Jan 29, 2015
H.S. Shoulder Injury Analysis

dawncomstock-head.jpgBy Dawn Comstock

The Center for Injury Research and Policy at The Research Institute at Nationwide Children’s Hospital in Cincinnati shares its analysis of high school shoulder injury data it gathered during the 2005 to 2007 school years.


With fall sports in full swing, athletes across the country are working hard, gearing up, and hopefully continuing on a path that leads towards a physically active adult lifestyle. As sports medicine professionals, our job is to help keep them on this path.

In addition to making sure athletes have fun and learn proper techniques, preventing injury and properly managing injuries that do occur is key to their success. One body site that is not usually given much attention until something goes wrong is the shoulder.

As the body’s most mobile ball-and-socket joint, the shoulder is one of the most commonly injured body sites, both in the general population and among athletes. Nagging, chronic shoulder injuries force many athletes, particularly in sports such as baseball and football, to give up the sport they love. For the first time, we now have sound information on shoulder injury rates and patterns in a variety of high school sports.

The National High School Sports-Related Injury Surveillance Study, the only current nationally representative source of shoulder injury information in high school athletes, has been compiling shoulder injury information since the 2005-06 school year. By understanding when and how shoulder injuries occur, coaches and athletic trainers can develop interventions to prevent these events before they happen. Here is an overview of findings:

How often do shoulder injuries occur?

• Shoulder injuries make up eight percent of all high school sports injuries

• Shoulder injuries are three times more likely to occur during competition compared to practice

• Shoulder injuries make up a particularly large proportion of injuries in the following sports: o Baseball: 18 percent o Wrestling: 18 percent o Football: 12 percent o Softball: 10 percent

What types of shoulder injuries should coaches and athletic trainers expect to see?

Most common shoulder injury diagnoses: o Sprains/strains: 40 percent o Dislocations/separations: 24 percent o Contusions: 12 percent o Fractures: seven percent o Tendonitis: four percent How serious are shoulder injuries?

• Almost half of all athletes returned to play in <1 week • One in four shoulder injuries kept the athlete out of play for >3 weeks • One in seven shoulder injuries were recurrent • One in 16 shoulder injuries required surgery

When do shoulder injuries occur?

Common mechanisms leading to shoulder injury: o Player-to-player contact: 58 percent o Contact with the playing surface: 23 percent o No contact: 10 percent o Overuse/chronic: five percent

What does this information tell us about shoulder injuries?

• Shoulder injury rates appear to have decreased in the past decade, when compared with rates found during the 1995-1997 seasons. This decrease is likely in part due to improved prevention efforts, such as improved protective equipment and rule modifications, and improvements in the early diagnosis and treatment of shoulder injuries.

• Targeted preventive interventions implemented during practice may help decrease the relatively high rate of shoulder injuries incurred in competition

• In impact sports such as football and wresting, coaches should focus on safe, effective hitting, tackling, and takedown maneuvers

• In sports such as baseball, softball, and volleyball that involve high amounts of repetitive shoulder activities, coaches and athletic trainers should focus on quality rather than quantity

• Coaches and athletic trainers should consider implementing gender-, sport-, and position-specific shoulder strength and flexibility programs

• Continued biomechanics and protective equipment research should continue to provide athletes with improved performance gear and novel insights into appropriate ergonomic techniques. References

Powell JW, Barber-Foss KD. Injury patterns in selected high school sports: a review of the 1995-1997 seasons. J Athl Train. 1999;34(3): 277-284.

Hill JL, Humphries B, Weidner T, Newton RU. Female collegiate windmill pitchers: influences to injury incidence. J Strength Cond Res. 2004;18(3):426-431.

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 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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