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 ◽  
...  

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.

2017 ◽  
Vol 9 (6) ◽  
pp. 518-523 ◽  
Author(s):  
Eric G. Post ◽  
David R. Bell ◽  
Stephanie M. Trigsted ◽  
Adam Y. Pfaller ◽  
Scott J. Hetzel ◽  
...  

Background: High school athletes are increasingly encouraged to participate in 1 sport year-round to increase their sport skills. However, no study has examined the association of competition volume, club sport participation, and sport specialization with sex and lower extremity injury (LEI) in a large sample of high school athletes. Hypothesis: Increased competition volume, participating on a club team outside of school sports, and high levels of specialization will all be associated with a history of LEI. Girls will be more likely to engage in higher competition volume, participate on a club team, and be classified as highly specialized. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: High school athletes completed a questionnaire prior to the start of their competitive season regarding their sport participation and previous injury history. Multivariable logistic regression analyses were used to investigate associations of competition volume, club sport participation, and sport specialization with history of LEI, adjusting for sex. Results: A cohort of 1544 high school athletes (780 girls; grades 9-12) from 29 high schools completed the questionnaire. Girls were more likely to participate at high competition volume (23.2% vs 11.0%, χ2 = 84.7, P < 0.001), participate on a club team (61.2% vs 37.2%, χ2 = 88.3, P < 0.001), and be highly specialized (16.4% vs 10.4%, χ2 = 19.7, P < 0.001). Athletes with high competition volume, who participated in a club sport, or who were highly specialized had greater odds of reporting a previous LEI than those with low competition volume (odds ratio [OR], 2.08; 95% CI, 1.55-2.80; P < 0.001), no club sport participation (OR, 1.50; 95% CI, 1.20-1.88; P < 0.001), or low specialization (OR, 2.58; 95% CI, 1.88-3.54; P < 0.001), even after adjusting for sex. Conclusion: Participating in high sport volume, on a club team, or being highly specialized was associated with history of LEI. Girls were more likely to participate at high volumes, be active on club teams, or be highly specialized, potentially placing them at increased risk of injury. Clinical Relevance: Youth athletes, parents, and clinicians should be aware of the potential risks of intense, year-round participation in organized sports.


2019 ◽  
Vol 7 (10) ◽  
pp. 232596711987305 ◽  
Author(s):  
Julia Aogaichi Brant ◽  
Bernadette Johnson ◽  
Lina Brou ◽  
R. Dawn Comstock ◽  
Tien Vu

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.


2020 ◽  
Vol 13 (1) ◽  
pp. 18-24
Author(s):  
Benjamin J. Chun ◽  
Troy Furutani ◽  
Ross Oshiro ◽  
Casey Young ◽  
Gale Prentiss ◽  
...  

Background: Current research on concussion incidence in youth athletes (age <18 years) is small and limited by variability in injury reporting and diagnostic methodology. Hypothesis: Concussion injuries commonly occur in high school sports programs. The likelihood of concussion among student-athletes (aged 13-18 years) depends on the sport they are participating in as well as the sex of the athlete. Study Design: Descriptive epidemiology study. Level of Evidence: Level 4. Methods: A retrospective analysis of all Hawaii high school athletes aged 13 to 18 years participating in 14 sports from 2011 through 2017 was performed as part of a statewide standardized concussion assessment and management program. Results: A total of 5993 concussions were identified among 92,966 athletes. The overall concussion rate was 0.96 (95% CI, 0.94-0.99). Girls’ judo had the highest concussion rate (1.92; 95% CI, 1.68-2.17) followed by football (1.60; 95% CI, 1.53-1.66). The concussion rate for boys (1.0; 95% CI, 0.97-1.03) was higher than that for girls (0.91; 95% CI, 0.87-0.95); however, in 4 of the 5 sports in which both girls and boys participated, girls had a higher rate of concussion injury. Conclusion: The likelihood of concussion among student-athletes aged 13 to 18 years may be higher than previously thought and varies depending on sport and sex. Clinical Relevance: Epidemiologic data on concussion injury in children and adolescents are useful in accurately determining the relative risks of high school sports participation and may be valuable in determining the appropriate allocation of health care and scholastic resources for student-athletes, as well as the impact of rule and training modifications designed to improve participant safety.


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 ◽  
...  

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.


2017 ◽  
Vol 45 (12) ◽  
pp. 2706-2712 ◽  
Author(s):  
Timothy A. McGuine ◽  
Eric G. Post ◽  
Scott J. Hetzel ◽  
M. Alison Brooks ◽  
Stephanie Trigsted ◽  
...  

Background: Sport specialization is associated with an increased risk of musculoskeletal lower extremity injuries (LEIs) in adolescent athletes presenting in clinical settings. However, sport specialization and the incidence of LEIs have not been investigated prospectively in a large population of adolescent athletes. Purpose: To determine if sport specialization was associated with an increased risk of LEIs in high school athletes. Study Design: Cohort study; Level of evidence, 2. Methods: Participants (interscholastic athletes in grades 9-12) were recruited from 29 Wisconsin high schools during the 2015-2016 school year. Participants completed a questionnaire identifying their sport participation and history of LEIs. Sport specialization of low, moderate, or high was determined using a previously published 3-point scale. Athletic trainers reported all LEIs that occurred during the school year. Analyses included group proportions, odds ratios (ORs) and 95% CIs, and days lost due to injury (median and interquartile range [IQR]). Multivariate Cox proportional hazard ratios (HRs) with 95% CIs were calculated to investigate the association between the incidence of LEIs and sport specialization level. Results: A total of 1544 participants (50.5% female; mean age, 16.1 ± 1.1 years) enrolled in the study, competed in 2843 athletic seasons, and participated in 167,349 athlete-exposures. Sport specialization was classified as low (59.5%), moderate (27.1%), or high (13.4%). Two hundred thirty-five participants (15.2%) sustained a total of 276 LEIs that caused them to miss a median of 7.0 days (IQR, 2.0-22.8). Injuries occurred most often to the ankle (34.4%), knee (25.0%), and upper leg (12.7%) and included ligament sprains (40.9%), muscle/tendon strains (25.4%), and tendinitis/tenosynovitis (19.6%). The incidence of LEIs for moderate participants was higher than for low participants (HR, 1.51 [95% CI, 1.04-2.20]; P = .03). The incidence of LEIs for high participants was higher than for low participants (HR, 1.85 [95% CI, 1.12-3.06]; P = .02). Conclusion: Athletes with moderate or high sport specialization were more likely to sustain an LEI than athletes with low specialization. Sports medicine providers need to educate coaches, parents, and interscholastic athletes regarding the increased risk of LEIs for athletes who specialize in a single sport.


2005 ◽  
Vol 161 (6) ◽  
pp. 511-519 ◽  
Author(s):  
J. Yang ◽  
S. W. Marshall ◽  
J. M. Bowling ◽  
C. W. Runyan ◽  
F. O. Mueller ◽  
...  

2016 ◽  
Vol 26 (6) ◽  
pp. 435-444 ◽  
Author(s):  
James A. Onate ◽  
Joshua S. Everhart ◽  
Daniel R. Clifton ◽  
Thomas M. Best ◽  
James R. Borchers ◽  
...  

2017 ◽  
Vol 52 (11) ◽  
pp. 1028-1034 ◽  
Author(s):  
Robert C. Lynall ◽  
Timothy C. Mauntel ◽  
Ryan T. Pohlig ◽  
Zachary Y. Kerr ◽  
Thomas P. Dompier ◽  
...  

Context:  Although an association between concussion and musculoskeletal injury has been described in collegiate and professional athletes, no researchers have investigated an association in younger athletes. Objective:  To determine if concussion in high school athletes increased the risk for lower extremity musculoskeletal injury after return to activity. Design:  Observational cohort study. Setting:  One hundred ninety-six high schools across 26 states. Patients or Other Participants:  We used data from the National Athletic Treatment, Injury and Outcomes Network surveillance system. Athletic trainers provided information about sport-related concussions and musculoskeletal injuries in athletes in 27 sports, along with missed activity time due to these injuries. Main Outcome Measure(s):  Three general estimating equations were modeled to predict the odds of sustaining (1) any lower extremity injury, (2) a time-loss lower extremity injury, or (3) a non–time-loss lower extremity injury after concussion. Predictors were the total number of previous injuries, number of previous concussions, number of previous lower extremity injuries, number of previous upper extremity injuries, and sport contact classification. Results:  The initial dataset contained data from 18 216 athletes (females = 39%, n = 6887) and 46 217 injuries. Lower extremity injuries accounted for most injuries (56.3%), and concussions for 4.3% of total injuries. For every previous concussion, the odds of sustaining a subsequent time-loss lower extremity injury increased 34% (odds ratio [OR] = 1.34; 95% confidence interval [CI] = 1.13, 1.60). The number of previous concussions had no effect on the odds of sustaining any subsequent lower extremity injury (OR = 0.97; 95% CI = 0.89, 1.05) or a non–time-loss injury (OR = 1.01; 95% CI = 0.92, 1.10). Conclusions:  Among high school athletes, concussion increased the odds of sustaining subsequent time-loss lower extremity injuries but not non–time-loss injuries. By definition, time-loss injuries may be considered more severe than non–time-loss injuries. The exact mechanism underlying the increased risk of lower extremity injury after concussion remains elusive and should be further explored in future research.


2017 ◽  
Vol 5 (7_suppl6) ◽  
pp. 2325967117S0028
Author(s):  
Timothy A. McGuine ◽  
David Bell ◽  
Margaret Alison Brooks ◽  
Scott Hetzel ◽  
Adam Pfaller ◽  
...  

Author(s):  
Kathryn Calpino ◽  
Jaclyn Morrissette

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.


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