scholarly journals Return to Play Recommendations After COVID-19 Diagnosis in High School Athletes

2021 ◽  
Author(s):  
Kathryn Calpino ◽  
Jaclyn Morrissette
Keyword(s):  
High School ◽  
Athletic Trainers ◽  
Return To Play ◽  
Long Term Effects ◽  
High School Athletes ◽  
High School Sports ◽  
School Sports ◽  
Medical Evaluation ◽  
High School Athletic

Abstract COVID-19 has drastically changed everyday life across the world and has dramatically impacted how athletics operate. Since the return of high school sports, high school athletic trainers are now responsible for ensuring the safe return of athletes previously diagnosed with COVID-19 to sports. Due to the relatively recent identification of this novel virus, very little is understood about the long-term effects of COVID-19 infection on the cardiac and respiratory systems. Due to the rapid return of athletics, there is unfortunately limited research available regarding how athletes respond to COVID-19 and how it may affect their ability to return to play. Therefore, it is recommended that high school athletes previously diagnosed with COVID-19 undergo a comprehensive medical evaluation with their physician and complete a graduated medically supervised return to play protocol.

scholarly journals A-09 Time to Unrestricted Participation Following Sport-Related Concussion in High School Athletes

2020 ◽  
Vol 35 (5) ◽  
pp. 605-605
Author(s):  
T Covassin ◽  
A Bretzin ◽  
E Beidler ◽  
J Wallace
Keyword(s):  
High School ◽  
Event Analysis ◽  
High School Athletes ◽  
High School Sports ◽  
School Sports ◽  
Time Estimates ◽  
Kaplan Meier ◽  
Medical Clearance ◽  
Injury Reporting ◽  
High School Athletic

Abstract Objective To measure time-to-unrestricted participation in high school athletes following a sport-related concussion (SRC) diagnosis. Method This was a descriptive epidemiological study using the Michigan High School Athletic Association (MHSAA) online Head Injury Reporting System (HIRS). This study included 10,411 (65.9%) male and 5,412 (34.1%) female SRC cases that occurred in 20 sports with greater than 30 SRC cases during the 2015–2016 to 2018–2019 academic years. The HIRS includes dates for SRC injury events and medical clearance for unrestricted return-to-participation for each case; dates were used to calculate recovery time. Kaplan-Meier time-to-event analysis identified crude proportions of athletes that had not obtained medical clearance in weekly increments (e.g., 7 days, 14 days, 21 days, 28 days, 35 days) across sports. Results The median time-to-unrestricted participation was 11 days. Overall, 71.8% of SRC cases took longer than 7 days to return, 29.6% of SRC cases took longer than 14 days, 13.1% of cases took longer than 21 days to return, and 6.5% took longer than 28 days to return to their respective sports. Results by sport show that over 25% of gymnasts took longer than 28 days to return-to-unrestricted participation, followed by competitive cheerleaders (15.5%), wrestlers (12.1%), and male divers (12.0%). Conclusions Almost one in three high school athletes with SRC took longer than 14 days to return-to-unrestricted participation. These results serve as proportional time estimates for return-to-unrestricted participation across a sample of 20 high school sports; and provide rationale to further evaluate recovery patterns in individual sport groups.

scholarly journals Medical Supervision of High School Athletics in Chicago: A Follow-up Study

2019 ◽  
Vol 7 (8) ◽  
pp. 232596711986250
Author(s):  
Nathaniel S. Jones ◽  
Kyle Wieschhaus ◽  
Brendan Martin ◽  
Pietro M. Tonino
Keyword(s):  
High School ◽  
High Schools ◽  
The United States ◽  
Return To Play ◽  
Athletic Trainer ◽  
Public High Schools ◽  
High School Sports ◽  
Medical Supervision ◽  
Concussion Management ◽  
School Sports

Background: High school sports participation in the United States has increased dramatically over the past 25 years. A corresponding increase in the number of injuries has been noted, particularly in contact sports such as football. This has led medical and sports organizations nationwide to advocate for proper medical supervision of athletes at games and practices. Purpose: To gather information from Chicago public high schools to gauge how medical supervision for high school sports has changed in 2017 compared with 2003. Study Design: Cross-sectional study. Methods: Survey questionnaires were sent to the athletic directors of all 99 Chicago public high schools to complete via email. The questionnaire survey contained the same questions as in a survey conducted in 2003 by Tonino and Bollier, with the addition of 4 novel questions relating to emergency action plans (EAPs), automated external defibrillators, concussion management policy, and tackling progression drills. Results: The response rate was 66.67% (66/99 schools). Of the 66 responding schools, all with football programs, no school had a physician on the sideline at home games (decrease from 10.6% in 2003), 37.9% had an athletic trainer present (increase from 8.5% in 2003), and 63.6% had a paramedic available (decrease from 89.4% in 2003). In 2017, 65.6% of responding schools had a coach certified in cardiopulmonary resuscitation (CPR) available at practice to handle medical problems, compared with 89.4% in 2003 ( P < .001). Regarding the 4 novel questions, 93.9% of the responding schools had proper tackling progression drills in place, followed by 89.1% who had appropriate EAPs and 93.9% with concussion management protocols, including return-to-play and return-to-learn protocols. Conclusion: Although significant improvement was found in athletic trainer coverage, especially at games, physician coverage was lacking and fewer coaches were certified in CPR in 2017 compared with 2003. EAPs and concussion management protocols were present in most Chicago public high schools. Overall, greater medical supervision is needed, which we believe should come in the form of increased athletic training and physician involvement and coverage, given that expert, expedited medical care saves lives.

scholarly journals Epidemiology of Sport-Related Concussions in High School Athletes: National Athletic Treatment, Injury and Outcomes Network (NATION), 2011–2012 Through 2013–2014

2017 ◽  
Vol 52 (3) ◽  
pp. 175-185 ◽  
Author(s):  
Kathryn L. O'Connor ◽  
Melissa M. Baker ◽  
Sara L. Dalton ◽  
Thomas P. Dompier ◽  
Steven P. Broglio ◽  
...  
Keyword(s):  
High School ◽  
Outcome Measure ◽  
Sports Participation ◽  
Descriptive Epidemiology ◽  
Epidemiology Study ◽  
High School Athletes ◽  
High School Sports ◽  
School Sports ◽  
Exposure Data ◽  
Rate Ratios

Context:Sports participation is one of the leading causes of concussions among nearly 8 million US high school student-athletes.Objective:To describe the epidemiology of sport-related concussion (SRC) in 27 high school sports during the 2011–2012 through 2013–2014 academic years.Design:Descriptive epidemiology study.Setting:Aggregate injury and exposure data from 27 sports in 147 high schools in the National Athletic Treatment, Injury and Outcomes Network (NATION).Patients or Other Participants:Boy and girl high school athletes during the 2011–2012 through 2013–2014 academic years.Main Outcome Measure(s):Sport-related concussion counts, percentages, rates per 10 000 athlete-exposures (AEs), rate ratios (RRs), and injury proportion ratios (IPRs) were reported with 95% confidence intervals (CIs). Rate ratios and IPRs with 95% CIs not containing 1.0 were considered significant.Results:Overall, 2004 SRCs were reported among 27 high school sports, for a rate of 3.89 per 10 000 AEs. Football had the highest SRC rate (9.21/10 000 AEs), followed by boys' lacrosse (6.65/10 000 AEs) and girls' soccer (6.11/10 000 AEs). The SRC rate was higher in competition than in practice (RR = 3.30; 95% CI = 3.02, 3.60). Among sex-comparable sports, the SRC rate was higher in girls than in boys (RR = 1.56; 95% CI = 1.34, 1.81); however, the proportion of SRCs due to player-to-player contact was higher in boys than in girls (IPR = 1.48; 95% CI = 1.27, 1.73). Common symptoms reported among all athletes with SRCs were headache (94.7%), dizziness (74.8%), and difficulty concentrating (61.0%). Only 0.8% of players with SRCs returned to play within 24 hours. The majority of athletes with SRCs (65.8%) returned to play between 7 and 28 days. More players had symptoms resolve after 7 days (48.8%) than less than a week (40.7%).Conclusions:Our findings provide updated high school SRC incidence estimates and further evidence of sex differences in reported SRCs. Few athletes with SRCs returned to play within 24 hours or a week. Most injured players returned after 7 days, despite a smaller proportion having symptoms resolve within a week.

scholarly journals Timing of Lower Extremity Injuries in Competition and Practice in High School Sports

2017 ◽  
Vol 9 (3) ◽  
pp. 238-246 ◽  
Author(s):  
Kyle Nagle ◽  
Bernadette Johnson ◽  
Lina Brou ◽  
Tyler Landman ◽  
Ada Sochanska ◽  
...  
Keyword(s):  
High School ◽  
Lower Extremity ◽  
Epidemiologic Study ◽  
Lower Extremity Injury ◽  
High School Athletes ◽  
Level Of Evidence ◽  
Severe Injuries ◽  
Injury Surveillance System ◽  
High School Sports ◽  
School Sports

Background: Laboratory-based experiments demonstrate that fatigue may contribute to lower extremity injury (LEI). Few studies have examined the timing of LEIs during competition and practice, specifically in high school athletes across multiple sports, to consider the possible relationship between fatigue and LEIs during sport events. Hypothesis: The purpose of this study was to describe the timing of LEIs in high school athletes within games and practices across multiple sports, with a hypothesis that more and severe injuries occur later in games and practices. Study Design: Descriptive epidemiologic study. Level of Evidence: Level 4. Methods: Using the National High School RIO (Reporting Information Online) sport injury surveillance system, LEI severity and time of occurrence data during practice and competition were extracted for 9 high school sports. Results: During the school years 2005-2006 through 2013-2014, 16,967,702 athlete exposures and 19,676 total LEIs were examined. In all sports surveyed, there was a higher LEI rate, relative risk for LEI, and LEI requiring surgery during competition than practice. During practice, the majority of LEIs occurred over an hour into practice in all sports. In quarter-based competition, more LEIs occurred in the second (31% to 32%) and third quarters (30% to 35%) than in the first (11% to 15%) and fourth quarters (22% to 26%). In games with halves, the majority (53% to 66%) of LEIs occurred in the second half. The greater severity LEIs tended to occur earlier in games. Conclusion: Fatigue may play a role in the predominance of injuries in the second half of games, though various factors may be involved. Greater severity of injuries earlier in games may be because of higher energy injuries when athletes are not fatigued. Clinical Relevance: These findings can help prepare sports medicine personnel and guide further related research to prevent LEIs.

The Epidemiology and Management of Exertional Heat Illnesses in High School Sports During the 2012/2013–2016/2017 Academic Years

2020 ◽  
Vol 29 (3) ◽  
pp. 332-338 ◽  
Author(s):  
Zachary Y. Kerr ◽  
Susan W. Yeargin ◽  
Yuri Hosokawa ◽  
Rebecca M. Hirschhorn ◽  
Lauren A. Pierpoint ◽  
...  
Keyword(s):  
High School ◽  
Rate Ratio ◽  
Athletic Trainers ◽  
Management Strategies ◽  
Injury Rate ◽  
American Football ◽  
High School Sports ◽  
School Sports ◽  
Cross Country ◽  
Us Census

Context: Recent data on exertional heat illness (EHI) in high school sports are limited yet warranted to identify specific settings with the highest risk of EHI. Objective: To describe the epidemiology of EHI in high school sports during the 2012/2013–2016/2017 academic years. Design: Descriptive epidemiology study. Setting: Aggregate injury and exposure data collected from athletic trainers working in high school sports in the United States. Patients or Other Participants: High school athletes during the 2012/2013–2016/2017 academic years. Intervention: High School Reporting Information Online surveillance system data from the 2012/2013–2016/2017 academic years were analyzed. Main Outcome Measures: EHI counts, rates per 10,000 athlete exposures (AEs), and distributions were examined by sport, event type, and US census region. EHI management strategies provided by athletic trainers were analyzed. Injury rate ratios with 95% confidence intervals (CIs) compared EHI rates. Results: Overall, 300 EHIs were reported for an overall rate of 0.13/10,000 AE (95% CI, 0.11 to 0.14). Of these, 44.3% occurred in American football preseason practices; 20.7% occurred in American football preseason practices with a registered air temperature ≥90°F and ≥1 hour into practice. The EHI rate was higher in American football than all other sports (0.52 vs 0.04/10,000 AE; injury rate ratio = 11.87; 95% CI, 9.22 to 15.27). However, girls’ cross-country had the highest competition EHI rate (1.18/10,000 AE). The EHI rate was higher in the South US census region than all other US census regions (0.23 vs 0.08/10,000 AE; injury rate ratio = 2.96; 95% CI, 2.35 to 3.74). Common EHI management strategies included having medical staff on-site at the onset of EHI (92.7%), removing athlete from play (85.0%), and giving athlete fluids via the mouth (77.7%). Conclusions: American football continues to have the highest overall EHI rate although the high competition EHI rate in girls’ cross-country merits additional examination. Regional differences in EHI incidence, coupled with sport-specific variations in management, may highlight the need for region- and sport-specific EHI prevention guidelines.

Sex-Related Injury Patterns among Selected High School Sports

2000 ◽  
Vol 28 (3) ◽  
pp. 385-391 ◽  
Author(s):  
John W. Powell ◽  
Kim D. Barber-Foss
Keyword(s):  
High School ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Athletic Trainers ◽  
Baseball Players ◽  
Certified Athletic Trainers ◽  
High School Sports ◽  
Injury Rates ◽  
School Sports ◽  
Anterior Cruciate

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.

scholarly journals A Comparison of High School Sports Injury Surveillance Data Reporting by Certified Athletic Trainers and Coaches

2009 ◽  
Vol 44 (6) ◽  
pp. 645-652 ◽  
Author(s):  
Ellen E. Yard ◽  
Christy L. Collins ◽  
R. Dawn Comstock
Keyword(s):  
High School ◽  
High Schools ◽  
Athletic Trainers ◽  
Sports Injury ◽  
Injury Surveillance ◽  
Ankle Injuries ◽  
Surveillance Study ◽  
Certified Athletic Trainers ◽  
High School Sports ◽  
School Sports

Abstract Context: High school athletes sustain more than 1.4 million injuries annually. National high school sports injury surveillance forms the foundation for developing and evaluating preventive interventions to reduce injury rates. For national surveillance, individuals must report consistently and accurately with little one-on-one interaction with study staff. Objective: To examine the feasibility of relying on high school coaches as data reporters in a national, Internet-based sports injury surveillance study, using the same methods that have already proven successful in the National High School Sports-Related Injury Surveillance Study, which calls on certified athletic trainers (ATs) as reporters. Design: Prospective injury surveillance study. Setting: Eighteen United States high schools Participants: Athletic trainers and varsity coaches for football, boys' and girls' soccer, and boys' and girls' basketball. Main Outcome Measure(s): Quantity and quality of exposure and injury reports. Results: All enrolled ATs participated, compared with only 43.0% of enrolled coaches. Participating ATs submitted 96.7% of expected exposure reports, whereas participating coaches submitted only 36.5%. All ATs reported athlete exposures correctly, compared with only 2 in 3 coaches. Participating ATs submitted 338 injury reports; participating coaches submitted only 55 (16.3% of the 338 submitted by ATs). Injury patterns differed between AT-submitted and coach-submitted injury reports, with ATs reporting a higher proportion of ankle injuries and coaches reporting a higher proportion of knee injuries. The reports submitted by ATs and coaches for the same injury had low agreement for diagnosis and time loss, with only 63.2% and 55.3% of pairs, respectively, providing the same response. The ATs lacked more responses for demographic questions, whereas coaches lacked more responses regarding the need for surgery. Conclusions: Whenever possible, ATs should be the primary data reporters in large, national studies. In high schools without access to an AT, researchers must be willing to devote significant time and resources to achieving high participation and compliance from other reporters.

Youth and High School Sports Law Issues

2017 ◽  
Author(s):  
Brian L. Porto
Keyword(s):  
High School ◽  
Title Ix ◽  
High School Athletes ◽  
High School Sports ◽  
School Sports ◽  
Private Organizations ◽  
Federal Constitution ◽  
Athletes With Disabilities ◽  
Private And Public ◽  
Free Speech Rights

Youth and high school sports are subject to regulation by private and public entities, resulting in numerous legal issues. Generally, private organizations regulate youth sports, and the rules primarily address the conduct of coaches and parents. Still, some states have extended to youth leagues statutory concussion protocols originally created for middle and high school sports. Governmental regulation is more prominent in high school sports, including state concussion laws and laws against hazing. Three federal laws are particularly important: Title IX, regarding the inclusion of female and, potentially, transgender athletes, and the Rehabilitation Act and the Americans with Disabilities Act, concerning athletes with disabilities. This chapter addresses an unresolved issue on each of those subjects before discussing high school athletes’ free-speech rights under the federal Constitution.

scholarly journals Rates and Patterns of Lower Extremity Sports Injuries in All Gender-Comparable US High School Sports

2019 ◽  
Vol 7 (10) ◽  
pp. 232596711987305 ◽  
Author(s):  
Julia Aogaichi Brant ◽  
Bernadette Johnson ◽  
Lina Brou ◽  
R. Dawn Comstock ◽  
Tien Vu
Keyword(s):  
High School ◽  
Lower Extremity ◽  
Sports Injuries ◽  
The United States ◽  
National Database ◽  
Radiographic Evaluation ◽  
High School Athletes ◽  
High School Sports ◽  
Injury Rates ◽  
School Sports

Background: High school athletes with lower extremity sports injuries (LESIs) frequently present to the emergency department in the United States. Previous epidemiological studies have presented rates and mechanisms of LESIs in these athletes. No studies, however, have looked at LESIs in gender-comparable sports in an attempt to evaluate what differences exist between LESIs in boys and girls. Purpose: To describe the epidemiology of LESIs among US high school athletes using a large national database of athletes in sports that could be considered gender comparable, given the rules of play and protective equipment. Study Design: Descriptive epidemiology study. Methods: Descriptive data from 2005 to 2016 were collected using the internet-based High School Reporting Information Online (High School RIO), a national high school sports injury surveillance system, for athletes participating in 8 gender-comparable sports (soccer, volleyball, basketball, baseball/softball, swimming and diving, track and field, cross-country, and tennis). Rates and patterns of injury were evaluated, with injury rates calculated as ratio of injuries per 10,000 athlete-exposures. Rate ratios (RRs) were calculated to compare the LESI rates in girls and boys. Results: In both genders, LESI rates (per 10,000 athlete-exposures) were highest in soccer (girls, 15.87; boys, 11.68) followed by basketball (girls, 11.51; boys, 9.35), and were lowest in swimming and diving (girls, 0.70; boys, 0.39). Although injury rates were significantly higher in girls compared with boys in all sports, only in tennis was the RR greater than 2 (RR, 2.03; 95% CI, 1.17-3.54). Girls had a greater proportion of severe LESIs and injuries that received radiographic evaluation, such as magnetic resonance imaging, compared with boys for all sports except volleyball. Consistency in the mechanism of injury was demonstrated between genders within each sport. Conclusion: This study demonstrated that LESIs are common among high school athletes and disproportionately affect girls more than boys, especially when looking at severe injuries and resource utilization. Further studies are needed to elucidate the cause of these findings. We hope that the awareness of gender-based differences in LESIs will lead to improvements in targeted efforts to decrease injury rates and injury severity.

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