Interscholastic Sports Research Articles

The privilege to play: race, gender, & SES advantages in boys’ high school athletic opportunities

ABSTRACT In this study, with an exploratory sequential mixed-methods design, we considered the components and implications of a habitus that (re)produces racial/ethnic, social class, and gender differences in US interscholastic sport participation. We drew from independently collected qualitative (N = 19 men and 47 total college athletes) and quantitative (N = 4,097 high school boys) data and noted and investigated dynamic links between individual choices; family, community, and school contexts; and power structures that inform interscholastic athletics. Findings positioned sports as offering valuable institutionalized cultural capital but being rife with reproductive struggles. Schools serve as fields that co-construct unequal athletic opportunity structures by nurturing and rewarding a cultivated athletic habitus associated with masculinity, whiteness, and affluent dispositions. These processes situate athletic advantages and successes as purely meritorious but restrict who is most likely to receive the individual and social benefits of high school sports participation.

School Characteristics and Interscholastic Tournament Success

Interscholastic sports are part of the educational mission of the schools. However, parents, athletes, and others seem to emphasize winning, causing success (or, at least, the possibility of success) to be the target of state policies to promote competitive balance, following from an egalitarian approach to the theory of distributive justice. For example, most states have divided schools into separate class tournaments based on school enrollment. Many have also attempted to counteract perceived advantages held by private (non-boundary) schools by using multipliers to artificially increase private schools’ enrollment. Some states compensate for poorer schools’ perceived disadvantages by artificially decreasing enrollment for those schools with a high percentage of the student body eligible for the National School Lunch Program (NSLP). To enact effective policies, however, it is helpful to know what school characteristics are linked with winning. This project is a case study examining high school boys’ basketball in Indiana with a basic research question of what school characteristics influence tournament success. The literature and many current state policies propose that being private, larger, urban, wealthier, and from certain regions of the state might all improve tournament success. Each is examined for its effects on winning a state championship and on a more-expansive measure of success based on how far in the tournament a team progresses using data collected for all entrants in the Indiana boys’ basketball tournament over a 26-year period. The relative size of the student body seems to be the most consistently important factor in tournament success across classes. Being a private school or being an urban school are only factors in success for the classes of smaller schools. The region of the state is not shown to be significant to success. Of particular note, though there has been an increase in state policies targeting an imbalance caused by economic factors, there has not yet been an empirical finding of a link between these economic factors and success. This study does find limited evidence of such a link as schools with a lower percentage of students eligible for NSLP are more successful in the tournament. These results can help refine the knowledge of what does and does not affect tournament success and can guide policy changes aimed at improving competitive balance.

Neighborhood Context as a Barrier to Sport Participation for Girls: Evidence From a Sport Diversity Index.

Evidence suggests neighborhood contexts play a vital role in shaping the availability and diversity of youth sport and participation rates, especially for African American or Black girls. Currently, no index captures interscholastic sport opportunities (eg, sport diversity) within and across school districts and specifically applied to African American or Black girls. To visualize the inequalities present in interscholastic sport opportunities for girls across school districts using a novel index in a selected study area of St Louis City and County, Missouri, and discuss the implications for African American or Black girls. Cross-sectional study. Database secondary analysis. Data for 47 public high schools in the 23 St Louis City and County school districts. We gathered data from the 2014-2018 American Community Survey and Missouri State High School Activities Association. We assessed sport diversity for girls by constructing a sport diversity index (SDI) that uses an entropy index as its foundation. Census-tract data were used to examine the association with neighborhood demographics and contributors to school district income and sport diversity. Descriptive spatial statistics were calculated to evaluate distributions in St Louis City and County, with the bivariate local indicator of spatial autocorrelation used to determine any correlations between variables of interest. The St Louis City school district, which has areas with high rates of renter-occupied housing and poverty and high percentages of non-Hispanic African American or Black students, had the lowest SDI for girls, contrasted with the school districts in St Louis County, which showed an inverse pattern on average. The SDI for girls was correlated with the percentages of renter-occupied housing and poverty. The SDI for girls was also correlated with race: an increasing presence of the non-Hispanic African American or Black population was associated with decreased sport diversity for girls. The SDI for girls demonstrated a spatial association with neighborhood-level determinants of sport-opportunity availability for non-Hispanic African American or Black girls in St Louis. The role of social and political determinants of health in shaping community context and resultant health in athletic training research, policy, and practice should be considered.

Sexual Harassment/Abuse Policies in U.S. Youth Sport Programs.

Sport governing bodies, such as the International Olympic Committee, have recommended youth sport organizations develop policies, procedures, and/or ethical guidelines to prevent and respond to sexual harassment and abuse (SHA) experienced by young athletes. To our knowledge, no studies have investigated SHA policies or procedures in U.S. youth sport programs. The purpose of this exploratory study was to examine U.S. youth sport programs' policies regarding SHA. The results are based on a cross-sectional survey completed by youth sport coaches (n = 200) from various organizations (e.g., public recreation organizations, private nonprofit organizations, and interscholastic sports). Findings suggest that most organizations have several SHA policies, such as education and training requirements, written policies and codes of conduct regarding coach-athlete sexual relationships, and formal complaint and disclosure procedures for investigating SHA. A bivariate analysis suggests that the presence of several SHA policies was associated with an increased number of self-reported SHA incidents. Moreover, youth sport programs located in urban areas had a greater extent of SHA policies compared to those located in suburban or rural areas. These results are discussed with respect to the potential relationships between the presence of policies and increased cases of SHA. Also, we discussed advocating for equitable resources among youth sport programs regardless of geographic and/or demographic factors. Future research should identify social and cultural barriers that inhibit the successful implementation of SHA policies. While developing and implementing SHA policies is a step in the right direction, it may not be used as the only means to address this complex, systematic, and structural issue.

U.S. Islamic Schools’ Promotion of Physical Education and Physical Activity

Abstract: Among Muslims, the states of spiritual well-being and physical health complement each other and should be developed in youth. Regular physical activity (PA) in childhood is associated with multiple health benefits immediately and persisting into adulthood. Schools are ideal venues for children to be physically active owing to curricular (i.e., physical education [PE]), co-curricular (i.e., recess, classroom activity breaks), and extracurricular (i.e., intramural and interscholastic sports) opportunities. Most schools utilize websites to convey and promote information about what they feel is important for website visitors to know. Previous studies on how PE/PA are promoted on school websites excluded U.S. Islamic schools. Therefore, we conducted a content analysis of 222 U.S. Islamic schools’ websites to determine the prevalence of images and verbiage promoting PE/PA and associated characteristics. Our descriptive findings suggest that PE/PA are emphasized less compared with other subject matter: PE was mentioned on 53% of websites, intramurals on 29%, and interscholastic sports on 21%. Thus, the holistic education of children in the Islamic tradition may be compromised.

U.S. Islamic Schools’ Promotion of Physical Education and Physical Activity

Abstract: Among Muslims, the states of spiritual well-being and physical health complement each other and should be developed in youth. Regular physical activity (PA) in childhood is associated with multiple health benefits immediately and persisting into adulthood. Schools are ideal venues for children to be physically active owing to curricular (i.e., physical education [PE]), co-curricular (i.e., recess, classroom activity breaks), and extracurricular (i.e., intramural and interscholastic sports) opportunities. Most schools utilize websites to convey and promote information about what they feel is important for website visitors to know. Previous studies on how PE/PA are promoted on school websites excluded U.S. Islamic schools. Therefore, we conducted a content analysis of 222 U.S. Islamic schools’ websites to determine the prevalence of images and verbiage promoting PE/PA and associated characteristics. Our descriptive findings suggest that PE/PA are emphasized less compared with other subject matter: PE was mentioned on 53% of websites, intramurals on 29%, and interscholastic sports on 21%. Thus, the holistic education of children in the Islamic tradition may be compromised.

The politics of exclusion: Analyzing U.S. state responses to interscholastic transgender athletes

ABSTRACT This paper provides a baseline characterisation of legislative action against transgender people participating in U.S. interscholastic sport. Using Kingdon’s multiple streams approach, we analyse legislation across the 50 states using data up to 1 October 2022. We also analyse qualitative data from public officials to document the framing and justification of legislative efforts. Our findings are clustered into four categories – legislators in states that have enacted legislation to prevent transgender participation in school sport (n = 19), those that have introduced legislation (n = 23), those that have not (yet) taken action (n = 7), and those that have progressive legislation requiring schools to permit participation by gender identity (n = 1). Our data suggest that national-level interest groups have played a critical role in policy diffusion across the states, leveraging the problem window in an intensely contested context, using sporting, judicial, and political focusing events to draw attention to the perceived problem. These dynamics have resulted in solutions searching for problems. Moreover, the issue of transgender inclusion in sport (a subset of legislative efforts against transgender people) has escalated a form of symbolic politics which is as much about partisan contestation as it is about addressing a perceived problem. While we recognise that the issue is complex, we believe that there are other solutions – beyond outright exclusion from school sport – that should be more fully explored. Because exclusionary policies claim to uphold sport’s fundamental values, sport organisations can lead on this issue by clearly defining these values and translating them into pragmatic policy solutions.

Impact of Early Sport Specialization on Interscholastic Athletes and Programs

Early sport specialization (ESS) is a popular pathway for athletic development with implications for enhanced skill acquisition but also adverse mental and physical outcomes (LaPrade et al., 2016). As such, adolescent athletes may face a dilemma regarding whether to play multiple sports or immediately narrow the focus to one. Coaches are positioned to influence motivational climates and sport-specific skill development (Amorose & Anderson-Butcher, 2007), making it important to understand their perceptions of ESS. Interviews were conducted with thirteen coaches of girls’ volleyball and basketball teams to gain an understanding of ESS as it pertains to athletes and programs at the interscholastic level. Participants identified influences and impacts of ESS, specifically how it can affect participation and competitiveness of interscholastic sports.

How Systemic Racism Shapes Access to Interscholastic Sports and Why It Matters

ABSTRACT Interscholastic sports are an important resource that provides access to social, cultural, and economic capital; however, not all students have equal access to sports in public high schools. Utilizing theories of systemic racism, this study shows how racism affects housing and property taxes, which shapes resources provided in public schools. The authors use the example of interscholastic sports as a school resource to highlight another form of resource inequality in public schools. Findings reveal that public schools with more White students have more sports while schools with more Black students have fewer sports. Findings also reveal that public schools with more students on free lunch have fewer sports than schools with fewer students on free lunch. The authors argue that the lack of access to interscholastic sports is another way in which racial and class inequality is perpetuated in Miami-Dade County, Florida.

Special Admission: How College Sports Recruitment Favors White Suburban Athletes

If this book serves as a reader's first entry into the perils of college athletics, they will not be able to look at any sporting event the same. Special Admission coincides with the timing of Operation Varsity Blues, the college acceptance scandal orchestrated by Rich Singer. Kirsten Hextrum contends the fact that families have been paying for their children to be admitted to schools for decades based on false athletic careers is not a big transgression as college admissions have always been “rigged” (xi). She begins the book by assessing the rise of Caylin Louis Moore, a Black male football player from Los Angeles who attended Texas Christian University. He later became a Rhodes Scholar in 2017. Such an honor led many news outlets to recognize Moore's feat (a Black male coming out of poverty receiving such an esteemed scholarship) as a rationale for how sport provides an opportunity for social mobility for people from economically deficient communities. It is an argument that has influenced and shaped much of the discourse around the problems with college athletics. Hextrum claims this type of positioning is based on a false assumption about the utility of a college education.Special Admission disputes the claim that “America is an open and upwardly mobile society.” Hextrum uses the narratives of various student-athletes focusing on issues of race, gender, and socioeconomic status to highlight this point. She contends sports have never been a meritocracy but rather an effort to promote the success of white males in higher education. Hextrum gives a history of how the United States is the only country that integrates sports into the fabric of higher education. In other countries, participants in interscholastic sports are not allowed to play at the collegiate level; rather, they are given the opportunity to attend an academy or turn professional. Why is that not the case across the sporting landscape in the United States? Hextrum argues it is because higher education is authorized through the state. Such a framework may seem awkward to a general reader, but this approach provides a greater understanding of the power dynamics at play within college admissions and athletics. This is seen through the recruitment process, which overwhelmingly favors white athletes from middle-class communities. The author contends this is based on residency, attendance in school districts with adequate resources, and social connections that provide them with ample sporting opportunities.Hextrum's book is well researched using an array of scholarly works in education and sport studies, along with interviews that allow the reader to learn about the experiences of white student-athletes. The author identifies this population of participants in “nonexploited, non-revenue-generating sports” as critical to her overall synthesis (19). Their stories enrich the narrative of this text. The discussion surrounds how the population gained unwarranted access for perceived athletic abilities. The honesty with which many of them realize their privilege is surprising, especially since the meritocracy argument is believed on many fronts. While it can be debated whether they are exploited or not because they do not bring great financial rewards to their respective schools, the inability of students to balance the demands of school and athletic competition across racial, gender, and socioeconomic lines illustrates larger issues within the structuring of college athletics as well. Hextrum's attention to the relationship between college athletics and the admissions process is important. Selection committees have come to favor certain populations who fit prescribed criteria for student-athletes and embrace lower academic standards with a greater guarantee for admission. White middle-class families are given access to highly selective institutions that provide higher graduation rates, better placement in top graduate programs, and better job opportunities through sport.Hextrum does not simply identify the problem of privilege within college athletics. She also provides solutions, encouraging schools, the administrators they hire, and student-athletes to embrace new elements of change to create equity in higher education. For example, new selection criteria need to be developed by admissions offices that will value more than a zip code, one's physical capabilities, and connections to pay for play sporting opportunities. She also argues for a reorganization of college athletics that allows for new sporting forms to be included, recommending activities like karate, surfing, skateboarding, and tai chi. While these recommendations are worthwhile and should be considered, such propositions will be hard to enact, considering many schools focus on their profit margin when determining what non-revenue-generating sports to support financially. Overall, sport studies scholars and practitioners must add Special Admission to their libraries. This work provides insight into the interconnectedness of college athletics and college admissions and how the college athletics arms race encompasses so much of the higher education experience.

A Mixed-Methods Approach to Identifying Ethical Issues Pertinent in Interscholastic Athletics

The purpose of this study was to investigate three research questions: (a) What are the ethical issues most pertinent to interscholastic sport today, as well as in the next 5 years? (b) How important are those ethical issues to interscholastic athletic administrators? (c) What are the potential implications of those pertinent ethical issues to practicing interscholastic athletic administrators? For the first inquiry, the Minnesota State High School League (MSHSL) provided 14 contemporary ethical issues that were most pertinent to interscholastic sport today, as well as in the next 5 years: behavioral issues, competing club sports, competitive balance, emphasis on winning, health concerns, nontraditional sports, outside sport organizations, participation for all, pay-to-play organizations, promises by camp organizers, scholarship myth, sportsmanship, too much structure, and win at all costs. For the second proposition, a national study was conducted with athletic directors from the National Interscholastic Athletic Administrators Association (n = 170) annual conference. Following a survey in which participants ranked issues according to importance, a one-tailed analysis of variance determined significant differences among the 14 ethical issues identified by the MSHSL. Four issues exhibited significant differences based on region: behavioral issues, promises by camp organizers, scholarship myth, and win at all costs. A Games-Howell post hoc determined significant differences across geographical regions of the United States for these four ethical issues. For the third research question, semistructured interviews provided insight on the implications for practicing athletic administrators. Athletic administrators generally emphasized the importance of the issues identified in this study.

Before- and After-School Physical Activity: Programs and Best Practices

Before- and after-school programs can be excellent opportunities for schools to provide supplemental physical activity (PA) and reinforce the knowledge, skills, and dispositions taught in physical education, particularly when some schools may perceive PA during the school day as competing with academic learning time. Before- and after-school PA programs can be offered directly by school staff, or in partnership with community organizations, and can include offerings like intramural sports, mileage clubs, active childcare programs, interscholastic sports, active transport initiatives, and PA clubs. Research findings suggest that before- and after-school programming can contribute meaningfully to children and adolescents’ daily PA accrual and offer additional benefits related to cognitive health and social-emotional wellbeing. Careful attention should be paid by program leaders and staff to the structure of these programs to maximize potential benefits for youth. The purpose of this article is to provide a brief summary of the research conducted to date on before- and after-school PA programs with a specific intention to extend the content reviewed since the last special issue of JOPERD on CSPAP nearly a decade ago (Beighle & Moore, 2012). In this article, we endeavor to translate the literature on before- and after-school PA programming and evidence of its impact into tangible strategies that school stakeholders can use to deliver these programs effectively in schools.

Dialogue in athletics: A program evaluation of a social justice education initiative in high school sports

Inclusive spaces and relationships that honor athletes’ unique identities are vital to ensure adaptive sport experiences (e.g., Coakley; Kochanek & Erickson). Youth athletes and adult leaders need to possess awareness and skills to foster inclusive sport environments and act as agents who can contribute to positive individual and social change. The prevalence and increased visibility of contemporary social justice issues have underscored the importance of developing such critical competencies. Scholars have recently called for exploratory and collaborative efforts to help athletes and adult leaders develop such critical competencies and carry out evaluation research that examines the effectiveness of programs. The purpose of this utilization-focused evaluation was to assess the impact and relevant processes of a social justice education initiative, Dialogue in Athletics, which used intergroup dialogue pedagogy. The lead author (and program facilitator-facilitator-evaluator) delivered and assessed the effectiveness of Dialogue in Athletics within one interscholastic sports community. A mixed methods convergent evaluation design was used to collect data at the session-specific, pre/post-program, and follow-up time points. Integrated analyses of data from student-athletes (n = 7) and adult leaders (n = 13) revealed that adults showed more marked increases in critical awareness and skills development/transference relative to student-athletes who showed some, though less pronounced, gains following the program. Results revealed favorable shifts in participants’ attitudes, with some variation between athletes and adults. Findings on participants’ program process helped elucidate meaningful aspects of their dialogue experience alongside various sources of discomfort, and barriers to learning transference.

A Multiyear Assessment of the Effect of Sport Participation on the Health of Adolescent Athletes During the COVID-19 Pandemic.

Sport cancellations early in the COVID-19 pandemic had a significant negative effect on the health of US adolescents. The effect of restarting sports during the pandemic has not been described. To identify the effect of sport participation on the health of adolescents before and during the COVID-19 pandemic. Cross-sectional study. Sample recruited via social media. Wisconsin adolescent athletes. Participants provided information regarding their age, sex, and sport(s) involvement and completed the Patient Health Questionnaire-9 Item to assess depression symptoms, the Hospital for Special Surgery Pediatric Functional Activity Brief Scale to measure physical activity, and the Pediatric Quality of Life Inventory 4.0 to measure quality of life (QoL). Data were collected in spring 2021 (Spring21; n = 1906, age = 16.0 ± 1.2 years, females = 48.8%), when interscholastic sports had fully resumed, and were compared with similar cohorts of adolescent athletes at 2 time points: (1) spring 2020 (Spring20; n = 3243, age = 16.2 ± 1.2 years, females = 57.9%) when sports were cancelled and (2) 2016-2018 (PreCOVID-19) before the pandemic (n = 5231, age = 15.7 ± 1.1 years, females = 65.0%). Comparisons were conducted via analysis-of-variance models and ordinal regressions with age and sex as covariates. The prevalence of moderate to severe depression was lower in Spring21 than in Spring20 but higher than in PreCOVID-19 (PreCOVID-19 = 5.3%, Spring20 = 37.8%, Spring21 = 22.8%; P < .001). Physical activity scores (mean [95% CI]) were higher in Spring21 than in Spring20 but lower than in PreCOVID-19 (PreCOVID-19 = 23.1 [22.7, 23.5], Spring20 = 13.5 [13.3, 13.7], Spring21 = 21.9 [21.6, 22.2]). Similarly, QoL scores were higher in Spring21 than in Spring20 but lower than in PreCOVID-19 (PreCOVID-19 = 92.8 [92.5, 93.1], Spring20 = 80.7 [80.3, 81.1], Spring21 = 84.3 [83.8, 84.8]). Although sports have restarted, clinicians should be aware that physical activity, mental health, and QoL are still significantly affected in adolescent athletes by the ongoing pandemic.

A mixed-methods approach to identifying participation issues pertinent in interscholastic sports

ABSTRACT The purpose of this mixed-methods study was to investigate three propositions: (a) What are the participation issues most pertinent to interscholastic athletic administrators? (b) What is the perceived level of importance of these participation issues to athletic administrators? and (c) What are the potential implications of those pertinent participation issues to practicing athletic administrators? A national study was conducted with athletic directors (n = 170) from the National Interscholastic Athletic Administrators Association annual conference. Athletic directors completed a survey to identify and then rank in terms of importance issues that they face on a daily basis. The 14 issues identified as most important were framed within five categories: Education Base Athletic Programs, Recruitment, Specialization, and Student-Athletes. A one-tailed ANOVA was executed to determine significant differences based on geographical region among these participation issues. Following the quantitative survey, follow-up qualitative interviews were conducted to further delve into the most important issues. The results offer insight from which further investigations could be conducted to continue building on policies that influence interscholastic administrators’ day-to-day accountability when overseeing their programs.

Activity Level and Sport Type in Adolescents Correlate with the Development of Cam Morphology.

Background:The purpose of this study was to evaluate the influence of the volume and type of sport on the development of cam-type femoroacetabular impingement and acetabular dysplasia.Methods:The Physical Activity Questionnaire for Adolescents (PAQ-A) was administered to Iowa Bone Development Study participants at the age of 17 years to identify those who had participated in at least 2 seasons of high school interscholastic sports. Based on relative peak strain and ground reaction forces, subjects were grouped as power sport athletes (basketball, cheerleading, football, gymnastics, soccer, and volleyball), non-power sport athletes (wrestling, baseball, cross-country or track and field, softball, or tennis), or non-athletes. Using anteroposterior views of the left hip formatted from dual x-ray absorptiometry (DXA) scans, the alpha angle, head-neck offset ratio (HNOR), and lateral center-edge angle (LCEA) were evaluated longitudinally at the ages of 17, 19, and 23 years. Logistic regression was used to evaluate the odds of hip cam morphology (alpha angle >55° and/or HNOR <0.17) or acetabular dysplasia (LCEA <24°) at the age of 23 years in all athlete groups. The relationships between physical activity level and hip measures (alpha angle, HNOR, and LCEA) from the ages of 17 to 23 years were examined using linear mixed models adjusted for sex.Results:Compared with non-athletes at the age of 23 years, power sport athletes had significantly greater odds of cam morphology according to the alpha angle (odds ratio [OR], 2.93 [95% confidence interval (CI), 1.02 to 8.41]; p = 0.046) and HNOR (OR, 1.91 [95% CI, 1.01 to 3.60]; p = 0.047), but not greater odds of acetabular dysplasia (p > 0.05). There were no significant differences in the odds of cam morphology or acetabular dysplasia in non-power sport athletes compared with non-athletes (all p > 0.05). Higher physical activity levels were significantly associated with an increase in the alpha angle (beta and standard error, 0.77° ± 0.30°; p = 0.011) and a decrease in the HNOR (−0.003 ± 0.001; p = 0.003), but not the LCEA (−0.05 ± 0.15; p = 0.744).Conclusions:A higher volume of physical activity and participation in sports with higher peak strain and ground reaction forces during the process of skeletal maturation may increase the risk of developing cam morphology during late adolescence.Level of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Raise a fist, take a knee: the intersection of interscholastic sports and democratic education

This study explores the ways in which controversies in U.S. interscholastic sports raise questions about race, gender, democracy, and citizenship. Drawing on a conceptualization of critical and multicultural citizenship, the authors use thematic analysis to analyse media coverage of two recent cases involving incidents in high school sports in the U.S. that highlight tensions among democratic values including equality, diversity, liberty, and patriotism. Findings suggest both patterns and differences across the cases that reveal important implications for ways that controversies in U.S. interscholastic sports have relevance to democratic education.

Comparison of Anterior Cruciate Ligament Injury Rates In High School and Middle School Sports Over a 30-year Period

Background:Anterior cruciate ligament (ACL) injuries are a major concern in interscholastic sports. Comparison of ACL injuries between high school (HS) and middle school (MS) athletes over multiple years is limited.Purpose:To examine the incidence of ACL injury in HS female [HS-F] and male [HS-M], and MS female [MS-F] and male [MS-M] sports over a 30-year period.Methods:We studied 55,147 athletes who competed in interscholastic sports at a secondary school from 1988 to 2018. Data included ACL injuries incurred during interscholastic sports, and clinically confirmed by a physician. Injury rates per 100,000 AEs (practice and games where the athlete was at risk of ACL injury) were calculated for gender, sport, and contact status. Incidence rate ratios [RR] and 95% confidence intervals (CIs) were used to compare injury rates.Results:The incidence rate of ACL injury for HS athletes (4.15/100,000 AEs) was almost three times greater (RR=2.63, 95%CI: 1.7-4.2; p<0.0001) than the incidence rate for MS athletes (1.58/100,000 AEs). The risk of sustaining an ACL injury among HS-F athletes (4.26/100,000 AEs) was similar to HS-M athletes (4.06/100,000 AEs) (RR=1.05, 95%CI: 0.7-1.6; p=0.81). The risk of sustaining an ACL injury among MS-F athletes (1.06/100,000 AEs) was less than MS-M athletes (1.96/100,000 AEs) (RR=0.54, 95%CI: 0.2-1.4; p=0.21). While the risk of incurring an ACL injury occurrence was four times greater (RR=4.01, 95%CI: 1.7-9.4; p=0.0002) among HS-F athletes than MS-F athletes, the risk of ACL injury was twice as high (RR=2.08, 95%CI: 1.2-3.7; p=0.009) among HS-M athletes than MS-M athletes. ACL injuries were incurred in 15 HS sports and was greatest for HS-F basketball (25.5/100,000 AEs; p<0.001), HS-M football (20.6/100,000 AEs), and HS-F soccer (20.4/100,000 AEs). ACL injuries were sustained in 7 MS sports and was highest for MS-F softball (9.1/100,000 AEs), MS-M basketball (6.3/100,000 AEs) and MS-M football (5.0/100,000 AEs). The risk of contact-related ACL injury (1.73/100,000 AEs) was almost two times greater than non-contact-related ACL (0.96/100,000 AEs) (RR=1.80, 95%CI: 1.2-2.7; p<0.001). The rate of contact ACL injury was highest among HS-M (3.38/100,000 AEs) while the rate for noncontact ACL injury greatest among HS-F (2.44/100,000 AEs).Conclusions:The risk for ACL injury is higher in HS than in MS for both sexes. Non-contact ACL injuries were more likely to occur among HS-F athletes while contact injuries were highest for HS-M athletes, suggesting the effects of maturation and competition may play a role with increasing competition level.

Comparison of Y-Balance Test Performance by maturation status in youth distance runners

Background:Distance running is a popular interscholastic sport, but also has an associated high risk of running-related injuries. Recent literature suggests that functional tests may help to identify athletes at increased risk of injury. The Y-Balance Test (YBT) is an objective measure used to assess functional muscle strength and balance and to expose asymmetries between tested limbs.Purpose:To determine if YBT performance was associated with maturation status in healthy, youth distance runners. We hypothesized that mid-pubertal (MP) runners would demonstrate less functional reach distance than pre-pubertal (PrP) or post-pubertal (PoP) runners.Methods:A convenience sample of 142 (Females: n=79, Males: n=63) uninjured youth runners (ages 13.5±2.7 years; weekly running distance: 18.2±20.4 km) were recruited from the local community. All runners met inclusion criteria, indicating that they were between 9 and 19 years old and participated in long-distance running activities such as school/club track and field, cross country, road races, trail running, and/or soccer. The runners completed a modified Pubertal Maturational Observation Scale (PMOS), then were screened for right (R) and left (L) anterior (ANT), posteromedial (PM) and posterolateral (PL) reach distances (cm) normalized by lower limb length (cm). Composite reach distance was calculated by the sum of the three reach distances divided by three times the limb length multiplied by 100 for R and L limbs. ANOVA with Bonferroni post hoc tests were used to compare maximum normalized reach distances for the three directions and composite reach distance by maturation status and sex.Results:Overall, 31.7% were classified as PrP status, 26.1% as MP, and 42.3% as PoP, with similar percentages by sex (p=0.84). The only significant mean difference was found for R ANT maximum normalized reach distance between PrP and PoP (p=0.02), indicating a greater normalized reach in PrP athletes. No significant mean differences were found for R or L PM and PL maximum normalized reach distances, or for R or L composite reach distances, by maturation status or when stratified by maturation and sex (p>0.05).Conclusions:In this sample of youth runners, the YBT was only a discriminator of anterior reach distance between pre-pubertal and post-pubertal runners. As decreased anterior reach is associated with reduced quadriceps muscle strength and anterior knee pain, reduced anterior reach in post-pubertal runners may potentially signify an increased risk of sustaining a running-related injury. Thus, preventive efforts to ensure good functional quadriceps muscle strength may be merited.

The Impact of COVID-19 Related School Closures and SPORT CANCELLATIONS on the Health of Adolescent Athletes

Background:In March 2020, schools were closed to in-person teaching and interscholastic sports cancelled in an attempt to slow the spread of the COVID-19. Child health experts have stated that school closures may have profound psychosocial consequences for students and need further study.Hypothesis/Purpose:To identify how COVID-19 related school closures and sport cancellations impacted the health of adolescent athletes.Methods:Adolescent athletes in Wisconsin were recruited via social media to complete an online survey in May 2020 while schools were closed to in-person teaching and interscholastic and club sports were cancelled. Assessments included the: General Anxiety Disorder-7 Item (GAD-7) for anxiety, Patient Health Questionnaire-9 Item (PHQ-9) for depression, the Pediatric Functional Activity Brief Scale (PFABS) for physical activity, and the Pediatric Quality of Life Inventory 4.0 (PedsQL) for quality of life. PHQ-9, PFABS and PedsQL scores were compared with historical data (HD) of Wisconsin adolescent athletes (N = 5,231) collected during normal school and sport operations in the years 2016–2018.Results:A total of 3,243 (58% female, Age = 16.1+1.2 yrs., grades 9 – 12) participated in the study. May 2020 participants reported higher (worse) PHQ-9 scores than the HD participants (mean: 8.0 (95%CI: 7.8, 8.2) vs 3.3 (3.1, 3.5), p < 0.001) as well as a higher prevalence of moderate to severe levels of depression (32.9% vs 9.7%, p < 0.001). May 2020 Participants also reported lower (worse) PFABS scores (mean: 12.2 (95%CI: 11.9, 12.5) vs 24.7 (24.5, 24.9) p < 0.001) and lower (worse) PedsQL total scores compared to athletes in the HD group (78.4 (78.0, 78.8) vs. 90.9 (90.5, 91.3) p < 0.001). Females in May 2020 reported increased moderate and severe anxiety percentages than the males in May 2020 (27.7% vs 22.3%, p < 0.001).Conclusions:COVID-19 related school closures and sport cancellations in Wisconsin were associated with increased anxiety and depression as well as decreased physical activity and quality of life in adolescent athletes. The potential negative health impacts of prolonged school closures and sport cancellations should be taken into account when evaluating steps to limit the spread of COVID-19.