Epidemiology of high school competition and practice injuries

Over 7 million United States (US) high school students participate in sports. We compared competition and practice injury rates and patterns in 5 boys' sports (football, soccer, basketball, wrestling, and baseball) and 4 girls' sports (soccer, volleyball, basketball, and softball) during the 2005-06 school year. Injury data were collected from 100 nationally representative US high schools via High School RIO™ (Reporting Information Online) and a weighting algorithm calculated national injury estimates. High school athletes participating in these nine sports sustained an estimated 1,442,533 injuries during the 2005-06 school year, with the rate of injury per 1,000 athlete-exposures higher in competition (4.63) compared to practice (1.69) (RR=2.73, 95% CI: 2.58-2.90). Of all sports, football had the highest competition (12.09) and practice (2.54) injury rates. Compared to injuries sustained during practice, higher proportions of competition injuries were head/face/neck injuries (IPR=1.61, 95% CI: 1.34-1.94), particularly in boys' soccer (IPR=7.74, 95% CI: 2.53-23.65) and girls' basketball (IPR=6.03, 95% CI: 2.39-15.22). Additionally, competition injuries were more likely to be concussions (IPR=2.02, 95% CI: 1.56-2.62), especially in boys' soccer (IPR=6.94, 95% CI: 2.01-23.95) and girls' basketball (IPR=5.83, 95% CI: 2.06-16.49). Higher proportions of competition injuries caused the athlete to miss >3 weeks of play (IPR=1.28, 95% CI: 1.08-1.52), particularly in baseball (IPR=3.47, 95% CI: 1.48-8.11) and volleyball (IPR=2.88, 95% CI: 1.01-8.24). Identifying such patterns of injury is a crucial step in the development of the targeted evidence-based interventions required to effectively reduce injury rates among the millions of students participating in high school sports.