history, and physical activity surveys. A two-way analysis of covariance was used to test the interaction between HS athlete status and previous injury severity on current self-reported MVPA. Results: Participants were 22.2 ± 2.1 years, primarily White (81.8%) or Asian (6.4%), and female (77.5%). After including body mass index and race as covariates, there was a statistically significant interaction between HS athlete status and previous injury history such that current MVPA was higher among former HS athletes compared to HS recreational/nonathletes when individuals reported no injuries or mild injury severity. MVPA was similar across athlete status groups when participants reported high levels of injury severity. Conclusions: Future studies should examine whether young adults who have experienced multiple and/or severe injuries as competitive HS athletes have unique physical activity barriers.

Epidemiology of Ankle Ligament Injuries in US High School Athletes

Category: Sports; Ankle; Trauma Introduction/Purpose: Foot and ankle injuries account for a large percentage of the over one million injuries sustained by high school level athletes. To date, many studies have examined the epidemiology of lower extremity injuries and ankle sprains, but few studies have classified sprains into subtypes across multiple sports. The purpose of this study was to describe the epidemiology of ankle sprain subtypes across 9 common high school sports. Methods: Athlete exposure and injury specific data from 7 seasons (2014 to 2021) were collected using the internet-based High School Reporting Information Online (High School RIO), a national high school sports injury surveillance system, for athletes participating in 1 of 9 sports (boys' and girls' soccer, girls' volleyball, boys' and girls' basketball, boys' baseball, girls' softball, boys' football, boys' wrestling). Incidence and ligament involvement of foot and ankle injuries were examined, with incidence being calculated as 1 injury per 10,000 athlete exposures (AE). Results: Ankle ligament injuries accounted for 89.0% of the 7,321 foot and ankle injuries across the 9 sports (81-94%). Girls and boys' basketball had the highest incidence of sprains, 3.46 and 3.37 respectively. Ankle ligament injuries accounted for 35.9% of all lower extremity injuries in basketball players. 85.0% of the sprains were classified as lateral ligament, 4.0% medial ligament, 11.5% syndesmosis (8.6% partial and 2.9% complete syndesmosis injuries). Football had the highest percentage of syndesmosis injuries at 11.0%, and the highest incidence of both syndesmosis injuries (0.44) and medial ligament injuries (0.17). Surgical intervention was required in 4.3% of complete syndesmosis injuries and 0.7% of lateral ligament injuries. No differences were found in incidence of ankle ligament injuries comparing pre-COVID-19 seasons (2014-2020) to the 2020-2021 season. Conclusion: Ankle sprains account for a large percentage of foot and ankle injuries sustained by high school level athletes. Syndesmosis injuries occur more commonly in football and are 6 times more likely to require early surgical intervention compared to lateral ligament injuries. Identifying sports commonly involved in these injuries and classifying the sprains is the first step in implementing early identification, rehabilitation, and prevention programs. Future studies should examine the efficacy of injury prevention programs and rates of ankle sprains among high school level athletes.

An epidemiologic comparison of acute and overuse injuries in high school sports

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.

Quantitative EEG Analysis in Clinical Practice: Concussion Injury.

Concussion is a common brain injury. The American Academy of Neurology provides a definition of concussion: "Concussion is a traumatically, or biomechanically, induced alteration of brain function. Emphasis is placed on a pathophysiological process, or functional disruption, as opposed to anatomic, structural, or tissue injury.". The incidence of mild traumatic brain injury (mTBI) is estimated at 200 per 100 000. The Centers for Disease Control and Prevention (CDC) estimates 3.8 million sport and recreational mTBIs occurring in the United States each year. A more recent CDC assessment estimates 2.5 million concussion injuries in high school sports alone. The controlled environment and opportunity for direct surveillance and observation has made the sports arena the scientific "wet lab" for the study of mTBI natural history, short- and long-term consequences and opportunities to intervene. Quantitative EEG methods have been utilized in the assessment and management of mTBI and lends to provide a cost-effective procedure that has the sensitivities needed to identify pathology where routine visual inspection of the EEG has failed.

Trends in Recurrent Anterior Cruciate Ligament Injuries Differ From New Anterior Cruciate Ligament Injuries in College and High School Sports: 2009-2010 Through 2016-2017.

Background:Knee injuries are common and result in extended time missed from sports participation. Little is known regarding the comparative characteristics of recurrent versus first-time anterior cruciate ligament (ACL) injuries sustained during athletic events and how they are influenced by sex, sports participation level, and game-time features.Purpose:To evaluate the characteristics (sex, sports level, and game timing [ie, early vs late in the game]) of recurrent ACL injury in National Collegiate Athletic Association (NCAA) and high school athletes compared with first-time ACL injury.Study Design:Descriptive epidemiology study.Methods:Athletic trainers reported ACL injury occurrences and characteristics for collegiate athletes during the 2009-2010 through 2016-2017 academic years and for high school athletes during the 2011-2012 through 2013-2014 academic years. Logistic regression was used to estimate odds ratios (ORs) and 95% CIs for recurrent versus first-time ACL injury. The number of ACL injuries, proportions, and ORs were calculated by sex, competition level, and time in game played. Results were also classified according to injury mechanism: noncontact, overuse, or surface contact.Results:A total of 705 ACL injuries were reported, including 644 first-time injures and 61 recurrent injuries. When restricting to noncontact ACL injuries, 416 were reported (373 first-time injuries and 43 recurrent injuries). The odds of a recurrent versus new ACL injury in NCAA student-athletes were 4.6 times that of high school student-athletes (95% CI, 1.41-15.24; P = .01). When restricting to noncontact ACL injuries, the odds of a recurrent versus new ACL injury during postseason and preseason were 4.5 and 2.8 times that during the regular season, respectively. Athletes in limited-contact and noncontact sports had greater odds of a recurrent versus new ACL injury compared with athletes playing football and other contact and collision sports. There was no significant difference in the odds of a recurrent ACL injury by sex or time in game.Conclusion:Based on the current study, the odds of recurrent ACL injuries are associated with the level of competition but not associated with sex or timing of game play. Determinants of reinjury after primary ACL reconstruction will help advance care for young injured athletes who continue to participate in competitive sports.

Rates and Patterns of Lower Extremity Sports Injuries in All Gender-Comparable US High School Sports.

Background:High school athletes with lower extremity sports injuries (LESIs) frequently present to the emergency department in the United States. Previous epidemiological studies have presented rates and mechanisms of LESIs in these athletes. No studies, however, have looked at LESIs in gender-comparable sports in an attempt to evaluate what differences exist between LESIs in boys and girls.Purpose:To describe the epidemiology of LESIs among US high school athletes using a large national database of athletes in sports that could be considered gender comparable, given the rules of play and protective equipment.Study Design:Descriptive epidemiology study.Methods:Descriptive data from 2005 to 2016 were collected using the internet-based High School Reporting Information Online (High School RIO), a national high school sports injury surveillance system, for athletes participating in 8 gender-comparable sports (soccer, volleyball, basketball, baseball/softball, swimming and diving, track and field, cross-country, and tennis). Rates and patterns of injury were evaluated, with injury rates calculated as ratio of injuries per 10,000 athlete-exposures. Rate ratios (RRs) were calculated to compare the LESI rates in girls and boys.Results:In both genders, LESI rates (per 10,000 athlete-exposures) were highest in soccer (girls, 15.87; boys, 11.68) followed by basketball (girls, 11.51; boys, 9.35), and were lowest in swimming and diving (girls, 0.70; boys, 0.39). Although injury rates were significantly higher in girls compared with boys in all sports, only in tennis was the RR greater than 2 (RR, 2.03; 95% CI, 1.17-3.54). Girls had a greater proportion of severe LESIs and injuries that received radiographic evaluation, such as magnetic resonance imaging, compared with boys for all sports except volleyball. Consistency in the mechanism of injury was demonstrated between genders within each sport.Conclusion:This study demonstrated that LESIs are common among high school athletes and disproportionately affect girls more than boys, especially when looking at severe injuries and resource utilization. Further studies are needed to elucidate the cause of these findings. We hope that the awareness of gender-based differences in LESIs will lead to improvements in targeted efforts to decrease injury rates and injury severity.

Trends in US High School Football Concussion Reporting, 2012-2017

Objectives: Football has been a sport with high concussion rates when examined independently (Rosenthal et al., 2014). Accurately describing injury trends in high school sports is necessary to identify student-athletes at the greatest risk of injury and where potential injury reduction interventions should be focused. With increased reported high school concussion injuries and associated state legislative requirements, increased incidence rates are needed. The purpose of this study was to provide updated high-school football concussion incidence rates. Methods: Data Source and Study Period This study used data from the Rank One Health Injury Surveillance Database (ROH ISD). Data for the current study were analyzed across 6 calendar years (2012 through 2017) from 1,999 high schools. Data from the current study examined high school football concussion data in males ages 14 to 18. The ROH ISD consists of a convenience sample of participating schools from 2012 to 2017. Exposure and injury data represent a convenience sample of US high schools. For the current study, only data provided across all 1,999 high schools were included. All 1,999 high schools included in the current study logged practice and game participation events for each individual athlete participating in football at the respective high school and athletic exposures (AEs) are an accurate representation of rostered athletes participating in either practices or games by age and calendar year. The ROH ISD was deemed Category 4 IRB exempt. Statistical Analysis Injury counts, practice exposures, game exposures, and distributions by event type (practice or game), age, and injury mechanism were examined. Injury rates per 1,000 AEs and injury rate ratios (IRRs) were calculated by event type. Injury proportion ratios (IPRs) were used to examine differences by calendar year. Risk ratios (RRs) were calculated to compare event type by calendar year. All 95% confidence intervals (CIs) not containing 1.0 were considered statistically significant. Results: 997,308 male student-athletes participated in high school football. ATs recorded a total of 14,103 concussions in high school football from a total of 235,134 total injuries across all high school sports. High school football concussions accounted for 6% of all injuries in high school sports from 2012-2017. More concussions occurred in games (51.8%) than practices (48.2%). Decreases were found in annual injury rates for practices in high school football student-athletes from 2012 to 2016 with an increase in 2017. Decreases were found in annual injury rates for games from 2012 to 2016 with an increase in 2017. IPR decreased by year from 2012 to 2016 (with an increase in 2017. IRR and RR comparisons for games versus practices were significant from 2012 to 2017 (Table 1). Conclusion: This study marks the largest epidemiological high school football concussion incidence investigation to date. The findings from this study provide updated high school football concussion incidence rates and provide further evidence of differences in injury rates when comparing practices and games. The higher rates of concussions occurring in games relative to practices emphasize prior trends of injury risk relative to the level of competition. Overall, results highlight a decline in injury rates over time and lower rates of injury compared to prior high school football epidemiological concussion studies. [Table: see text]

An 11-year analysis of peripheral nerve injuries in high school sports

ABSTRACTIntroduction: Sports surveillance databases provide valuable information regarding common ailments, yet fewer studies have focused on more rare peripheral nerve injuries. Our objective was to characterize peripheral nerve injuries in high school athletics with respect to incidence, time loss, mechanism, and diagnoses.Methods: Sport-related nerve injury data on high school athletes were collected during the 2005/2006 through 2015/2016 academic years via the High School Reporting Information Online (RIO) database. All injuries were reported by certified athletic trainers (ATs). Descriptive statistics were performed.Results: A total of 588 peripheral nerve injuries were recorded during the 2005/06–2015/16 academic years, with an overall incidence of 1.46/100,000 athlete-exposures (AE; 95%CI: 1.34, 1.58). Boys’ football had the majority of injuries (71.3%) and the highest injury rate (5.46/100,000AE; 95%CI: 4.93, 5.98), followed by boys’ wrestling (7.1%) and boys’ baseball (3.4%). Over half (50.3%) of peripheral nerve injuries resulted in time loss < 1 week, while 9.4% resulting in the athletes prematurely ending their seasons. The most common mechanisms were player contact (67.3%), overuse (10.0%), and surface contact (9.7%). A specific diagnosis was available for 40 (6.8%) injuries, including upper extremity stinger (n = 26), spinal cord neurapraxia (n = 3), subacromial nerve impingement (n = 2) neuroma (n = 2), axillary nerve palsy (n = 1), sciatic nerve impingement (n = 1), femoral nerve impingement (n = 1), tarsal tunnel syndrome (n = 1), peroneal neuropathy (n = 1), thoracic outlet syndrome (n = 1), and ulnar nerve subluxation (n = 1).Discussion: Recognized peripheral nerve injuries are rare among high school athletes, occurring most commonly in boys’ football. While most are minor, approximately 1:10 were season-ending. Specific diagnoses were available for 7% of injuries, with upper extremity stingers being the most commonly reported diagnosis. Working with ATs to identify and implement methods to obtain more specific diagnostic information via surveillance will help researchers better understand the epidemiology of peripheral nerve injuries.

The First Decade of Web-Based Sports Injury Surveillance (2004-2005 Through 2013-2014): Methods of the National Collegiate Athletic Association Injury Surveillance Program and High School Reporting Information Online.

To describe the methods of the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) and High School Reporting Information Online (HS RIO) system as a complement to the sport-specific manuscripts that will follow. The NCAA-ISP and HS RIO collect injury and exposure data from samples of collegiate and high school sports programs, respectively. The NCAA-ISP, which the NCAA has maintained since 1982, was relaunched as a Web-based platform at the beginning of the 2004-2005 academic year. In 2005, the HS RIO was introduced to capture data on high school athletes and modeled after the NCAA-ISP. Relevant data are shared with the NCAA and high school sport and policy committees to develop evidence-based rules and programs that help protect the health and safety of student-athletes. The NCAA-ISP and HS RIO monitor participation in school-sanctioned competitions and practices that occur from the first preseason practice to the final postseason contest for more than 25 sports. For this series of publications in the Journal of Athletic Training, injury information on 13 sports at the collegiate level during the 2004-2005 through 2013-2014 academic years and the high school level during the 2005-2006 through 2013-2014 academic years was evaluated. Athletic trainers have been a vital source of data collection over the past decade to help produce the largest datasets of collegiate and high school sports injuries. Such data have helped various sport and policy committees advance protocols that aim to increase sports safety. This series of publications will aid by continuing to provide data to stakeholders in the sports community.

Injury Recurrence Among High School Athletes in the United States: A Decade of Patterns and Trends, 2005-2006 Through 2015-2016.

Background:As participation in high school athletics increases, so does the number of adolescents experiencing sports-related injury. Understanding injury patterns is an important component to developing and evaluating prevention and rehabilitation programs.Purpose:To analyze recurrent injury rates and patterns among high school athletes, to compare recurrent injuries with new injuries, and to evaluate injury trends over time.Study Design:Descriptive epidemiology study.Methods:High school sports injury data on 24 sports were collected from 2005-2006 through 2015-2016 via the High School RIO (Reporting Information Online) surveillance system. Injury rates were calculated as number of injuries per 10,000 athletic exposures (AEs). Injury rate ratios and injury proportion ratios (IPRs) were calculated to compare differences among subgroups.Results:Overall, 78,005 injuries were sustained during 40,195,806 AEs, for an injury rate of 19.41 per 10,000 AEs. Of these, 69,821 (89.5%) were new injuries, and 8184 (10.5%) were recurrent. The ankle was the most commonly injured body part among recurrent injuries, while the head/face was the most common body part that sustained new injuries. Ligament sprains were more often recurrent, while concussions were more commonly diagnosed as new, although concussions represented 16.7% of recurrent injuries. Trends for recurrent injuries over time were relatively stable. The proportion of athletes who had >3 weeks of time loss or medical disqualification (15.8% vs 13.3%; IPR, 1.19; 95% CI, 1.13-1.26) or who voluntarily withdrew from sport (2.5% vs 1.1%; IPR, 2.33; 95% CI, 2.00-2.73) was significantly greater for recurrent injuries than new injuries. Furthermore, a greater proportion of recurrent injuries resulted in surgery (8.1% vs 6.0%; IPR, 1.34; 95% CI, 1.24-1.46).Conclusion:Although only 10.5% of all injuries were recurrent, they more frequently resulted in missing >3 weeks of playing time and were more often managed surgically when compared with new injuries. The rate of recurrent injuries has not increased over the past decade.

Rankings of High School Sports Injury Rates Differ Based on Time Loss Assessments.

To examine how injury definition inclusiveness affects the rank order of injury rates in 27 high school (HS) sports. The National Athletic Treatment, Injury and Outcomes Network (NATION) used certified athletic trainers (ATs) to collect injury and athlete-exposure (AE) data in practices and competitions for 27 HS sports during the 2011/2012 to 2013/2014 academic years. Time loss (TL) injuries resulted in ≥24 hours of participation restriction. Nontime loss (NTL) injuries resulted in <24 hours of participation restriction. Aggregate injury and exposure data collected from 27 HS sports. High school student-athletes. Sports injury data from the National Athletic Treatment, Injury and Outcomes Network. Time loss and TL + NTL injury rates were calculated. Sport-specific rates were placed in rank order, stratified by gender. Most of the 47 014 injuries reported were NTL (82.8%). Among boys' sports, TL injury rates were greatest in football (3.27/1000AE) and wrestling (2.43/1000AE); TL + NTL injury rates were greatest also in football (15.29/1000AE) and wrestling (11.62/1000AE). Among girls' sports, TL injury rates were greatest in soccer (1.97/1000AE) and basketball (1.76/1000AE); TL + NTL injury rates were greatest in field hockey and lacrosse (both 11.32/1000AE). The rank order of injury rates and the resulting injury prevention priorities may depend on injury definition inclusiveness, particularly in female HS sports.

Time Trends in Concussion Symptom Presentation and Assessment Methods in High School Athletes

Background: Concussion rates have increased significantly over the past decade. This may reflect an increase in the knowledge and diagnosis of the symptoms of a concussion rather than a true increase in the incidence. Assessing trends in the way that concussions are presenting to and being identified by clinicians over the same period may provide additional insight into the apparent rise in concussions. Purpose: To evaluate patterns of change in concussion symptom presentation, diagnostic/evaluation methods, and symptom resolution time reported for United States high school athletes from the 2007-2008 through 2014-2015 academic years. Study Design: Descriptive epidemiology study. Methods: This study is a retrospective analysis of a web-based longitudinal high school sports injury surveillance database (High School RIO [Reporting Information Online]) collected from 2007-2008 through 2014-2015. For each concussion, athletic trainers entered data regarding symptom presentation, resolution time, and diagnostic/evaluation tools utilized. Academic year was the primary exposure in assessing each aim. Time trends were then assessed using linear regression or the Cochran-Armitage test for trends, depending on the outcome distribution. Results: The proportion of concussed athletes presenting with amnesia, loss of consciousness (LOC), and tinnitus significantly decreased from 2007-2008 through 2014-2015, while the proportion presenting with drowsiness, irritability, light sensitivity, and noise sensitivity increased significantly. The use of diagnostic radiography, magnetic resonance imaging, and computed tomography all significantly decreased during the study period, while the use of computerized neurocognitive tests increased. Concussion symptoms took significantly longer to resolve in more recent years. Conclusion: The decrease in what have traditionally been considered severe symptoms (LOC, amnesia) and the increase in what were traditionally considered minor symptoms (drowsiness, irritability, light sensitivity) suggest that clinicians may have a lower threshold in diagnosing sports-related concussions in more recent years. The significant reduction in the use of all forms of diagnostic head imaging demonstrates an increased recognition of concussions as functional disturbances rather than structural abnormalities. Improved concussion education and the nationwide passage of state-level concussion legislation have likely led to the increased recognition of lingering symptoms in athletes with a diagnosed concussion, thereby leading to a longer symptom resolution time.

Epidemiology of Chest, Rib, Thoracic Spine, and Abdomen Injuries Among United States High School Athletes, 2005/06 to 2013/14.

Describe chest and abdominal injury epidemiology among US high school athletes. Retrospective analysis of longitudinal surveillance data. Injury data from 2005/06 to 2013/14 academic years were collected using an internet-based surveillance system. A large sample of US high schools. Injuries sustained as a function of sport. Chest, rib, thoracic spine, and abdominal injuries sustained during high school athletic events. Overall 1487 chest, rib, thoracic spine, and abdominal injuries occurred during 30 415 179 athletic exposures (AEs); an injury rate of 4.9 injuries per 100 000 AEs. Over half (56.8%) of injured athletes were evaluated by another medical provider in addition to the athletic trainer, and 34 injuries (2.3%) required surgery. Diagnostic techniques, including x-ray, magnetic resonance imaging or computed tomography were used in 729 (49.0%) injuries. The injury rate was higher in boys' (6.8) than girls' (2.0) sports [rate ratio (RR), 3.43; 95% CI, 3.04-4.10]. Football (47.7%) accounted for the highest proportion of injuries followed by wrestling (18.5%), boys' soccer (4.6%), and girls' soccer (3.7%). The rate of injury was higher in competition than practice, (RR, 2.86; 95% CI, 2.59-3.23). Only 57.7% of injured athletes were able to return to play within 1 week. Chest and abdominal injuries in high school sports although relatively rare, can result in loss of playing time and frequently prompt medical evaluation. Thus, they present a physical and economic burden. To optimize prevention, further studies can focus on subgroup risk factor identification to drive development of targeted prevention strategies.

Eye Injuries in High School and Collegiate Athletes.

Background:Although eye injuries constitute a small percentage of high school and college sports injuries, they have the potential to be permanently debilitating.Hypothesis:Eye injury rates will vary by sport, sex, and between the high school and college age groups.Study Design:Descriptive epidemiology study.Level of Evidence:Level 3.Methods:Data from eye injury reports in high school and college athletes were obtained from the National High School Sports-Related Injury Surveillance System, High School Reporting Information Online (HS RIO) database over a 10-year span (2005-2006 through 2014-2015 school years) and the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) over an 11-year span (2004-2005 through 2014-2015 school years). Injury rates per 100,000 athlete-exposures (AEs), injury rate ratios (RRs), and 95% CIs were calculated. Distributions of eye injuries by diagnosis, mechanism, time loss, and surgery needs were also examined.Results:A total of 237 and 273 eye injuries were reported in the HS RIO and the NCAA ISP databases, respectively. The sports with the highest eye injury rates (per 100,000 AEs) for combined high school and college athletes were women’s basketball (2.36), women’s field hockey (2.35), men’s basketball (2.31), and men’s wrestling (2.07). Overall eye injury rates at the high school and college levels were 0.68 and 1.84 per 100,000 AEs, respectively. Eye injury rates were higher in competition than practice in high school (RR, 3.47; 95% CI, 2.69-4.48) and college (RR, 3.13; 95% CI, 2.45-3.99). Most injuries were contusions (high school, 35.9%; college, 33.3%) and due to contact (high school, 89.9%; college, 86.4%). Only a small percentage of injuries resulted in time loss over 21 days (high school, 4.2%; college, 3.0%).Conclusion:Eye injury rates and patterns vary by sport, sex, and between the high school and college age groups. Although severe injuries do occur, most eye injuries sustained by high school and college athletes are minor, with limited time loss and full recovery.Clinical Relevance:Additional focus needs to be placed on preventing eye injuries at the collegiate level in women’s and men’s basketball, women’s field hockey, and men’s wrestling.

Descriptive Epidemiology of Non-Time-Loss Injuries in Collegiate and High School Student-Athletes.

Research on non-time-loss (NTL) injuries, which result in less than 24 hours of restriction from participation, is limited. To describe the epidemiology of NTL injuries among collegiate and high school student-athletes. Descriptive epidemiology study. Aggregate injury and exposure data collected from a convenience sample of National College Athletic Association varsity teams and 147 high schools in 26 states. Collegiate and high school student-athletes participating in men's and boys' baseball, basketball, football, lacrosse, soccer, and wrestling and women's and girls' basketball, field hockey, lacrosse, soccer, softball, and volleyball during the 2009-2010 through 2013-2014 and the 2011-2012 through 2013-2014 academic years, respectively, participated. Collegiate student-athletes participating in men's and women's ice hockey were also included. Injury data from the National Collegiate Athletic Association Injury Surveillance Program and the National Athletic Treatment, Injury and Outcomes Network were analyzed. Injury counts, rates per 1000 athlete-exposures (AEs), and rate ratios were reported with 95% confidence intervals (CIs). A total of 11 899 and 30 122 NTL injuries were reported in collegiate and high school student-athletes, respectively. The proportion of NTL injuries in high school student-athletes (80.3%) was 1.61 times greater than that of collegiate student-athletes (49.9%; 95% CI = 1.59, 1.63). The NTL injury rate in high school student-athletes (8.75/1000 athlete-exposures [AEs]) was 2.18 times greater than that of collegiate student-athletes (4.02/1000 AEs; 95% CI = 2.13, 2.22). Men's ice hockey (5.27/1000 AEs) and boys' football (11.94/1000 AEs) had the highest NTL injury rates among collegiate and high school athletes, respectively. Commonly injured body parts in collegiate and high school student-athletes were the hip/thigh/upper leg (17.5%) and hand/wrist (18.2%), respectively. At both levels, contusions, sprains, and strains were the most frequent diagnoses. Contact with another player was the most cited injury mechanism (college = 38.0%, high school = 46.3%). Non-time-loss injuries compose large proportions of collegiate and high school sports injuries. However, the NTL injury rate was higher in high school than in collegiate student-athletes. Tracking NTL injuries will help to better describe the breadth of injuries sustained by athletes and managed by athletic trainers.

THE EPIDEMIOLOGY OF US HIGH SCHOOL FOOTBALL (SOCCER) INJURIES, 2005–06 THROUGH 2013–14

BackgroundDespite the worldwide popularity of football, research on epidemiology of high school injury is sparse.ObjectiveTo describe high school football injury rates and patterns by type of athletic exposure and gender.DesignThis...

Nine-year study of US high school soccer injuries: data from a national sports injury surveillance programme

BackgroundResearch on high school soccer injury epidemiology is sparse.AimTo describe high school soccer injury rates, trends and patterns by type of athlete exposure (AE), position and sex.MethodsThis descriptive epidemiological study...

Evaluating Postural Control and Ankle Laxity Between Taping and High-Top Cleats in High School Football Players.

Lateral ankle sprains are the most common injuries in high school sports. While ankle taping is a preferred method of external prophylactic support, its restrictive properties decline during exercise. The Under Armour® Highlight cleat is marketed on the premise that it provides added support without the need for additional ankle taping. To determine if differences in ankle joint laxity and postural control exist between football players wearing the Under Armour® Highlight cleat (Under Armour Inc, Baltimore, MD) as compared to a low/mid-top cleat with ankle tape. Crossover trial. Athletic training room and football practice field sideline. 32 interscholastic football players (15.8 ± 1.0y; 178.9 ± 7.4cm; 87.1 ± 21.4kg). Ankle laxity was assessed using an instrumented ankle arthrometer (Blue Bay Research Inc, Milton, FL), while postural control testing was performed on the Tekscan MobileMat™ Balanced Error Scoring System (BESS; South Boston, MA). The 2 treatments included Under Armour® Highlight cleats and a low/mid-top cleat with ankle tape applied to the nondominant ankle only. Measurements were taken before and immediately after practice. The independent variable was treatment (Highlight vs low/mid-top cleat with ankle tape). Dependent variables included ankle arthrometry measures of anterior displacement (mm), inversion/eversion rotation (deg), and the modified BESS error scores. A linear mixed-effects model was used for analysis. The low/mid-top cleat with tape condition had significantly higher inversion range-of-motion (ROM) and inversion/eversion rotation postexercise when compared to the Highlight cleat (P < 0.05). The results of this study provide some evidence that the Under Armour® Highlight cleat restricts ankle ROM following a training session better than the taped low/mid-top cleat. Further study is warranted to determine if this high-top style of football cleat can reduce the incidence of ankle sprains and how it might compare to spat taping.