Jan 29, 2015
Been There, Done That

dawncomstock-head.jpgBy Dawn Comstock

The only thing worse than an injury is a re-injury. Here, the Center for Injury Research and Policy at The Research Institute at Nationwide Children’s Hospital in Cincinnati shares its analysis of recurrent injury rates and trends for high school athletes.


As athletic trainers and strength and conditioning coaches, we push our athletes to work out hard, hoping for them to excel on the field while being protected against injury. However, sometimes despite our best efforts, injuries do occur. What can be particularly frustrating is when an injury reoccurs.

How often do re-injuries happen? And what can we do to prevent them from occurring? The National High School Sports-Related Injury Surveillance Study is currently the only nationally representative source of information about recurrent injuries in high school sports. Recently we conducted an in-depth investigation on recurrent injuries to find out more about them.

To start, we defined a recurrent injury as an injury to a location on the body that previously sustained the same injury. The recurrent injury needed to result in at least a one-day time loss from play and needed to require some type of medical attention, whether that be an athletic trainer’s analysis on the sideline or more advanced treatment at a local hospital or urgent care center. The recurrent injury also needed to occur during participation in a school-sanctioned athletic practice or competition.

Overall, we found that one in 10 injuries sustained by high schools athletes are recurrent. Although recurrent injuries are relatively uncommon, they occur most frequently during football competition. Here, players on average sustained one recurrent injury in every 800 competitions.

The next highest rate was seen in girls’ soccer, where players on average sustained one recurrent injury in every 1,900 competitions. Girls were also 40 percent more likely than boys to sustain a recurrent injury in soccer. Recurrent injury rates were similar between boys and girls in basketball as well as those playing baseball and softball.

Some of the main patterns were as follows: • The ankle was the most common site for recurrent injury. By sport, ankle injuries accounted for: – One in two recurrent injuries in boys’ and girls’ basketball – One in three recurrent injuries in volleyball and boys’ soccer – One in four recurrent injuries in girls’ soccer and softball – One in five recurrent injuries in football

• The shoulder was the next most common site for recurrent injury, accounting for one in four recurrent injuries in wrestling and baseball.

• Incomplete ligament sprains accounted for one in three recurrent injuries. Specifically, one in four recurrent injuries were incomplete ankle sprains.

• Concussions accounted for one in recurrent injuries. Concussions were particularly frequent in girls’ soccer, where one in five recurrent injuries were concussions. Concussions also accounted for one in seven recurrent injuries in girls’ basketball.

• Overall, recurrent injuries were not more likely to require surgery compared to new injuries. The most common recurrent injuries requiring surgery were shoulder dislocations and torn knee cartilage.

• Although half of all athletes sustaining a recurrent injury were able to return to play in less than one week, almost one in 10 athletes were medically disqualified for the remainder of their season.

• Compared to an athlete sustaining a new injury, an athlete sustaining a recurrent injury was over three times more likely to discontinue participation in their sport.

The best way to preventing recurrent injuries begins with preventing initial injuries. In particular, developing balance, flexibility, and functional strength may help prevent against ankle injuries. Once an injury does occur, appropriate rest and rehabilitation are crucial. An athlete who returns to play too soon following an initial injury is more likely to sustain a recurrent injury. Although prophylactic devices such as ankle braces may help protect against future injury, additional research is needed to determine the efficiency of such equipment.

Dawn Comstock, PhD, is a principle investigator at the Center for Injury Research and Policy at The Research Institute at Nationwide Children’s Hospital. She is also an assistant professor at The Ohio State University in the College of Medicine and the College of Public Health. Her research interests include the epidemiology of sports, recreation, and leisure activity-related injuries among children and adolescents as well as the life-long health benefits associated with an active childhood. She can be reached at: [email protected]




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