A nationally representative study of severe injuries sustained by high school athletes in the US, 2005-07 school years

Purpose: Severe sports-related injuries sustained by US high school athletes may result in psychological stress, missed school, potentially permanent physical disabilities, and financial burdens on the athlete's family and overall health care system.

Methods: Using an internet-based data collection tool, RIO(TM), certified athletic trainers from 100 nationally representative high schools reported athletic exposure and injury data for athletes participating in nine sports during the 2005-07 school years. Severe injuries were defined as injuries resulting in time loss of >21 days or ending the athlete's season or career.

Results: 1,376 severe injuries occurred during 3,550,141 athletic-exposures (AE) for an injury rate of 3.9 per 10,000 AE. Nationally, there were an estimated 446,291 severe injuries among US high school athletes. The most common diagnoses were fractures (36.1%), ligament sprains (complete tears) (15.2%), and ligament sprains (incomplete tears) (14.2%). The most commonly injured body sites were the knee (29.0%), ankle (12.4%), and shoulder (10.9%). 28.3% of severe injuries required surgery, with the most common being complete ligament sprains (38.0%), torn knee cartilage (9.6%), and hand fractures (7.4%). Injury rates varied by sport, gender, and type of exposure. The injury rate of severe injuries was higher in competition (7.8) than practice (2.4) (RR=3.29, 95% CI: 2.95-3.65). In basketball, girls sustained a higher rate of severe injury (3.4) than boys (2.4) (RR=1.41, 95% CI: 1.09-1.84).

Conclusions: Severe injuries among US high school athletes vary by sport and type of exposure. Identifying such differences is important for the development of evidence-based, targeted injury prevention interventions.