Jan 29, 2015Severe Injury Trends For Prep Sports
By Dawn Comstock
Injuries can run the gamut from a contused leg that results in no playing time loss at all to a season-ending complete knee ligament sprain. We recently used data from the National High School Sports-Related Injury Surveillance Study to examine rates and patterns of severe injury in nine high school sports: football, boys’ and girls’ soccer, volleyball, boys’ and girls’ basketball, wrestling, baseball, and softball.
Defined as any injury that resulted in the loss of more than three weeks of sports participation, severe injuries are fortunately less common than minor injuries. In fact, severe injuries account for only one out of every seven injuries sustained by athletes. However, even one in seven is a pretty large number. During the 2005-06 and 2006-07 school years, U.S. high school athletes sustained over 220,000 severe injuries per year. As one might expect, these severe injuries are often costlier to treat. Half of all severe injuries ultimately resulted in a medical disqualification for the rest of the season and one in four required surgery.
We found that severe injury rates were highest in football, where players sustained an average of one severe injury every 1,500 times they practiced or competed. The next highest rates were in wrestling (one severe injury in every 1,900 practices or competitions) and girls’ basketball and girls’ soccer (one severe injury in every 3,000 practices or competitions).
When restricting our data to the sports played by both genders (soccer, basketball, and baseball/softball), severe injury rates were 28 percent higher among girls. In all the sports we studied, severe injuries were over three times more likely to occur in competition compared to practice. This was particularly apparent in football and girls’ soccer, where severe injuries were five times more likely to occur during competition.
Although the type of severe injury varied by sport, the most common were fractures (36 percent), complete ligament sprains (15 percent), and incomplete ligament sprains (14 percent). Fractures were most commonly to the hand/finger, ankle, and wrist, while complete ligament sprains were most commonly to the knee. Fractures were the most frequent severe injury in all sports studied except girls’ soccer and girls’ basketball, where complete knee ligament sprains were more common.
Overall, severe injuries were most frequently to the knee (29 percent), ankle (12 percent), and shoulder (11 percent). Knee injuries were the most frequent severely injured body site in all sports studied except wrestling and baseball, where shoulder injuries were most common.
When we reviewed mechanisms and activities leading to severe injuries, we noted that one in 20 were directly related to an action that was ruled illegal activity by a referee, official, or disciplinary committee. Contact with another player was the most commonly cited mechanism in football and soccer. Other commonly cited mechanisms were rotation around a planted foot in soccer, jumping/landing in volleyball and basketball, and contact with the bases in baseball and softball.
Each sport also had specific activities that most frequently led to severe injury. Here they are in each of the nine sports:
• Football: being tackled or tackling • Boys’ soccer: chasing a loose ball, heading the ball, and ball handling • Girls’ soccer: ball handling, general play, and defending • Volleyball: blocking • Boys’ basketball: rebounding, defending, and general play • Girls’ basketball: rebounding, chasing a loose ball, and ball handling • Wrestling: takedowns and near falls • Baseball: fielding, pitching, and sliding • Softball: sliding, fielding, and batting
Comparing the current study with previous sports injury research conducted over a decade ago suggests that the proportion of all high school sports injuries that are severe has remained steady over the last several years. This suggests that developments such as preventive interventions and improved protective equipment may be offset by increases in competition intensity or increases in the size, strength, and/or speed of high school athletes. Or, another possibility is that severe injury rates may have decreased, but athletic trainers and coaches may be requiring injured athletes to sit out longer in order to make sure they are fully recovered before returning to play.
Because severe injuries negatively impact athletes’ health and often place an increased burden on the healthcare system, future research should focus on developing interventions to decrease the incidence and severity of sports-related injuries.
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].