Sex-related injury patterns among selected high school sports

This cohort observational study was undertaken to test the hypothesis that the incidence of injuries for girls participating in high school sports is greater than that for boys. From 1995 through 1997, players were included in our study if they were listed on the school's varsity team roster for boys' or girls' basketball, boys' or girls' soccer, boys' baseball, or girls' softball. Injuries and opportunities for injury were recorded daily. Certified athletic trainers reported injury and exposure data. Based on 39,032 player-seasons and 8988 reported injuries, the injury rates per 100 players for softball (16.7) and for girls' soccer (26.7) were higher than for baseball (13.2) and boys' soccer (23.4). The knee injury rates per 100 players for girls' basketball (4.5) and girls' soccer (5.2) were higher than for their male counterparts. Major injuries occurred more often in girls' basketball (12.4%) and soccer (12.1%) than in boys' basketball (9.9%) and soccer (10.4%). Baseball players (12.5%) had more major injuries than softball players (7.8%). There was a higher number of surgeries, particularly knee and anterior cruciate ligament surgeries, for female basketball and soccer players than for boys or girls in other sports.     

The incidence of injury in Texas high school basketball. A prospective study among male and female athletes.

Recent publications have reported differences in the incidence, rate, risk, and type of sports injury among men and women. We undertook a prospective study to determine the incidence of injury among high school basketball players and to examine the differences in injury type, incidence, rate, and risk between male and female athletes. During a single basketball season, an injury survey of girls' varsity teams at 100 class 4A and 5A high schools in Texas was conducted. These data were previously reported. We surveyed the same 100 high schools during a subsequent season to gather injury data from the boys' varsity teams. The athletic trainer collected data on each reportable injury and reported the data weekly to the University Interscholastic League. A reportable injury was defined as one that occurred during a practice or a game, resulted in missed practice or game time, required physician consultation, or involved the head or the face. The boys' and girls' data were compared and statistically analyzed. The rate of injury was 0.56 among the boys and 0.49 among the girls. The risk of injury per hour of exposure was not significantly different between the two groups. In both groups, the most common injuries were sprains, and the most commonly injured area was the ankle, followed by the knee. Female athletes had a significantly higher rate of knee injuries including a 3.79 times greater risk of anterior cruciate ligament injuries. For both sexes, the risk of injury during a game was significantly higher than during practice.     

Epidemiology of injuries in men’s lacrosse: injury prevention implications for competition level,type of play,and player position

Objective: The growth in participation in men’s lacrosse has increased the likelihood of sport-specific injuries, yet there continues to be a need for specific epidemiological data concerning lacrosse injuries. The purpose of this literature review is to aggregate available published data on injuries that occur in the sport of men’s lacrosse at the youth, high school, collegiate, and professional levels.

Methods: A comprehensive literature search was performed in PubMed, High Wire Press, SPORTDiscus, Google Scholar, and Ovid, using the keywords Lacrosse Injuries, Epidemiology Lacrosse Injuries, Lacrosse Injury, Lacrosse AND Injury and limited to 1990–2016. All bibliographies were cross-referenced to identify any additional publications. Sources were categorized based on data provided and were aggregated into groups based on reported overall injury rates, rates by setting (competition vs. practice), nature of injury, location, type, severity, and player position.

Results: The game and practice injury rates in college are greater than the rates in high school, similarly rates greater for high school players than in youth leagues. Rates of injury varied from 0.095–12.98 per 1000 athlete exposures. Game injury rates were higher across all studies. Injuries in men’s lacrosse occur most often from player-to-player contact, which result in immediate injuries, such as concussions, contusions, and lacerations. Overall concussion incidence was reported to range from 0.11–0.84 per 1000 AE. The most common types of injuries were sprain, strain, concussion, and contusions and the most common area of injury was hand (23%), with a significant proportion of these (59.4%) being to the thumb. Limited evidence of different injuries among the player positions suggests there might be a pattern that midfield players had the most injuries, followed by offensive players and then defensive players.

Conclusions: The potential for sports-related injury is of relative concern; especially considering rising participation and total number of injuries. Further development and proper enforcement of safety rules on player contact and protective equipment are recommended to decrease the rate of lacrosse-related injury. Additional longitudinal research is needed to better classify and to ultimately predict lacrosse injury factors and mechanisms across all levels of play.     

Injuries in intercollegiate women's lacrosse

BACKGROUND: Historically, the sport of women's lacrosse has required little or no protective equipment. Recently, there has been increasing concern over trauma to the face and head incurred during play. A rule change passed in spring 2003, during the course of this study, mandates goggles in 2005. PURPOSE: To survey injuries in women's lacrosse over multiple seasons and institutions and to categorize injury rates and patterns. STUDY DESIGN: A prospective survey. METHODS: A standard report-of-injury form was sent to participating institutions. Injuries were defined by athletic training staff as any event resulting in the athlete missing one or more games or practices. RESULTS: The overall injury rate for women's lacrosse for the 2001-2002 and 2002-2003 seasons from participating schools was 3.8 per 1000 athlete exposures. The rate of head and face injuries was 1.4 per 1000 athlete exposures, representing 38.5% of all injuries incurred. The rate of eye injuries was 0.43 per 1000 athlete exposures, accounting for 11.5% of the total injuries. The practice injury rate was 2.7 per 1000 athlete exposures, and the competition injury rate was 8.8 per 1000 athlete exposures. CONCLUSION: Data support the future requirements for protective eyewear. There is significant and increasing exposure for head and face trauma. Further investigation is needed to monitor injury patterns in women's lacrosse as rules for protective gear evolve.     

Epidemiology of meniscal injuries in US high school athletes between 2007 and 2013

Purpose

Knowledge of epidemiologic trends of meniscal injuries in young active populations is limited. Better awareness of injury patterns is a first step to lowering injury rates. Our hypothesis was that meniscal injuries in high school athletes would vary by gender, sport, and type of exposure.

Methods

During the 2007/2008 and 2012/2013 academic years, a large nationally disperse sample of US high schools reported athlete exposure and injury data for 22 sports by having certified athletic trainers complete an internet-based data collection tool.

Results

One thousand and eighty-two meniscal injuries were reported during 21,088,365 athlete exposures for an overall injury rate of 5.1 per 100,000 athlete exposures. The overall rate of injury was higher in competition (11.9) than practice (2.7) (RR = 4.4; 95 % CI 3.9–5.0), and 12/19 sports showed significantly higher injury rates in competition compared to practice. Of all injuries, 68.0 % occurred in boys, yet among the gender-comparable sports of soccer, basketball, track and field, lacrosse, and baseball/softball injury rates were higher for girls than boys (5.5 and 2.5, respectively, RR = 2.2; 95 % CI 1.8–2.7). Contact injury represented the most common mechanism (55.9 %). Surgery was performed for the majority of injuries (63.8 %), and 54.0 % of athletes had associated intra-articular knee pathology.

Conclusions

Meniscal injury patterns among high school athletes vary by gender, sport, and type of exposure. Our study is clinically relevant because recognition of distinct differences in these injury patterns will help drive evidence-based, targeted injury prevention strategies and efforts.

Level of evidence

III.

     

Comparing the incidence of anterior cruciate ligament injury in collegiate lacrosse, soccer, and basketball players: implications for anterior cruciate ligament mechanism and prevention

BACKGROUND: Female college basketball and soccer athletes have higher rates of anterior cruciate ligament injury than do their male counterparts. Rates of anterior cruciate ligament injuries for women and men in collegiate lacrosse have not been examined. Understanding anterior cruciate ligament injury patterns in lacrosse, a full-contact sport for men and noncontact sport for women, could further injury prevention efforts. HYPOTHESES: Female anterior cruciate ligament injury rates will decrease over time owing to longer participation in sports. Lacrosse anterior cruciate ligament injury rates will be lower than rates in basketball and soccer possibly owing to beneficial biomechanics of carrying a lacrosse stick. STUDY DESIGN: Cohort study (Prevalence); Level of evidence, 2. METHODS: Data from the National Collegiate Athletic Association Injury Surveillance System were analyzed to compare men's and women's anterior cruciate ligament injuries in basketball, lacrosse, and soccer over 15 years. RESULTS: Anterior cruciate ligament injury rates in women's basketball and soccer were 0.28 and 0.32 injuries per 1000 athlete exposures, respectively, and did not decline over the study period. In men's basketball, injury rate fluctuated between 0.03 and 0.13 athlete exposures. Rates of anterior cruciate ligament injury did not significantly change in men's soccer over the study period. The rate of anterior cruciate ligament injury in men's lacrosse (0.17 athlete exposures, P < .05) was significantly higher than in men's basketball (0.08 athlete exposures) and soccer (0.12 athlete exposures). Injury rate in women's lacrosse (0.18 athlete exposures, P < .05) was significantly lower than in women's basketball and soccer. CONCLUSION: There was no discernable change in rate of anterior cruciate ligament injury in men or women during the study period. Men's lacrosse is a high-risk sport for anterior cruciate ligament injury. Unlike basketball and soccer, the rates of anterior cruciate ligament injury are essentially the same in men's and women's lacrosse. The level of allowed contact in pivoting sports may be a factor in determining sport-specific anterior cruciate ligament risk.     

Soccer injuries among youth

This study reports the quantitative and qualitative aspects of sports injuries in a 5-day youth soccer tournament with 12,907 players. A total of 132 injuries that resulted in at least one days' absence from soccer playing were of special interest. The overall injury rate was 3.6 for boys and 4.4 injuries per 1000 hours of play for girls. Statistically significantly higher injury rates between players in puberty and differences in type and location of injuries between boys and girls were found. In 77% of the cases, the injury happened while the injured player was in physical contact with another player, 59% had ball contact and 7% had no contact with any person or ball at all. Five months later a questionnaire was send out to the serious injured players. Of 85 injured players, 10 were absent from school or work on average 11.5 days. Five had surgery. Injury prophylaxis in soccer tournaments is proposed.     

Intercollegiate Lacrosse Injuries

In brief:Injury data for an intercollegiate lacrosse team were collected after one season of practices and games and compared with injury data from a summer league team. Only five players (15%) completed the season without injury, and there were 78 total injuries to the 34 players. The most frequent injury was ankle sprain. The experience, skills, and age of collegiate athletes are more homogeneous and they often have superior equipment and playing surfaces, which suggests that they should have fewer injuries. However, the authors believe that the competitiveness of collegiate lacrosse results in higher frequency of injury.     

Epidemiological survey of anterior cruciate ligament injury in Japanese junior high school and high school athletes: cross-sectional study

We investigated the incidence of anterior cruciate ligament (ACL) injuries among athletes in junior high school and high school by retrospectively reviewing Japan Sports Council notification data registered over a period of 10 years. The total number of ACL injuries during the 10-year period was 30,458, with an incidence of 0.81 per 1000 athlete-years. Among those with ACL injuries, the ratio of girls to boys was 2.8, and incidence of injury was significantly greater among girls than boys (1.36 as against 0.48). Athletes in the 11th grade demonstrated the highest incidence of ACL injuries. We also found that the greatest incidence of ACL injuries was among female high school basketball players; the second highest being among female high school Judo athletes. For sports with a greater number of ACL injuries and a higher injury rate, it is necessary to obtain more detailed data and analysis to determine an effective prevention programme.     

Head and face injuries in scholastic women's lacrosse with and without eyewear.

PURPOSE: The use of protective equipment has been absent or inconsistent in scholastic women's lacrosse leading to increasing concern for eye and head injury. There is a paucity of field data, however, on which to base strategic decisions on how best to prevent head injuries in young athletes. METHODS: This study examined the effects of protective eyewear on injury rates in scholastic women's lacrosse in a cohort of approximately 700 varsity and junior varsity players in central New York studied prospectively for 2 yr during a transition from sparse to almost complete eyewear use. RESULTS: The overall head/face injury rate was 0.71 injuries per 1000 exposures (games and practices) and was 16.5% lower in goggle wearers. In games alone, where more aggressive play and stick use prevails, the rate associated with protective eyewear use was markedly lower (51%). Considering specific regions, the rates for peri-orbit and forehead injuries among goggle users were substantially lower than for nonusers (6% and 13%, respectively). Cheek and scalp injury rates tended to be higher among goggle wearers, but not statistically significantly so. Significant compensatory increases with goggle wear at other sites were not observed. Only a few injuries appeared to be mediated by the goggles themselves and potentially could have been more serious if the goggles had not been present. No direct eye (orbit) injuries were reported throughout the study period. CONCLUSION: On balance, then, the use of eyewear in women's lacrosse appears to be beneficial when users are compared with nonusers.     

The effect of a balance training program on the risk of ankle sprains in high school athletes

BACKGROUND: Ankle sprains are the most common musculoskeletal injuries that occur in athletes, and they have a profound impact on health care costs and resources. HYPOTHESIS: A balance training program can reduce the risk of ankle sprains in high school athletes. STUDY DESIGN: Randomized controlled clinical trial; Level of evidence, 1. METHODS: Seven hundred and sixty-five high school soccer and basketball players (523 girls and 242 boys) were randomly assigned to either an intervention group (27 teams, 373 subjects) that participated in a balance training program or to a control group (28 teams, 392 subjects) that performed only standard conditioning exercises. On-site athletic trainers recorded athlete exposures and sprains. RESULTS: The rate of ankle sprains was significantly lower for subjects in the intervention group (6.1%, 1.13 of 1000 exposures vs 9.9%, 1.87 of 1000 exposures; P = .04). Athletes with a history of an ankle sprain had a 2-fold increased risk of sustaining a sprain (risk ratio, 2.14), whereas athletes who performed the intervention program decreased their risk of a sprain by one half (risk ratio, 0.56). The ankle sprain rate for athletes without previous sprains was 4.3% in the intervention group and 7.7% in the control group, but this difference was not significant (P = .059). CONCLUSION: A balance training program will significantly reduce the risk of ankle sprains in high school soccer and basketball players.     

High school football injuries: a prospective study and pitfalls of data collection

A 4 year prospective study (1982 to 1985) of high school varsity football injuries from the four Peoria high school football teams was undertaken. Two hundred fifty-one injuries were recorded among a player population of 598, resulting in an injury rate of 42.1% per 100 players. All of the players followed a prescribed preseason summer conditioning program that was endorsed by the Illinois High School Athletic Association. The injuries were recorded on an athletic injury profile and entered into a computer for data analysis and retrieval. The injury distribution by player position showed that halfbacks, tackles, linebackers, and guards had a higher risk of injury than other positions. The knee was the body part injured most frequently (20.3%). A matrix of injuries to halfbacks was set up to examine the relationship of body part injured to type of play, time of injury, and activity during injury. An anthropometric study using the Quetelet index did not reveal any correlation between injury and body size when the injured players were compared with the non-injured players. Experience since 1969 has taught us many of the errors and pitfalls involved in injury surveillance. Strict adherence to recording of data will ensure an accurate and useful injury surveillance program.     

Incidence and player risk factors for injury in youth football.

OBJECTIVE: To estimate the incidence of injuries in youth football and to assess the relationship between player-related risk factors (age, body size, biological maturity status) and the occurrence of injury in youth football. DESIGN: Prospective over two seasons. SETTING: Two communities in central Michigan. PARTICIPANTS: Subjects were 678 youth, 9-14 years of age, who were members of 33 youth football teams in two central Michigan communities in the 2000 and 2001 seasons. METHODS: Certified athletic trainers (ATCs) were on site to record the number of players at all practices and home games (exposures) and injuries as they occurred. A reportable injury (RI) was defined by the criteria used in the National Athletic Trainers' Association (NATA) survey of several high school sports. Estimated injury rates (95% confidence intervals) per athlete exposures (AE) and per number of athletes were calculated for practices and games by grade. Player risk factors included age, height, weight, BMI and estimated maturity status. MAIN OUTCOME MEASURE: Estimated injury rates and relative risks of injury during practices and games by grade; logistic regression to evaluate relationships between player-related risk factors and risk of injury. RESULTS: A total of 259 RIs, 178 in practice and 81 in games, were recorded during the two seasons. Practice injury rates increased with grade level, while game injury rates were similar among fourth through fifth grade and sixth grade players and about twice as high among seventh and eighth grade players. The majority of RIs during the two seasons was minor (64%); the remainder was moderate (18%) and major (13%). Injured fourth through fifth grade players were significantly lighter in weight and had a lower BMI; otherwise, injured and non-injured players within each grade did not differ in age, body size and estimated biological maturity status. Logistic regressions within grade revealed no significant associations between injury and age, height, BMI, and maturity status. CONCLUSION: Game injury rates are higher than practice injury rates, and the incidence of injury tends to increase with grade level. Age, height, BMI and maturity status were not related to the risk of injury in youth football players.     

少年排球运动员手部骨损伤——由X光骨龄片所见调查分析

<正> 以手部主动击球为主要特征的排球运动,在训练或比赛时,对手部技术动作的要求是很高的,局部负荷量亦是相当大的,因而,手部损伤并不罕见。以往,国内对排球运动的一些损伤报导,大多集中于膝、腰或肩部,     

Risk factors for acute and overuse sport injuries in Swedish children 11 to 15 years old: What about resistance training with weights?

To determine the 1‐year self‐reported incidence of overuse and traumatic sport injuries and risk factors for injuries in children participating in a summer sports camp representing seven different sports. 4363 children, 11 to 15 years old participating in a summer camp in seven different sports answered a questionnaire. Injury in this cross‐sectional study was defined as a sport‐related trauma or overload leading to pain and dysfunction preventing the person from participation in training or competition for at least 1 week. A number of risk factors for injury were investigated such as sex, age, number of hours spent on training in general, and on resistance training with weights. Nearly half [49%, 95% confidence interval (CI) 48–51%] of the participants had been injured as a result of participation in a sport during the preceding year, significantly more boys than girls (53%, 95% CI 50–55% vs 46%, 95% CI 43–48%; P < 0.001). Three factors contributed to increased incidence of sport injuries: age, sex, and resistance training with weights. Time spent on resistance training with weights was significantly associated with sport injuries in a logistic regression analysis. In children age 11 to 15 years, the risk of having a sport‐related injury increased with age and occurred more often in boys than in girls. Weight training was the only modifiable risk factor that contributed to a significant increase in the incidence of sport injuries.     

Injury rates and profiles in female ice hockey players

BACKGROUND: Little data exist on injury rates and profiles in female ice hockey players. OBJECTIVE: To examine the incidence of injury in female ice hockey players and compare injury rates with those of male players. STUDY DESIGN: Prospective cohort study. METHODS: Six male and six female teams from the Canada West Universities Athletic Association were followed prospectively for one varsity season. Preseason medical history forms were completed by each player. Injury report forms and attendance records for each team session were submitted by team therapists. RESULTS: Male players reported 161 injuries, whereas female players reported 66 injuries. However, the overall injury rates for male (9.19 injuries per 1000 athlete-exposures) and female (7.77 injuries per 1000 athlete-exposures) players did not differ significantly. Ninety-six percent of injuries in female players and 79% in male players were related to contact mechanisms, even though intentional body checking is not allowed in female ice hockey. Women were more likely than men to be injured by contacting the boards or their opponent. Men sustained more severe injuries than women and missed about twice as many sessions (exposures) because of injury. Concussions were the most common injury in female players, followed by ankle sprains, adductor muscle strains, and sacroiliac dysfunction. CONCLUSION: Although the injury rate in female ice hockey players was expected to be lower than that in male players because of the lack of intentional body checking, the injury rates were found to be similar.     

An assessment of maturity from anthropometric measurements

PURPOSE: The range of variability between individuals of the same chronological age (CA) in somatic and biological maturity is large and especially accentuated around the adolescent growth spurt. Maturity assessment is an important consideration when dealing with adolescents, from both a research perspective and youth sports stratification. A noninvasive, practical method predicting years from peak height velocity (a maturity offset value) by using anthropometric variables is developed in one sample and cross-validated in two different samples. METHODS: Gender specific multiple regression equations were calculated on a sample of 152 Canadian children aged 8-16 yr (79 boys; 73 girls) who were followed through adolescence from 1991 to 1997. The equations included three somatic dimensions (height, sitting height, and leg length), CA, and their interactions. The equations were cross-validated on a combined sample of Canadian (71 boys, 40 girls measured from 1964 through 1973) and Flemish children (50 boys, 48 girls measured from 1985 through 1999). RESULTS: The coefficient of determination (R2) for the boys' model was 0.92 and for the girls' model 0.91; the SEEs were 0.49 and 0.50, respectively. Mean difference between actual and predicted maturity offset for the verification samples was 0.24 (SD 0.65) yr in boys and 0.001 (SD 0.68) yr in girls. Conclusion: Although the cross-validation meets statistical standards for acceptance, caution is warranted with regard to implementation. It is recommended that maturity offset be considered as a categorical rather than a continuous assessment. Nevertheless, the equations presented are a reliable, noninvasive and a practical solution for the measure of biological maturity for matching adolescent athletes     

Catastrophic head injuries in high school and college football players

BACKGROUND: Catastrophic head injuries in football are rare but tragic events. PURPOSE: To update the profile of catastrophic head injuries in high school and college football players and to describe relevant risk factors. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: We reviewed 94 incidents of severe football head injuries reported to the National Center for Catastrophic Sports Injury Research during 13 academic years (September 1989 through June 2002). RESULTS: In the study period there were an average of 7.23 (standard deviation = 2.05) direct high school and college catastrophic head injuries in scholastic football participants per year. There were 0.67 injuries per 100 000 (95% confidence interval: 0.54, 0.81 per 100 000) high school and 0.21 injuries per 100 000 (95% confidence interval: 0.0, 0.49 per 100 000) college participants for a risk ratio of 3.28 (95% confidence interval: 0.81, 13.3). The injuries resulted in subdural hematoma in 75 athletes, subdural hematoma with diffuse brain edema in 10 athletes, diffuse brain edema in 5 athletes, and arteriovenous malformation or aneurysm in 4 athletes. Fifty-nine percent of the contacts reported that the athlete had a history of a previous head injury, of which 71% occurred within the same season as the catastrophic event. Thirty-nine percent of the athletes (21 of 54) were playing with residual neurologic symptoms from the prior head injury. There were 8 (9%) deaths as a result of the injury, 46 (51%) permanent neurologic injuries, and 36 (40%) serious injuries with full recovery. Most players sustained a major impact to the head either from tackling or being tackled. CONCLUSION: The incidence of catastrophic head injuries in football has remained low since the advent of the modern day football helmet in the early 1970s. The incidence of catastrophic head injuries in football is dramatically higher at the high school level than at the college level. Although the reason for this discrepancy is unclear, an unacceptably high percentage of high school players were playing with residual symptoms from a prior head injury. Coaches, athletes, athletic trainers, and medical personnel need to adhere to the guideline that an athlete with any neurologic symptoms from a head injury should be strongly discouraged from returning to play.