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

Epidemiology of injuries in U.S. high school track and field throwing events from 2008 to 2019

BACKGROUND

Injury characteristics of high school track and field throwing athletes in the United States are not well studied. Understanding epidemiology of injuries is important to identify treatment and prevention strategies.

OBJECTIVE

To describe injury rates and patterns in U.S. high school track and field throwing events from a longitudinal national sports injury surveillance system.

DESIGN

Descriptive epidemiology study.

SETTING

Data were provided by the National High School Sports Related Injury Surveillance System, High School RIO (Reporting Information Online).

METHODS

Athletic trainers reported injury and exposure data through the High School RIO website on a weekly basis. An athlete exposure (AE) was defined as one athlete participating in one school-sanctioned practice or competition. Throwing events of discus, shot put, and javelin were analyzed in this study.

MAIN OUTCOME MEASURES

Injury rate, rate ratios (RR), injury proportion ratios (IPR).

PARTICIPANTS

U.S. high school athletes.

RESULTS

A total of 267 track and field throwing injuries occurred during 5,486,279 AEs. Overall, the rate of injuries in competition was higher than in practice (RR 1.35, 95% confidence interval [CI] 1.01-1.80). In practice, the rate of injuries was higher for girls than boys (RR 1.53, 95% CI 1.12-2.08). The most frequently injured body part was the shoulder (21.7%), followed by the ankle (16.5%) and knee (12.0%). The most common types of injury were muscle strains (26.14%) and ligament sprains (25%). Recurrent injuries accounted for a higher proportion of chronic injuries compared to new injuries (IPR 1.85, 95% CI 1.16-2.97).

CONCLUSION

This study described injury characteristics of high school track and field throwing athletes from 2008 to 2019. Based on our results, injury prevention may be particularly important for female throwers with prior injury.

Incidence of injury and illness among paediatric Team USA athletes competing in the 2020 Tokyo and 2022 Beijing Olympic and Paralympic Games

Objective

To describe the incidence of injuries and illnesses among paediatric Team USA athletes competing in the Tokyo 2020 Olympic and Paralympic Games, and the 2022 Beijing Olympic and Paralympic Games.

Methods

An electronic medical record system documented all injuries and illnesses that occurred while competing in the four Games periods. Incidence (IR) with 95% CI per 1000 athlete days were calculated for both injuries and illnesses. Incidence rate ratios (IRR) were calculated to compare injury and illness rates based on age (paediatric vs non-paediatric) sex, Games period and sport type.

Results

Two hundred paediatric athletes (age range, 15-21 years) competed across the four Games periods, representing 16.1% of all Team USA athletes. The overall injury IR (95% CI) was 13.4 (9.8 to 18.1), and the overall illness IR was 5.5 (3.3 to 8.7). There were no differences in incidence between paediatric and non-paediatric athletes for either injury (IRR (95% CI): 0.9 (0.6 to 1.2)) or illness (IRR (95% CI): 0.9 (0.5 to 1.5)). Female paediatric athletes were more likely to sustain an injury compared with male paediatric athletes (IRR (95% CI): 2.4 (1.1 to 5.3)). The most common mechanism of injury was gradual onset (IR, 4.3 (2.3 to 7.2)), and injuries most commonly occurred during practices (IR, 7.0 (4.5 to 10.5)).

Conclusion

Paediatric athletes account for a substantial proportion of Team USA athletes. It is essential that paediatric sports medicine experts are included in the medical team given that paediatric Team USA athletes are just as likely as their adult teammates to sustain an injury or illness.

Injury incidence among adolescent and senior basketball players: a prospective study in 19 teams across an entire season

OBJECTIVE

To quantify and compare injury incidence between national-level, adolescent and regional-level, senior, male basketball players competing in Serbia overall and according to injury mechanism (contact, non-contact, or overuse), exposure setting (training or games), and history (new or recurrent).

METHODS

A total of 218 male basketball players from 19 teams (106 senior and 112 adolescent players) volunteered to participate in the study. Descriptive data regarding game and training injury incidence were gathered across all players and reported per 10,000 athlete-exposures (AE) with 95% confidence intervals.

RESULTS

Overall, 26 injuries were reported across 52,509 AE. Ankle (n = 10, incidence rate [IR] = 1.90 [0.97, 3.40]) and knee injuries (n = 8, IR = 1.52 [0.71, 2.89]) accounted for 69% of all reported injuries, with only 1-2 injuries documented for other body regions. Ankle injuries were attributed to contact (60%, IR = 1.14 [0.46, 2.38]) or non-contact mechanisms (40%, IR = 0.76 [0.24, 1.84]). Most knee injuries occurred due to overuse (50%, IR = 0.76 [0.24, 1.84]) or non-contact mechanisms (38%, IR = 0.57 [0.15, 1.56]). Comparisons according to exposure setting revealed significantly higher knee (incidence rate ratio [IRR] = 9.95 [1.85, 53.41], p = 0.004) and ankle (IRR = 39.79 [7.94, 384.67], p < 0.001) injuries per 10,000 AE during games compared to training. Recurrent injuries were most prominent in the ankle (30% of all ankle injuries, p = 0.11). Total contact (p = 0.04), non-contact (p = 0.04), and recurrent IR (p = 0.005) were significantly higher in senior than adolescent players.

CONCLUSION

The players examined were most susceptible to ankle and knee injuries, particularly during games compared to training. Ankle injuries were mostly attributed to player contact, while knee injuries were mostly attributed to overuse and non-contact mechanisms. Senior players were at a greater risk of sustaining contact, non-contact and recurrent injuries than adolescent players.

The incidence rate of ACL injuries and ankle sprains in basketball players: A systematic review and meta-analysis

OBJECTIVE

To quantify the incidence rate of anterior cruciate ligament (ACL) injuries and ankle sprains according to player sex, playing level, and exposure setting (training vs. games) in basketball players.

METHODS

PubMed, MEDLINE, Google Scholar, and ScienceDirect were searched. Only studies reporting the number of ACL injuries and/or ankle sprains alongside the number of athlete-exposures (training sessions and/or games) in basketball players were included.

RESULTS

Thirty studies (17 reporting ACL injuries and 16 reporting ankle sprains) were included in the meta-analysis. Higher (p < 0.05) ACL injury incidence rates per 1000 athlete-exposures were recorded in females (female: 0.20 95% confidence intervals [0.16-0.25]; male: 0.07 [0.05-0.08]; female-to-male ratio: 3.33 [3.10-3.57]), in players competing at higher playing levels (amateur: 0.06 [0.04-0.09]; intermediate: 0.16 [0.13-0.20]; elite: 0.25 [0.14-0.64]), and in games (games: female, 0.27 [0.21-0.32]; male, 0.06 [0.03-0.08]; training: female, 0.03 [0.02-0.05]; male: 0.01 [0.00-0.02]; game-to-training ratio: 7.90 [4.88-12.91]). Higher (p < 0.05) ankle sprain incidence rates per 1000 athlete-exposures were observed in males (female: 0.82 [0.61-1.03]; male: 0.90 [0.61-1.19]; female-to-male ratio: 0.91 [0.83-0.99]), in players competing at higher playing levels (amateur: 0.54 [0.51-0.57]; intermediate: 1.12 [1.00-1.24]; elite: 1.87 [1.29-2.46]), and in games (games: 2.51 [1.85-3.16]; training: 0.80 [0.52-0.80]; game-to-training ratio: 2.77 [2.35-3.26]).

CONCLUSION

According to player sex, ACL injury incidence rate is higher in females, while ankle sprain incidence rate is greater in males. ACL injury and ankle sprain incidence rates are greater in players competing at higher playing levels and during games compared to training.

Lower Extremity Musculoskeletal Injuries After Concussion in Collegiate Student-Athletes

BACKGROUND

An association has been identified between concussion and lower extremity musculoskeletal injury (LEMSKI) after return to sports participation. However, the collegiate student-athlete studies have relied on relatively small single-institution studies, which limits generalizability.

PURPOSE

To assess odds of, and time to, LEMSKI after concussion in US collegiate athletes, using the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP).

STUDY DESIGN

Descriptive epidemiology study.

METHODS

Data from the NCAA ISP during the 2010-2011 through 2019-2020 athletic seasons were considered for analysis. Frequency distributions were examined for details related to the initial and subsequent injuries (injuries to bone, bursa, joint, ligament, muscle, or tendon). Multivariable logistic regression models and random-effects Poisson regression models examined odds of time loss (TL) and non-time loss (NTL) LEMSKI after concussion, as well as the time interval between initial concussion and subsequent LEMSKI in a single athletic season, or initial musculoskeletal injury (MSKI) and subsequent LEMSKI in a single athletic season. Analyses were performed separately for football and other sports.

RESULTS

A total of 31,556 initial injuries were recorded (football: 11,900; other sports: 19,656), which were followed by 0 or 1 injury in the same season. Overall, first injury type was not a significant predictor of subsequent LEMSKI, although certain contrasts yielded significant estimates. In football, the odds of NTL LEMSKI were higher after concussion than after upper extremity MSKI (UEMSKI; adjusted odds ratio [OR_Adj], 1.56; 95% CI, 1.06-2.31). In football, the odds of TL LEMSKI were lower after concussion than after UEMSKI (OR_Adj, 0.71; 95% CI, 0.51-0.99). No other significant effect estimates were observed for football or other sports.

CONCLUSION

First injury type, either concussion or upper extremity, was not associated with an elevated risk of LEMSKI. Specifically, the results of this study did not identify an elevated odds of LEMSKI after a concussion. However, the authors observed greater odds of NTL LEMSKI and lower odds of TL LEMSKI in football.

Descriptive Epidemiology of Campus Recreation Injuries

Campus recreation is an underserved population lacking specific medical standards, access to on-site medical personnel, and a universal injury surveillance system. The purpose of this study was to retrospectively examine injury epidemiology within a campus recreation center across 4 years. A total of 1,680 injuries were analyzed from one U.S. university with the greatest number of injuries occurring in intramural sports, informal recreation, and club sports, respectively. Of all injuries reported, 73% were musculoskeletal in nature and 9% were from concussions. As most injuries fall outside the scope of basic first aid, on-site medical services should be considered for all campus recreation settings.

Analysis of common shoulder injuries in collegiate baseball players

OBJECTIVES

Baseball players are highly susceptible to shoulder injuries due to repetitive overhead throwing. The purpose of this study was to investigate men's collegiate baseball shoulder injury rates and associated risk factors.

METHODS

Using the NCAA Injury Surveillance Program (ISP) database, shoulder injury data for men's baseball players was analyzed from 2009-2010 through 2013-2014. Only the most common shoulder injuries were examined, including acromioclavicular (AC) sprain, anterior dislocation, biceps tear, biceps tendinitis, SLAP (superior labrum from anterior to posterior) tear, non-SLAP labral tear, rotator cuff tear, rotator cuff tendinitis, and shoulder impingement. Statistical analysis was performed using proportion ratios (PR). Statistical significance was initially defined as p < 0.05; a post-hoc Bonferroni adjustment was applied using a p < 0.005 threshold balancing the likelihood of false positive and false negative findings.

RESULTS

Overall, 138 shoulder injuries were identified of which 51.4% occurred during practice. Rotator cuff pathology represented 45.6% of all injuries, with rotator cuff tears significantly more likely to be season-ending injuries (PR 2.5, 95% CI 1.2-5.6, p = 0.019). Pitching or throwing was the mechanism of injury in 100% of players with rotator cuff tendonitis, 87.5% of SLAP tears, 70% of players with biceps tendinitis, and 67% of players with rotator cuff tears. Biceps tendinitis (PR 3.9, 95% CI 1.2-12.5, p = 0.024) and SLAP tears (PR 6.4, 95% CI 1.6-25.0, p = 0.008) were significantly more likely to be chronic. SLAP tears were significantly more likely to be recurrent (PR 5.5, 95% CI = 1.5-20.4, p = 0.010). Being a freshman or sophomore was significantly associated with a lower proportion of biceps tendinitis (PR = 0.2, 95% CI = 0.04-0.8, p = 0.028). All anterior shoulder dislocations occurred while running the bases or sliding, and AC sprains were significantly associated with contact (PR 20.6, 95% CI = 2.5-168.7, p = 0.0048).

CONCLUSIONS

Repetitive overhead throwing in college baseball is a common cause of overuse shoulder injuries. These athletes are especially susceptible to rotator cuff pathology, which is significantly more likely to cause season-ending injuries. While we have to interpret these results in light of both adjusted and unadjusted p-values, this information signifies the importance of shoulder injury prevention strategies by physicians and trainers taking care of collegiate baseball players.

Epidemiology of sport-related concussion rates in female contact/collision sport: a systematic review

Objectives

To determine sport-related concussion (SRC) incidence rates in female contact/collision sport.

Design

Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

Data sources

Four databases (PubMed, SportsDiscus, Web of Science, CINAHL) were searched for data from 2012 to 2021.

Eligibility criteria

Studies reporting SRC incidence rates or the number of concussions and athletic exposures (AEs) per 1000 participating events or hours in healthy female contact and collision sport athletes of any age were included.

Results

The search yielded 8438 non-duplicate articles. Following screening, 19 were included in the analysis (median quality score=70%), with 8 reporting match or training incidence rates. Studies were primarily from US high school and collegiate populations; data are reported for eight sports. Rugby union reported the highest match SRC rates (8.2-16.11 per 1000 AE hours), followed by Gaelic football (5.21 per 1000 AE hours) and soccer (2.08-4.04 per 1000 AE events). Where available, match SRC rates were substantially higher than training and overall SRC rates.

Conclusion

Female sports such as rugby union, Gaelic football and soccer present the highest risk for SRCs within the available data. Previous research indicates a potentially greater injury burden for female athletes experiencing SRCs than their male counterparts. Thus, future research should analyse concussion knowledge and return-to-play protocols in these sports. Future research should also prioritise exploration of the gap in SRC rates within amateur sports, and data should be presented specifically in the context of athletic exposures (match vs training).

Trial registration number

CRD42021281569.

Characterizing athletic healthcare: A perspective on methodological challenges, lessons learned, and paths forward

Recently, there has been an emphasis on collecting large datasets in the field of sports medicine. While there have been great advances in areas of sport performance and sport epidemiology, there have been fewer efforts dedicated to understanding the effectiveness and impact of athletic healthcare, including injury prevention programs and rehabilitation interventions provided at the point-of-care. In 2009, the Athletic Training Practice-Based Research Network (AT-PBRN) was launched to address this need, with the mission of improving the quality of care provided by athletic trainers. Unlike other research efforts in sports and medicine, such as sport epidemiology, there are fewer methodological best practices specifically related to clinical data in athletic healthcare. As a result, the AT-PBRN has encountered several methodological challenges during its tenure and has established guidelines based on various sources within the fields of sports and medicine to address these challenges. Therefore, the purpose of this perspective is to identify the challenges and describe strategies to address these challenges related to characterizing athletic healthcare using a large database. Specifically, challenges related to data entry (data quality and reliability) and data extraction and processing (data variability and missing data) will be discussed. Sharing challenges and perspectives on solutions for collecting and reporting on athletic healthcare data may facilitate a greater consistency in the approach used to collect, analyze, and report on clinical data in athletic healthcare, with the goal of improving patient outcomes and the quality of care provided by athletic trainers.

Epidemiological Comparison of ACL Injuries on Different Playing Surfaces in High School Football and Soccer

Background:

Anterior cruciate ligament (ACL) injuries are among the most common serious injuries to athletes in the United States. Among high school sports, the highest rates of ACL injury occur in soccer and football.

Purpose:

To compare ACL injuries on artificial turf and natural grass using a nationally representative sample of high school athletes participating in football and boys’ and girls’ soccer.

Study Design:

Descriptive epidemiology study.

Methods:

ACL injuries among high school athletes participating in football and soccer were obtained from the High School Reporting Information Online surveillance system during the 2007-08 through 2018-19 school years. National estimates and injury proportion ratios (IPRs) with 95% CIs were calculated for ACL injuries that occurred on artificial turf versus natural grass.

Results:

A total of 1039 ACL injuries were reported, which represented an estimated 389,320 (95% CI, 358,010-420,630) injuries nationally. There were 74,620 estimated football-related ACL injuries on artificial turf and 122,654 on natural grass. Likewise, 71,877 of the estimated soccer-related ACL injuries occurred on artificial turf and 104,028 on natural grass. A contact-injury mechanism accounted for 50.2% of football-related ACL injuries on artificial turf and 60.8% on natural grass. For soccer-related ACL injuries, a noncontact mechanism predominated on artificial turf (61.5%) and natural grass (66.4%). Among all injuries, ACL injuries were more likely to occur on artificial turf than natural grass in both football (IPR, 1.23 [95% CI, 1.03-1.47]) and girls’ soccer (IPR, 1.53 [95% CI, 1.08-2.16]); however, no significant association was found in boys’ soccer (IPR, 1.65 [95% CI, 0.99-2.75]). Among lower extremity injuries, ACL injuries were more likely to occur on artificial turf than natural grass in both boys’ soccer (IPR, 1.72 [95% CI, 1.03-2.85]) and girls’ soccer (IPR, 1.61 [95% CI, 1.14-2.26]); however, the association was not significant in football (IPR, 1.17 [95% CI, 0.98-1.39]).

Conclusion:

ACL injuries were more likely to occur (ie, had larger IPRs) on artificial turf than natural grass; however, this relationship was not statistically significant for all sports.

Epidemiology of Concussions in National Collegiate Athletic Association (NCAA) Sports: 2014/15-2018/19

BACKGROUND

Updated epidemiology studies examining sports-related concussions (SRCs) are critical in evaluating recent efforts aimed at reducing the incidence of SRCs in National Collegiate Athletic Association (NCAA) sports.

PURPOSE

To describe the epidemiology of SRCs in 23 NCAA sports during the 2014/15-2018/19 academic years.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

SRC and exposure data collected in the NCAA Injury Surveillance Program were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics by sport, event type (practices, competitions), injury mechanism (player contact, surface contact, equipment/apparatus contact), and injury history (new, recurrent). Injury rate ratios (IRRs) were used to examine differential injury rates, and injury proportion ratios (IPRs) were used to examine differential distributions.

RESULTS

A total of 3497 SRCs from 8,474,400 athlete-exposures (AEs) were reported during the study period (4.13 per 10,000 AEs); the competition-related SRC rate was higher than was the practice-related SRC rate (IRR, 4.12; 95% CI, 3.86-4.41). The highest SRC rates were observed in men's ice hockey (7.35 per 10,000 AEs) and women's soccer (7.15 per 10,000 AEs); rates in women's soccer and volleyball increased during 2015/16-2018/19. Player contact was the most prevalently reported mechanism in men's sports (77.0%), whereas equipment/apparatus contact was the most prevalently reported mechanism in women's sports (39.2%). Sex-related differences were observed in soccer, basketball, softball/baseball, and swimming and diving. Most SRCs reported in men's sports (84.3%) and women's sports (81.1%) were reported as new injuries.

CONCLUSION

Given the increasing SRC rates observed in women's soccer and volleyball during the latter years of the study, these results indicate the need to direct further attention toward trajectories of SRC incidence in these sports. The prevalence of equipment/apparatus contact SRCs in women's sports also suggests that SRC mechanisms in women's sports warrant further investigation. As most SRCs during the study period were reported as new injuries, the prevalence of recurrent SRCs in men's and women's ice hockey is also noteworthy.

Prevalence and incidence of injuries among female cricket players: a systematic review and meta-analyses

OBJECTIVE

The objective of the review was to describe the incidence and prevalence of injuries among female cricket players of all ages, participating in all levels of play.

INTRODUCTION

Cricket, a bat-and-ball sport, is becoming popular among women of all ages and abilities worldwide. However, cricket participation carries a risk of injury. Injuries negatively affect sport participation, performance, and short- and long-term health and well-being. Injury prevention, therefore, is the key to safe, long-term cricket participation as a physical activity goal. Epidemiological data are needed to underpin evidence-based injury-prevention strategies.

INCLUSION CRITERIA

Studies reporting incidence and prevalence of injuries in female cricket players of all ages, participating in all levels of play, were included in this review, including studies that report data by sex or by sport. Studies without enough data to calculate prevalence or incidence, that do not distinguish female injury data from males', that focus on athletes participating in other sports, or that focus on case studies were excluded.

METHODS

A systematic review and meta-analyses were conducted according to the JBI and PRISMA 2020 guidelines. MEDLINE, SPORTDiscus, Physiotherapy Evidence Database (PEDro), EBSCO MasterFILE Premier, EBSCO CINAHL Complete, ProQuest Health and Medical Complete, Scopus, and Science Direct were systematically searched from inception to August 2021. Additionally, Cochrane Controlled Trials Register and ClincalTrail.gov were searched. EBSCO MegaFile Premier (EBSCO), OpenGrey (SIGLE), WorldCat, Grey Matters, Grey Literature, and Google Scholar databases were searched for gray literature. Full-text articles that met the inclusion criteria were critically appraised using JBI-tools, and were extracted and synthesized in narrative summary and tabular forms. Three meta-analyses were conducted: injury incidence rate, injury prevalence proportions, and injury incidence proportions. Heterogeneity was assessed using the I2 statistic and the random-effects model.

RESULTS

Of the 7057 studies were identified and only 4256 screened after duplicates removed, 23 studies met the inclusion criteria. Risk of bias was low for 21 studies. The injury incidence rate for elite cricket was 71.9 (SE 21.3, 95% CI 30.2-113.6) injuries per 1000 player hours, time-loss injury incidence rate was 13.3 (SE 4.4, 95% CI 4.6-22.0) injuries per 1000 player hours, and non-time-loss injury incidence rate was 58.5 (SE 16.9, 95% CI 25.6-91.7) injuries per 1000 player hours. The injury prevalence proportions for community to elite cricket was 65.2% (SE 9.3, 95% CI 45.7-82.3) and injury prevalence proportions for community cricket was 60% (SE 4.5, 95% CI 51.1-68.6). The injury incidence proportions for community cricket was 5.6 (SE 4.4, 95% CI 0.1-18.3) injuries per 10,000 participants. Elite cricket players were more frequently injured than community cricket players. The most prevalent body regions injured were the shoulder and knee, and most were sustained by fast bowlers. Injuries to the hand, wrist, and fingers had the highest incidence and were most sustained by fielders.

CONCLUSIONS

The study's findings can help stakeholders (including players, coaches, clinicians, and policymakers) make informed decisions about cricket participation by informing and implementing strategies to promote cricket as a vehicle for positive public health outcomes. This review also identified gaps in the available evidence base and addressing these through future research would enhance women's cricket as a professional sport.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42020166052.

High Injury and Concussion Rates in Female Youth Team Sport: An Opportunity for Prevention

The aim of this study was to investigate sport-related injury rates, types, locations, and mechanisms in female youth team sports.This was a secondary analysis of a cross-sectional study. An anonymous online survey was administered to high school students (ages 14-19) in Canada. The survey included questions regarding demographic information, sport participation and self-reported injuries sustained in the past year. Results were analyzed for girls who reported playing a top ten team sports for female participation. For girls participating in team sports, the overall injury rate was 55.5 injuries/100 participants/year. The rate of at least one concussion was 9.4 concussions/100 participants/year. Injury and concussion rates were highest in ringette (Injury rate=42.9 injuries/100 participants/year, Concussion rate=19.0 concussions/100 participants/year) and rugby (Injury rate=40.0, Concussion rate=15.3). The top three most serious injury locations were the knee (24.7%), ankle (21.6%) and head (16.1%). The most common injury types were joint/ligament sprain (26.71%), fracture (13.0%) and concussion (11.8%). Contact mechanisms accounted for 73.4% of all serious injuries reported in girls team sports.Team sport injury rates are high in female youth team sports. Specific consideration of sport-specific injury rates, types and mechanisms in girls' team sports will inform development and evaluation of targeted sport-specific prevention strategies.

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

Background

Acute 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.

Methods

Injuries 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.

Results

Of 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.

Conclusions

Acute 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.

Epidemiology of Injuries in National Collegiate Athletic Association Women's Softball: 2014-2015 Through 2018-2019

CONTEXT

Women's softball athletes account for approximately 9% of all female athletes competing within the National Collegiate Athletic Association (NCAA).

BACKGROUND

Routine surveillance of NCAA women's softball injuries is important for identifying the emerging injury patterns in this sport.

METHODS

Exposure and injury data collected during competitive seasons in the NCAA Injury Surveillance Program during 2014-2015 through 2018-2019 (5 years) academic years were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics; injury rate ratios (IRRs) were used to examine differential injury rates.

RESULTS

The overall injury rate was 3.92 per 1000 athlete exposures. Practice and preseason injury rates increased during 2015/16 through 2018/19. Most injuries were shoulder (15.2%), hand/wrist (11.8%), knee (11.2%), and head/face injuries (11.2%) and were classified as contusions (14.2%), sprains (14.1%), and inflammatory conditions (14.1%). Concussion (6.8%) was the most commonly reported injury, and concussion incidence fluctuated during 2014-2015 through 2018-2019.

SUMMARY

Results indicate an increasing trend in practice and preseason injury incidence. Findings also suggest that workload accumulation in the shoulder and the mechanisms of concussion warrant further attention in this population.

Epidemiology of Injuries in National Collegiate Athletic Association Women's Swimming and Diving: 2014-2015 Through 2018-2019

CONTEXT

The number of women's swimming and diving teams sponsored by the National Collegiate Athletic Association has increased over the last 5 years.

BACKGROUND

Routine examinations of women's swimming and diving injuries are important for identifying emerging temporal patterns.

METHODS

Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014-2015 through 2018-2019 athletic seasons were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differences in injury rates.

RESULTS

The overall injury rate was 1.78 per 1000 athlete-exposures in swimmers and 2.49 per 1000 AEs in divers. Shoulder (33.0%) injuries accounted for the largest proportion of all swimming injuries; most injuries were classified as overuse (51.3%). Head or face (29.4%) and trunk (20.2%) injuries accounted for the largest proportions of all diving injuries.

SUMMARY

Findings indicated that shoulder and trunk injuries, as well as injuries resulting from overuse mechanisms, warrant further attention in swimming. Given the low in the National Collegiate Athletic Association Injury Surveillance Program observed across the study period, the need for greater participation in sports injury surveillance is also apparent.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Baseball: 2014-2015 Through 2018-2019

CONTEXT

The National Collegiate Athletic Association has supported men's baseball championships since 1947. Since its inception, the number of participating teams and athletes has considerably expanded.

BACKGROUND

Frequently conducting injury surveillance of collegiate baseball athletes is essential for identifying developing temporal patterns.

METHODS

Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics; injury rate ratios were used to examine differential injury rates.

RESULTS

The overall injury rate was 3.16 per 1000 athlete-exposures. The preseason injury rate was significantly higher than the regular season injury rate. The most commonly injured body parts were shoulder (16.1%), arm or elbow (16%), and hand or wrist (13.9%). The most reported specific injury was hamstring tear (7.9%).

CONCLUSIONS

The findings of this study aligned with previous studies-most injuries were due to noncontact and overuse mechanisms, less than one-half of injuries were related to upper extremity body parts, and one-third of all injuries were reported among pitchers.

Epidemiology of Injuries in National Collegiate Athletic Association Women's Soccer: 2014-2015 Through 2018-2019

CONTEXT

The National Collegiate Athletic Association held the first women's soccer championship in 1982; sponsorship and participation have greatly increased since.

BACKGROUND

Routine examinations of athlete injuries are important for identifying emerging temporal patterns.

METHODS

Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014-2015 through 2018-2019 seasons were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates.

RESULTS

The overall injury rate was 8.33 per 1000 athlete-exposures. Lateral ligament complex tears (ankle sprains) (8.6%), concussions (8.3%), and quadriceps tears (5.0%) were the most commonly reported injuries. Rates of lateral ligament complex tears followed an increasing trajectory during the study period, whereas quadriceps tear rates fluctuated during the early years, and concussion rates decreased then increased.

SUMMARY

The findings of this study were mostly consistent with existing evidence; notable temporal patterns were observed with regard to lateral ligament complex tears and concussions.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Track and Field: 2014-2015 Through 2018-2019

CONTEXT

College athletes have been competing in championship track and field events since 1921; the numbers of competing teams and participating athletes have expanded considerably.

BACKGROUND

Monitoring injuries of men's track and field athletes using surveillance systems is critical in identifying emerging injury-related patterns.

METHODS

Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014-2015 through 2018-2019 academic years were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics; injury rate ratios were used to examine differential injury rates.

RESULTS

Overall, men's track and field athletes were injured at a rate of 2.37 per 1000 athlete-exposures; injuries occurred at a higher rate during competition compared with practice. Most injuries were to the thigh (26.2%), lower leg (17.3%), or knee (10.7%) and were caused by noncontact (37.2%) or overuse (31.5%) mechanisms. The most reported injury was hamstring tear (14.9%).

SUMMARY

The etiologies of thigh and lower-leg injuries warrant further attention in this population. Future researchers should also separately examine injury incidence during indoor and outdoor track and field seasons.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Football: 2014-2015 Through 2018-2019

CONTEXT

Football is among the most popular collegiate sports in the United States, and participation in National Collegiate Athletic Association (NCAA) football has risen in recent years.

BACKGROUND

Continued monitoring of football injuries is important for capturing the evolving burden of injuries in NCAA football. The purpose of this study was to describe the epidemiology of football-related injuries among men's NCAA football players during the 2014-2015 through 2018-2019 academic years.

METHODS

Exposure and injury data collected in the NCAA Injury Surveillance Program were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates.

RESULTS

The overall injury rate was 9.31 per 1000 athlete-exposures. Most injuries occurred during general play (17.5%), blocking (15.8%), and tackling (14.0%). Concussions (7.5%), lateral ligament complex tears (6.9%), and hamstring tears (4.7%) were the most commonly reported injuries.

CONCLUSIONS

Results of this study were generally consistent with previous findings, though changes over time in rates of commonly reported injuries warrant attention. Continued monitoring of injury incidence is needed to appraise the effectiveness of recently implemented rules changes.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Cross-Country: 2014-2015 Through 2018-2019

CONTEXT

The National Collegiate Athletic Association has sponsored men's cross-country programs since 1938, and the sport has grown greatly in scope since then.

BACKGROUND

Routine examinations of men's cross-country injuries are important for identifying emerging temporal patterns.

METHODS

Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates.

RESULTS

The overall injury rate was 4.01 per 1000 athlete-exposures (AEs). Most reported injuries were inflammatory conditions (30.2%), strains (18.7%), and sprains (11.5%); rates of inflammatory conditions were highest in preseason. The most commonly reported injuries were lateral ligament complex tears (ankle sprains; 8.2%).

SUMMARY

Findings of this study were not entirely consistent with existing evidence; continued monitoring of competition injury rates and rates of commonly reported injuries is needed beyond 2018-2019.

Methods of the National Collegiate Athletic Association Injury Surveillance Program, 2014-2015 Through 2018-2019

BACKGROUND

Since 1982, the National Collegiate Athletic Association (NCAA) has collaborated with athletic trainers (ATs) to create the largest ongoing collegiate sports injury database in the world. This report provides an operational update of the NCAA Injury Surveillance Program (NCAA ISP) during the academic years 2014-2015 through 2018-2019.

SURVEILLANCE SYSTEM STRUCTURE

The NCAA ISP used a convenience sampling technique via a rolling recruitment model. The ATs at contributing institutions voluntarily submitted data into their respective electronic medical record systems; common data elements were pushed to and maintained by the Datalys Center. The ATs provided information about all team-related activities, even if no injury occurred during that activity, as well as detailed reports on each injury, including condition and circumstances.

SUMMARY

The NCAA ISP has a long-standing role in supplying NCAA stakeholders with crucial injury surveillance data, playing a critical part in safeguarding student-athletes participating in collegiate sports.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Swimming and Diving: 2014-2015 Through 2018-2019

CONTEXT

The National Collegiate Athletic Association (NCAA) has sponsored men's swimming and diving since 1937.

BACKGROUND

Routine examinations of men's swimming and diving injuries are important for identifying emerging injury-related patterns.

METHODS

Exposure and injury data collected in the NCAA Injury Surveillance Program during the 2014-2015 through 2018-2019 academic years were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differences in injury rates.

RESULTS

The overall injury rate was 1.56 per 1000 athlete-exposures (AEs) for swimmers and 1.52 per 1000 AEs for divers. Shoulder (27.0%) injuries accounted for the largest proportion of all swimming injuries, and most injuries were attributed to overuse mechanisms (42.6%). Shoulder (23.3%) and trunk (23.3%) injuries accounted for the largest proportion of all diving injuries, and most injuries resulted from surface contact (32.6%).

CONCLUSIONS

Findings were consistent with existing literature on swimming and diving. The need for continued surveillance, coupled with more robust participation by swimming and diving programs was also highlighted.

Epidemiology of Injuries in National Collegiate Athletic Association Women's Track and Field: 2014-2015 Through 2018-2019

CONTEXT

Women's track and field events at the National Collegiate Athletic Association level have grown in popularity in recent years, and track and field athletes are vulnerable to a broad range of potential injuries.

BACKGROUND

Routine examination of track and field injuries is important for identifying emerging patterns in injury incidence.

METHODS

Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014-2015 to 2018-2019 academic years were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates.

RESULTS

The overall injury rate was 2.20 per 1000 athlete exposures; the competition injury rate was higher than the practice injury rate (injury rate ratio = 1.73; 95% confidence interval = 1.51, 1.97). Hamstring tears (8.9%), medial tibial stress syndrome (5.4%), and lateral ligament complex tears (4.2%) were the most reported injuries.

CONCLUSIONS

Given the results of this study, further attention may be directed toward factors associated with noncontact injury risk in the competitions. The changing injury rates of most reported injuries also warrant monitoring post 2018-2019.

Epidemiology of Sports-Related Injuries and Associated Risk Factors in Adolescent Athletes: An Injury Surveillance

The present study aimed to determine the epidemiology of sport-related injuries in amateur and professional adolescent athletes and the incidence of different risk factors on those injuries. Four hundred ninety-eight athletes aged 14 to 21 voluntarily participated in this prospective injury surveillance, conducted from 1 January 2019 to 31 December 2019. The information collected included: personal data, sports aspects, characteristics of the injuries, and lifestyle. Forty point four percent of the participants suffered an injury in 2019 (39% of them in a previously injured area). The average injury rate was 2.64 per 1000 h. Soccer presented the highest rate (7.21). The most common injuries were: lumbar muscle strains (12.24%), ankle sprains (11.98%), and bone fractures (9.31%). Ankles (36.12%), knees (19.32%), and shoulders (6.47%) concentrated the highest number of injuries. Fifty-nine point twenty-eight percent of the injuries occurred during practices, and 40.72% during competition or peri-competition. Higher injury rates were associated (in this order) with the following factors: (a) Greater number of hours of practice per week. (b) Not performing warm-ups. (c) Using inadequate sports facilities. (d) Being aged 14–17. (e) Not performing physical preparation. (f) Inappropriate training load. (g) Not performing injury-preventive activities. (h) Performing sports technique without the supervision of one sports coach. (i) Inadequate sports equipment. In conclusion, since most injury risk factors are modifiable, it is imperative to implement strategies to reduce amateur and professional adolescent athletes’ injury rates.

Methods of the National Athletic Treatment, Injury and Outcomes Network Surveillance Program (NATION-SP), 2014-2015 Through 2018-2019

BACKGROUND

The National Athletic Treatment, Injury and Outcomes Network Surveillance Program (NATION-SP) was established in 2011 to provide a comprehensive appraisal of injuries sustained by high school student-athletes who received services from athletic trainers (ATs). The purpose of this article is to update the surveillance methods of the NATION-SP for data reported during the 2014-2015 through 2018-2019 academic years.

SURVEILLANCE SYSTEM STRUCTURE

The NATION-SP used a rolling recruitment model to identify a convenience sample of US high schools with access to ATs. The ATs at participating institutions volunteered to contribute data via electronic medical records systems; common data elements were then pushed to and maintained by the Datalys Center for Sports Injury Research and Prevention. The ATs completed detailed reports on each injury, including the condition and circumstances. The treatments component was used to comprehensively assess the services provided to athletes by ATs. The outcomes companion component was developed to monitor patient-reported outcomes after athletic injury.

SUMMARY

The NATION-SP continues to serve a critical purpose in informing injury-prevention and treatment efforts among high school athletes.

Characteristics of Injuries Occurring During Cross-Country: A Report from the Athletic Training Practice-Based Research Network

CONTEXT

Cross-country is a popular sport activity, particularly in adolescent populations. Although epidemiologic investigations have provided insight into patient and injury characteristics associated with running injuries, little is known about how these injuries are managed at the point of care.

OBJECTIVE

To describe injury and treatment characteristics of injuries sustained during cross-country.

DESIGN

Cross-sectional study.

SETTING

High school athletic training clinics within the Athletic Training Practice-Based Research Network.

PATIENTS OR OTHER PARTICIPANTS

Patient cases were included if the patient was diagnosed with an injury that occurred during interscholastic cross-country participation. All patients received usual care by an athletic trainer.

MAIN OUTCOME MEASURE(S)

We used summary statistics to describe injury (sex, age, participation level, time of injury, mechanism of injury, body part, injury type, diagnosis) and treatment (type, amount, duration, number of services) characteristics.

RESULTS

Most cross-country injuries occurred to the lower extremity and were musculotendinous or ligamentous in nature. The most common injury types were sprain/strain (43.8%), tendinopathy (18.5%), and general pain (9.5%). Injured body parts and diagnoses were typically similar between sexes. The most frequently used treatment was therapeutic exercises or activities (28.7%), and patients received an average of 7.4 ± 17.4 total athletic training services during 5.5 ± 15.1 episodes of care over 27.8 ± 87.5 days.

CONCLUSIONS

Adolescent cross-country student-athletes frequently sustained non-time-loss injuries that required up to 1 month of treatment and management. These findings will generate awareness surrounding the role of athletic trainers in providing care for cross-country athletes.

Epidemiology of Patients with Dance-Related Injuries Presenting to Emergency Departments in the United States, 2014-2018

BACKGROUND

Updated rates and patterns associated with patients with dance-related injuries reporting to US emergency departments (EDs) is needed.

HYPOTHESIS

Between the years 2014 and 2018, there will be an observed rise of patients with dance-related injuries seen within US EDs.

STUDY DESIGN

Retrospective analysis.

LEVEL OF EVIDENCE

Level 4.

METHODS

Utilizing the National Electronic Injury Surveillance System (NEISS) database, data were abstracted for all structured dance-related injuries for all people who presented to a NEISS participating hospital from January 1, 2014, to December 31, 2018. Data were abstracted on age, sex, race, disposition, location on the body where the injury happened, and free text box regarding the mechanism and nature of the injury. Each patient case was associated with a weight to provide national incidence rate (per 100,000) estimates. Descriptive statistics were used to summarize counts, percentages, and rates across patient cases.

RESULTS

Between years 2014 and 2018, 4152 patients reported to the NEISS EDs with a dance-related injury. Most injuries occurred in female patients (83.3%; n = 3459) and among those who were 10 to 18 years old (76.2%; n = 3164). The most common injuries were ankle sprain/strain (12.7%; n = 527) and knee sprain/strain (10.4%; n = 431). Almost all patients were treated and released (97.1%; n = 4033). These data yielded population-weighted estimates of 125,618 injuries for the study period, with an increasing trend over time (19.2% increase over 5 years). Incidence rates were over 4 times higher for female (12.4) than for male patients (3.0) and highest in the 10- to 18-year-old age group (incidence rate = 46.4).

CONCLUSION

Patients with dance-related injuries reporting to EDs increased over a 5-year period from 2014 to 2018. The majority of dancers in the study were female patients, between the ages of 10 and 18 years, nearly half of the patients reported to the ED with a sprain/strain, and almost all patients were treated and released.

CLINICAL RELEVANCE

An increase in access to proper injury prevention medical services and education should be provided to female dancers between the ages of 10 and 18 years.

STRENGTH OF RECOMMENDATION TAXONOMY

B.

Concussion Symptom Characteristics and Resolution in 20 United States High School Sports, 2013/14-2017/18 Academic Years

BACKGROUND

High school (HS) sport-related concussions (SRCs) remain a public health concern in the United States.

OBJECTIVE

To describe patterns in symptom prevalence, symptom resolution time (SRT), and return-to-play time (RTP) for SRCs sustained in 20 HS sports during the 2013/14-2017/18 academic years.

METHODS

A convenience sample of athletic trainers reported concussion information to the HS RIOTM surveillance system. Symptom prevalence, average number of symptoms, and SRT and RTP distributions were examined and compared by event type (practice, competition), injury mechanism (person contact, nonperson contact), sex, and contact level (collision, high contact, and low contact) with chi-square tests and Wilcoxon rank-sum tests.

RESULTS

Among all SRCs (n = 9542), headache (94.5%), dizziness (73.8%), and difficulty concentrating (56.0%) were commonly reported symptoms. On average, 4.7 ± 2.4 symptoms were reported per SRC. Overall, 51.3% had symptoms resolve in <7 d, yet only 7.9% had RTP < 7 d. Differential prevalence of amnesia was seen between practice and competition-related SRCs (8.8% vs 13.0%; P < .001); nonperson-contact and person-contact SRCs (9.3% vs 12.7%; P < .001); and female and male SRCs in low-contact sports (5.8% vs 17.5%; P < .001). Differential prevalence of loss of consciousness was seen between practice and game-related SRCs (1.3% vs 3.2%; P < .001); and female and male SRCs in high contact sports (1.2% vs 4.0%; P < .001). Differential longer SRT (>21 d) was seen between new and recurrent SRCs (9.4% vs 15.9%; P < .001).

CONCLUSION

Headache was the most commonly reported symptom. Notable group differences in the prevalence of amnesia, loss of consciousness, and SRT may be associated with more severe SRCs, warranting further attention.

The NICA injury surveillance system: Design, methodology and preliminary data of a prospective, longitudinal study of injuries in youth cross country mountain bike racing

OBJECTIVES

To describe the design and implementation of an injury surveillance system for youth mountain bike racing in the United States, and to report preliminary first-year results.

DESIGN

Descriptive sports injury epidemiology study.

METHODS

After two and a half years of development and extensive beta-testing, an electronic injury surveillance system went live in January, 2018. An automated email is sent to a Designated Reporter on each team, with links to the injury reporting form. Data collected include demographic information, injured body part, injury diagnosis, trail conditions and other factors associated with injury occurrence.

RESULTS

837 unique injuries were reported in 554 injury events among 18,576 student-athletes. The overall injury event proportion was 3.0%. The most common injury among student-athletes was concussion/possible concussion (22.2%), followed by injuries to the wrist and hand (19.0%). Among 8,738 coaches, there were 134 unique injuries reported that occurred in 68 injury events, resulting in an overall injury event proportion of 0.8%. The shoulder (38.2%) was the most commonly injured body part among coaches. Injuries among coaches tended to more frequently result in fractures, dislocations and hospital admission compared with injuries among student-athletes. Among student-athletes, female riders sustained lower limb injuries more than male riders (34.0% vs. 20.7%, p<0.001).

CONCLUSIONS

A nationwide injury surveillance system for youth mountain bike racing was successfully implemented in the United States. Overall injury event proportions were relatively low, but many injury events resulted in concussions/possible concussions, fractures, dislocations and 4 weeks or longer of time loss from riding.

Are high school girls' lacrosse players at increased risk of concussion because they are not allowed to wear the same helmet boys' lacrosse players are required to wear?

BACKGROUND

Boys' lacrosse (LAX), a full contact sport allowing body and stick checking, mandates hard shell helmets with full face masks. Girls' LAX, which prohibits body checking and whose sphere rule is supposed to prevent stick checking to the head, allows optional flexible headgear with/without integrated eye protection. Whether the required boys' LAX helmets should also be mandated in girls' LAX has been debated.

METHODS

In this retrospective cohort study we used LAX concussion data from a national high school sports-related injury surveillance study to determine if girls' LAX players were at increased risk of concussion from stick or ball contact due to differences in helmet regulations by calculating the attributable risk and attributable risk percent (AR%) for concussion resulting from ball or stick impacts.

RESULTS

From 2008-09 through 2018-19, boys' LAX players sustained 614 concussions during 1,318,278 athletic exposures (AEs) (4.66 per 10,000 AEs) and girls' LAX players sustained 384 concussions during 983,291 AEs (3.91 per 10,000 AEs). For boys, athlete-athlete contact was the most common mechanism of concussion accounting for 66.4% of all concussions, while stick or ball contact accounted for 23.5%. For girls, stick or ball contact accounted for 72.7% of all concussions, while athlete-athlete contact accounted for 19.8%. Concussion rates from stick or ball contact were significantly higher in girls vs. boys (RR = 2.60, 95% CI 2.12-3.18). The attributable risk associated with playing girls' vs. boys' LAX for concussion resulting from stick or ball contact was 1.75 concussions per 10,000 AEs (95% CI 1.37-2.12) and the AR% was 61.5% (95% CI 52.9-68.5). An estimated 44.7% of all girls' LAX concussions could have been prevented if girls' LAX players wore the helmet mandated in boys' LAX.

CONCLUSIONS

Girls' LAX players who are allowed, but not required, to wear a flexible headgear are at increased risk of concussions from stick or ball impacts compared to boys' LAX players, who are required to wear a hard shell helmet with full face mask. Additional research is needed to determine if there are any defendable arguments to continue justifying restricting girls' LAX players access to this effective piece of protective equipment.

The North Texas Concussion Registry (ConTex)

PURPOSE

The North Texas Concussion Registry (ConTex) was established in 2015 as a multi-institutional collaboration intended to study risk factors, recovery patterns and clinical outcomes associated with concussion across the lifespan, with a particular emphasis on sport-related concussion.

PARTICIPANTS

Prospective enrolment of individuals who sustained a concussion within the past 6 months who were seen at one of four North Texas ConTex concussion clinics which employ common diagnostic criteria and assessment metrics to evaluate effects of a concussion as well as longitudinal tracking of recovery.

FINDINGS TO DATE

The ConTex database and multidisciplinary oversight team has been established, and over 1700 participants aged 5-88 years have been enrolled. A majority of concussions were sport-related (60%), with a mean age of 17.5 years and similar numbers of males and females. Three-month follow-up compliance has been excellent (86%), with a majority of subjects reporting good recovery by that time. ConTex has provided a rich data source for multiple research projects focused on concussion characteristics, risk factors and outcomes, and led to the development of a statewide youth concussion registry.

FUTURE PLANS

ConTex data are being analysed to add to the body of knowledge regarding concussion mechanisms, factors related to recovery and improving outcomes for concussion patients. ConTex will serve as a platform for future treatment studies and may serve as a model for other concussion surveillance programmes.

Epidemiology and Incidence of Pediatric Concussions in General Aspects of Life

BACKGROUND

Concussions are one of the most common head injuries acquired within the pediatric population. While sport-related concussions are well documented, concussions within other aspects of a child's life are not as well researched. The purpose of this study is to examine the incidence of a large pediatric concussion population in a broad range of daily activities.

METHODS

Patients' gender and nature of injury were extracted from 1408 medical records of patients who were diagnosed with a concussion at Saint Peter's Sports Medicine Institute. Statistical analyses were conducted for activities and environmental settings using chi-squared tests.

RESULTS

Concussions were most prevalent in organized sports (53.3%), followed by injuries within the following settings: school (16.5%), recreational (6.7%), motor vehicle collisions (6.6%), home (5.5%), and other (11.3%). Specifically, soccer (12.9%), school physical education (PE) class (10.6%), and football (9.8%) subcategories recorded the most incidences of concussion. For the PE class cohort (n = 149), significantly more females were diagnosed with a concussion compared to males (p < 0.001).

CONCLUSIONS

PE-related concussions had the second highest incidence rate after organized sports. A significant gender difference was observed in PE class. Awareness about concussions and methods to reduce the risk of concussion is suggested for PE classes.

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls' Lacrosse (2008-2009 Through 2013-2014) and National Collegiate Athletic Association Women's Lacrosse (2004-2005 Through 2013-2014)

CONTEXT

The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online (HS RIO) system and the National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) has aided the acquisition of girls' and women's lacrosse injury data.

OBJECTIVE

To describe the epidemiology of injuries sustained in high school girls' lacrosse in the 2008-2009 through 2013-2014 academic years and collegiate women's lacrosse in the 2004-2005 through 2013-2014-academic years using Web-based sports injury surveillance.

DESIGN

Descriptive epidemiology study.

SETTING

Online injury surveillance from high school girls' (annual average = 55) and collegiate women's (annual average = 19) lacrosse teams.

PATIENTS OR OTHER PARTICIPANTS

Female lacrosse players who participated in practices or competitions during the 2008-2009 through 2013-2014 academic years for high school or the 2004-2005 through 2013-2014 academic years for college.

MAIN OUTCOME MEASURE(S)

Athletic trainers collected time-loss injury (≥24 hours) and exposure data. We calculated injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis.

RESULTS

High school RIO documented 700 time-loss injuries during 481 687 AEs; the NCAA-ISP documented 1027 time-loss injuries during 287 856 AEs. The total injury rate during 2008-2009 through 2013-2014 was higher in college than in high school (2.55 versus 1.45/1000 AEs; IRR = 1.75; 95% CI = 1.54, 1.99). Most injuries occurred during competitions in high school (51.1%) and practices in college (63.8%). Rates were higher during competitions compared with practices in high school (IRR = 2.32; 95% CI = 2.00, 2.69) and college (IRR = 2.38; 95% CI = 2.09, 2.70). Concussion was the most common diagnosis among all high school and most collegiate player positions, and the main mechanism of contact was with a playing apparatus (eg, stick, ball). Ligament sprains were also common (HS RIO practices = 22.2%, competitions = 30.3%; NCAA-ISP practices = 25.5%, competitions = 30.9%).

CONCLUSIONS

Rates of injury were higher in college versus high school female lacrosse players and in competitions versus practices. Injury-prevention strategies are essential to decrease the incidence and severity of concussions and ligament sprains.

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Lacrosse (2008-2009 Through 2013-2014) and National Collegiate Athletic Association Men's Lacrosse (2004-2005 Through 2013-2014)

CONTEXT

The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of boys' and men's lacrosse injury data.

OBJECTIVE

To describe the epidemiology of injuries sustained in high school boys' lacrosse in the 2008-2009 through 2013-2014 academic years and collegiate men's lacrosse in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

DESIGN

Descriptive epidemiology study.

SETTING

Online injury surveillance from lacrosse teams of high school boys (annual average = 55) and collegiate men (annual average = 14).

PATIENTS OR OTHER PARTICIPANTS

Boys' and men's lacrosse players who participated in practices and competitions during the 2008-2009 through 2013-2014 academic years in high school or the 2004-2005 through 2013-2014 academic years in college.

MAIN OUTCOME MEASURE(S)

Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated.

RESULTS

High School Reporting Information Online documented 1407 time-loss injuries during 662 960 AEs. The National Collegiate Athletic Association Injury Surveillance Program documented 1882 time-loss injuries during 390 029 AEs. The total injury rate from 2008-2009 through 2013-2014 was higher in college than in high school (3.77 versus 2.12/1000 AEs; IRR = 1.78; 95% CI = 1.63, 1.94). Most injuries occurred during competitions in high school (61.4%) and practices in college (61.4%). Injury rates were higher in competitions compared with practices in high school (IRR = 3.59; 95% CI = 3.23, 4.00) and college (IRR = 3.38; 95% CI = 3.08, 3.71). Lower limb injuries, muscle strains, and ligament sprains were common at both levels. Concussion was the most frequent competition diagnosis for all high school player positions.

CONCLUSIONS

Rates of time-loss injury were higher in college versus high school and in competitions versus practices. Attention to preventing common lower leg injuries and concussions, especially at the high school level, is essential to decrease their incidence and severity.

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Wrestling (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Men's Wrestling (2004-2005 Through 2013-2014)

CONTEXT

The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of wrestling injury data.

OBJECTIVE

To describe the epidemiology of injuries sustained in high school boys' wrestling in the 2005-2006 through 2013-2014 academic years and collegiate men's wrestling in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

DESIGN

Descriptive epidemiology study.

SETTING

Online injury surveillance from wrestling teams of high school boys (annual average = 100) and collegiate men (annual average = 11).

PATIENTS OR OTHER PARTICIPANTS

Male wrestlers who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school or the 2004-2005 through 2013-2014 academic years in college.

MAIN OUTCOME MEASURE(S)

Athletic trainers collected time-loss (≥24 hours) injuries and exposure data during this time period. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios with 95% confidence intervals, and injury proportions by body site and diagnosis were calculated.

RESULTS

The High School Reporting Information Online documented 3376 time-loss injuries during 1 416 314 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 2387 time-loss injuries during 257 297 AEs. The total injury rate was higher in college than in high school (9.28 versus 2.38/1000 AEs; injury rate ratio = 3.89; 95% confidence interval = 3.69, 4.10). In high school, the most commonly injured body parts for both practices and competitions were the head/face (practices = 19.9%, competitions = 21.4%) and shoulder/clavicle (practices = 14.1%, competitions = 21.0%). In college, the most frequently injured body parts for both practices and competitions were the knee (practices = 16.7%, competitions = 30.4%) and head/face (practices = 12.1%, competitions = 14.6%).

CONCLUSIONS

Injury rates were higher in collegiate than in high school players, and the types of injuries sustained most often differed. Based on these results, continued study of primary and secondary prevention of injury in wrestlers across levels of competition is warranted.

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Ice Hockey (2008-2009 Through 2013-2014) and National Collegiate Athletic Association Men's and Women's Ice Hockey (2004-2005 Through 2013-2014)

CONTEXT

Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided efforts to collect data on ice hockey injuries.

OBJECTIVE

To describe the epidemiology of injuries sustained in high school boy's ice hockey in the 2008-2009 through 2013-2014 academic years and collegiate men's and women's ice hockey in the 2004-2005 through 2013-2014 academic years using Web-based surveillance.

DESIGN

Descriptive epidemiology study.

SETTING

Online injury surveillance of ice hockey teams of high school boys (annual average = 34), collegiate men (annual average = 20), and collegiate women (annual average = 11).

PATIENTS OR OTHER PARTICIPANTS

Boys', men's, and women's ice hockey players who participated in practices and competitions during the 2008-2009 through 2013-2014 high school academic years or the 2004-2005 through 2013-2014 collegiate academic years.

MAIN OUTCOME MEASURE(S)

Athletic trainers collected time-loss (≥24 hours) injury and exposure data. We calculated injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis.

RESULTS

The High School Reporting Information Online system documented 831 boys' ice hockey time-loss injuries during 356 997 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 2611 men's ice hockey time-loss injuries during 552 642 AEs and 752 women's ice hockey injuries during 232 051 AEs. Injury rates were higher in collegiate men than in high school boys during 2008-2009 through 2013-2014 (4.38 versus 2.33/1000 AEs; IRR = 1.88; 95% CI = 1.73, 2.05) and collegiate women during 2004-2005 through 2013-2014 (IRR = 1.46; 95% CI = 1.34, 1.58). Most injuries occurred during competitions (boys = 80.0%, men = 66.9%, women = 55.3%); injury rates were higher in competitions than in practices for boys (IRR = 8.14; 95% CI = 6.87, 9.65), men (IRR = 6.58; 95% CI = 6.06, 7.13), and women (IRR = 3.63; 95% CI = 3.14, 4.19). At all levels, most injuries occurred to the head/face and shoulder/clavicle and resulted in concussions, contusions, or ligament sprains.

CONCLUSIONS

Injury rates varied across sports but were consistently higher in competitions than in practices. In competitions, concussions were common injuries, highlighting the need for continued development of injury-prevention strategies.

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls' Basketball (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Women's Basketball (2004-2005 Through 2013-2014)

CONTEXT

The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of girls' and women's basketball injury data.

OBJECTIVE

To describe the epidemiology of injuries sustained in high school girls' basketball in the 2005-2006 through 2013-2014 academic years and collegiate women's basketball in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

DESIGN

Descriptive epidemiology study.

SETTING

Online injury surveillance from basketball teams in high school girls (annual average = 100) and collegiate women (annual average = 57).

PATIENTS OR OTHER PARTICIPANTS

Girls' and women's basketball players who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school or the 2004-2005 through 2013-2014 academic years in college.

MAIN OUTCOME MEASURE(S)

Certified athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs) were calculated. Injury rate ratios (IRRs) with 95% confidence intervals (CIs) were used to compare injury rates by school size or division, time in season, event type, and competition level.

RESULTS

The High School Reporting Information Online system documented 2930 time-loss injuries during 1 609 733 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 3887 time-loss injuries during 783 600 AEs. The injury rate was higher in college than in high school (4.96 versus 1.82/1000 AEs; IRR = 2.73; 95% CI = 2.60, 2.86). The injury rate was higher in competitions than in practices for both high school (IRR = 3.03; 95% CI = 2.82, 3.26) and collegiate (IRR = 1.99; 95% CI = 1.86, 2.12) players. The most common injuries at both levels were ligament sprains, concussions, and muscle/tendon strains; the majority of injuries affected the ankle, knee, and head/face. These injuries were often caused by contact with another player or a noncontact mechanism.

CONCLUSIONS

Injury rates were higher in collegiate than in high school athletes and in competitions than in practices. Similarities in distributions of injuries by body parts, specific diagnoses, and mechanisms of injury suggest that both levels may benefit from similar injury-prevention strategies.

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Basketball (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Men's Basketball (2004-2005 Through 2013-2014)

CONTEXT

The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of boys' and men's basketball injury data.

OBJECTIVE

To describe the epidemiology of injuries sustained in high school boys' basketball in the 2005-2006 through 2013-2014 academic years and collegiate men's basketball in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

DESIGN

Descriptive epidemiology study.

SETTING

Online injury surveillance from basketball teams of high school boys (annual average = 100) and collegiate men (annual average = 55).

PATIENTS OR OTHER PARTICIPANTS

Boys' and men's basketball players who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school or the 2004-2005 through 2013-2014 academic years in college.

MAIN OUTCOME MEASURES

Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs) were calculated. Injury rate ratios (IRRs) with 95% confidence intervals (CIs) compared injury rates by school size or division, time in season, event type, and competition level.

RESULTS

The High School Reporting Information Online system documented 3056 time-loss injuries during 1 977 480 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 4607 time-loss injuries during 868 631 AEs. The injury rate was higher for college than for high school (5.30 versus 1.55/1000 AE; IRR = 3.43; 95% CI = 3.28, 3.59). The injury rate was higher for competitions than for practices in both high school (IRR = 2.38; 95% CI = 2.22, 2.56) and college (IRR = 2.02; 95% CI = 1.90, 2.14). The most common injuries at both levels were ligament sprains, muscle/tendon strains, and concussions; most injuries affected the ankle, knee, and head/face. Injuries were most often caused by contact with another player or noncontact mechanisms.

CONCLUSIONS

Injury rates were greater among collegiate players compared with high school players and were greater during competitions than practices at both levels. Distributions of injuries by body part, diagnoses, and mechanisms of injury were similar, suggesting that athletes at both levels may benefit from similar injury-prevention strategies.

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls' Softball (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Women's Softball (2004-2005 Through 2013-2014)

CONTEXT

The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of girls' and women's softball injury data.

OBJECTIVE

To describe the epidemiology of injuries sustained in high school girls' softball in the 2005-2006 through 2013-2014 academic years and collegiate women's softball in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

DESIGN

Descriptive epidemiology study.

SETTING

Online injury surveillance from softball teams in high school girls (annual average = 100) and collegiate women (annual average = 41).

PATIENTS OR OTHER PARTICIPANTS

Girls' or women's softball players who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school and the 2004-2005 through 2013-2014 academic years in college.

MAIN OUTCOME MEASURE(S)

Athletic trainers collected time-loss injury and exposure data. Injury rates per 1000 athlete-exposures (AEs) were calculated. Injury rate ratios (IRRs) with 95% confidence intervals (CIs) compared injury rates by competition level, school size or division, event type, and time in season.

RESULTS

The High School Reporting Information Online system documented 1357 time-loss injuries during 1 173 722 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 1848 time-loss injuries during 579 553 AEs. The injury rate was higher in college than in high school (3.19 versus 1.16/1000 AEs; IRR = 2.76; 95% CI = 2.57, 2.96). The competition injury rate was higher than the practice injury rate in high school (IRR = 2.02; 95% CI = 1.82, 2.25) and in college (IRR = 1.39; 95% CI = 1.27, 1.52). Softball players at both levels sustained a variety of injuries, with the most common being ankle sprains and concussions. Many injuries also occurred while fielding or running bases.

CONCLUSIONS

Injury rates were greater in collegiate versus high school softball and in competitions versus practices. These findings highlight the need for injury-prevention interventions, including strength-training and prevention programs to reduce ankle sprains and provide protection for batters from pitches and fielders from batted balls.

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Baseball (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Men's Baseball (2004-2005 Through 2013-2014)

CONTEXT

The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of boys' and men's baseball injury data.

OBJECTIVE

To describe the epidemiology of injuries sustained in high school boys' baseball in the 2005-2006 through 2013-2014 academic years and collegiate men's baseball in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

DESIGN

Descriptive epidemiology study.

SETTING

Online injury surveillance from baseball teams in high school boys (annual average = 100) and collegiate men (annual average = 34).

PATIENTS OR OTHER PARTICIPANTS

Boys' or men's baseball players who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school or the 2004-2005 through 2013-2014 academic years in college, respectively.

MAIN OUTCOME MEASURE(S)

Athletic trainers collected time-loss injury and exposure data. Injury rates per 1000 athlete-exposures (AEs) were calculated. Injury rate ratios (IRRs) with 95% confidence intervals (CIs) compared injury rates by school size or division, time in season, event type, and competition level.

RESULTS

The High School Reporting Information Online system documented 1537 time-loss injuries during 1 573 257 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 2574 time-loss injuries during 804 737 AEs. The injury rate was higher in college than in high school (3.20 versus 0.98/1000 AEs; IRR = 3.27; 95% CI = 3.07, 3.49). The competition injury rate was higher than the practice injury rate in high school (IRR = 2.27; 95% CI = 2.05, 2.51) and college (IRR = 2.32; 95% CI = 2.15, 2.51). Baseball players at the high school and collegiate levels sustained a variety of injuries across the body, with the most common injuries reported to the upper extremity. Many injuries also occurred while fielding or pitching.

CONCLUSIONS

Injury rates were greater in collegiate versus high school baseball and in competition versus practice. These findings highlight the need for injury-prevention interventions focused on reducing the incidence of upper extremity injuries and protecting batters from pitches and fielders from batted balls.

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls' Volleyball (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Women's Volleyball (2004-2005 Through 2013-2014)

CONTEXT: 

The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided in the acquisition of girls' and women's volleyball injury data.

OBJECTIVE: 

To describe the epidemiology of injuries sustained in high school girls' volleyball in the 2005-2006 through 2013-2014 academic years and collegiate women's volleyball in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

DESIGN: 

Descriptive epidemiology study.

SETTING: 

Online injury surveillance from high school girls' (annual average = 100) and collegiate women's (annual average = 50) volleyball teams.

PATIENTS OR OTHER PARTICIPANTS: 

Girls' and women's volleyball players who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school and the 2004-2005 through 2013-2014 academic years in college.

MAIN OUTCOME MEASURE(S): 

Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated.

RESULTS: 

The High School Reporting Information Online system documented 1634 time-loss injuries during 1 471 872 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 2149 time-loss injuries during 563 845 AEs. The injury rate was higher in college than in high school (3.81/1000 versus 1.11/1000 AEs; IRR = 3.43; 95% CI = 3.22, 3.66), and higher in high schools with ≤1000 students than in those with >1000 students (IRR = 1.35; 95% CI = 1.23, 1.49). Injury rates did not vary by collegiate division. The injury rate was higher during competitions than practices for high school (IRR = 1.23; 95% CI = 1.12, 1.36) but not for college (IRR = 1.01; 95% CI = 0.92, 1.10). Ankle sprains were common in both the high school and collegiate setting. However, liberos had a high incidence of concussion.

CONCLUSIONS: 

Injury rates were higher among collegiate than high school players. However, injury rates differed by event type in high school, unlike college. Concussion injury patterns among liberos varied from those for other positions. These findings highlight the need for injury-prevention interventions specific to setting and position.

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Soccer (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Men's Soccer (2004-2005 Through 2013-2014)

CONTEXT: 

The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of boys' and men's soccer injury data.

OBJECTIVE: 

To describe the epidemiology of injuries sustained in high school boys' soccer in the 2005-2006 through 2013-2014 academic years and collegiate men's soccer in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

DESIGN: 

Descriptive epidemiology study.

SETTING: 

Online injury surveillance from soccer teams of high school boys (annual average = 100) and collegiate men (annual average = 41).

PATIENTS OR OTHER PARTICIPANTS: 

Boys' or men's soccer players who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school and the 2004-2005 through 2013-2014 academic years in college, respectively.

MAIN OUTCOME MEASURE(S): 

Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated.

RESULTS: 

High School Reporting Information Online documented 2912 time-loss injuries during 1 592 238 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 4765 time-loss injuries during 686 918 AEs. The injury rate was higher in college than in high school (6.94 versus 1.83/1000 AEs; IRR = 3.79; 95% CI = 3.62, 3.97). Injury rates increased with smaller school size for high schools and were higher in Division I than in Divisions II and III. The injury rate was higher during competitions than during practices in both high school (IRR = 3.55; 95% CI = 3.30, 3.83) and college (IRR = 3.45; 95% CI = 3.26, 3.65). Most injuries were to the lower extremity. However, concussion was a common injury, particularly in collegiate goalkeepers and at all positions for high school players. Concussions accounted for more than one-fifth of injuries in high school games.

CONCLUSIONS: 

Injury-prevention interventions should be tailored to reflect variations in the incidence and type of injury by level of competition, event type, and position.

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls' Soccer (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Women's Soccer (2004-2005 Through 2013-2014)

CONTEXT:

The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of girls' and women's soccer injury data.

OBJECTIVE:

To describe the epidemiology of injuries sustained in high school girls' soccer in the 2005-2006 through 2013-2014 academic years and collegiate women's soccer in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

DESIGN:

Descriptive epidemiology study.

SETTING:

Online injury surveillance from soccer teams in high school girls (annual average = 100) and collegiate women (annual average = 52).

PATIENTS OR OTHER PARTICIPANTS:

Female high school and collegiate soccer players who participated in practices or competitions during the 2004-2005 through 2013-2014 academic years.

MAIN OUTCOME MEASURE(S):

Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), injury proportions by body site, and diagnoses were calculated.

RESULTS:

The High School Reporting Information Online system documented 3242 time-loss injuries during 1 393 753 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 5092 time-loss injuries during 772 048 AEs. Injury rates were higher in college than in high school (6.60 versus 2.33/1000 AEs; IRR = 2.84; 95% CI = 2.71, 2.96), and during competitions than during practices in high school (IRR = 4.88; 95% CI = 4.54, 5.26) and college (IRR = 2.93; 95% CI = 2.77, 3.10). Most injuries at both levels affected the lower extremity and were ligament sprains or muscle/tendon strains. Concussions accounted for 24.5% of competition injuries in high school but 14.6% of competition injuries in college. More than one-third of competition injuries to high school goalkeepers were concussions.

CONCLUSIONS:

Injury rates were higher in college versus high school and during competitions versus practices. These differences may be attributable to differences in reporting, activity intensity, and game-play skill level. The high incidence of lower extremity injuries and concussions in girls' and women's soccer, particularly concussions in high school goalkeepers, merits further exploration and identification of prevention strategies.