scholarly journals Epidemiology of Shoulder and Elbow Injuries Among US High School Softball Players, 2005-2006 Through 2016-2017

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711986742 ◽  
Author(s):  
Gretchen D. Oliver ◽  
Michael G. Saper ◽  
Monika Drogosz ◽  
Hillary A. Plummer ◽  
Alan T. Arakkal ◽  
...  

Background: Injury prevalence has been well described among baseball athletes; similarly, a better understanding of injuries in softball athletes is needed. Purpose: To examine shoulder and elbow injury epidemiology among high school softball athletes in the United States. Study Design: Descriptive epidemiological study. Methods: Injury data were obtained from the National High School Sports-Related Injury Surveillance System, which captures data from a large national sample of US high schools. Annually, a random sample of 100 high schools provided a representative sample with respect to the 4 US Census geographic regions and 2 school sizes (cutoff point, 1000 students). Athletic trainers from participating schools reported data for athlete-exposures (AEs; practice or competition) and shoulder and elbow injuries from 2005-2006 through 2016-2017. Results: A total of 239 shoulder injuries and 85 elbow injuries occurred within 2,095,329 AEs. The overall shoulder injury rate was 1.14 per 10,000 AEs, whereas the overall elbow injury rate was 0.41 per 10,000 AEs. Injuries to the shoulder were more likely to occur during competition as compared with practice (rate ratio, 1.28; 95% CI, 0.99-1.65). Half of the shoulder (50.4%) and elbow 48.9% injuries were due to an overuse/chronic mechanism. Of the athletes sustaining an injury, 86.8% with shoulder injuries and 93.0% with elbow injuries returned to play within 21 days. Only 16.7% of shoulder injuries and 17.5% of elbow injuries were sustained by pitchers. Conclusion: Shoulder and elbow injury rates, time to return, and percentage of injuries among pitchers were far lower in high school softball than previously reported values for high school baseball. There were relatively low incidences of shoulder and elbow injuries in high school softball as compared with baseball, with few injuries requiring lengthy time to return to play.

2017 ◽  
Vol 46 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Michael G. Saper ◽  
Lauren A. Pierpoint ◽  
Wei Liu ◽  
R. Dawn Comstock ◽  
John D. Polousky ◽  
...  

Background: Shoulder and elbow injuries are common in young athletes, especially high school baseball players. Understanding the risk factors associated with baseball injuries is an essential first step in the development of injury prevention strategies. Purpose: To provide a comprehensive understanding of the epidemiology of shoulder and elbow injuries among high school baseball players in the United States. Study Design: Descriptive epidemiological study. Methods: Baseball-related injury data were obtained from the National High School Sports-Related Injury Surveillance Study using High School RIO (Reporting Information Online), an Internet-based sports injury surveillance system. Athletic trainers from high schools across the country uploaded data regarding athlete-exposures (AEs) (defined as practice or game participation) and shoulder and elbow injuries from the school years 2005-2006 through 2014-2015. Results: A total of 241 shoulder injuries and 150 elbow injuries occurred during 1,734,198 AEs during the study period, for an overall shoulder injury rate of 1.39 per 10,000 AEs and an overall elbow injury rate of 0.86 per 10,000 AEs. The overall rates of injury were higher in competitions compared with practices for shoulders (rate ratio, 1.44; 95% CI, 1.11-1.85) and elbows (rate ratio, 2.15; 95% CI, 1.56-2.96). The majority of shoulder (39.6%) and elbow (56.9%) injuries were sustained by pitchers, and most injuries were chronic and caused by overuse. Position players were more likely to sustain injuries by contact with the playing surface or apparatus. For pitchers, muscle strains were the most common shoulder injuries (38.7%), while ligament sprains were the most common elbow injuries (42.7%). The majority of pitchers with shoulder (70.8%) and elbow (64.6%) injuries returned to play within 21 days. Among pitchers, a higher proportion of elbow injuries (11.4%) resulted in medical disqualification compared with shoulder injuries (5.6%). Among pitchers, the majority of shoulder (89.2%) and elbow (96.4%) injuries were managed nonsurgically. Conclusion: Shoulder and elbow injury rates and patterns in high school baseball players differed between field positions (pitchers vs position players) and by type of exposure (practice vs competition). This study suggests several areas of emphasis for targeted injury prevention interventions, most notably limiting fatigue and preventing overuse injuries.


2009 ◽  
Vol 44 (1) ◽  
pp. 76-83 ◽  
Author(s):  
John E. Bonza ◽  
Sarah K. Fields ◽  
Ellen E. Yard ◽  
R. Dawn Comstock

Abstract Context: The shoulder is one of the most commonly injured body sites among athletes. Little previous research describes shoulder injury patterns in high school athletes. Objective: To describe and compare shoulder injury rates and patterns among high school athletes in 9 sports (football, soccer, basketball, baseball, and wrestling for boys and soccer, volleyball, basketball, and softball for girls). Design: Prospective injury surveillance study. Setting: Injury data were collected from 100 nationally representative US high schools via High School Reporting Information Online. Patients or Other Participants: Athletes from participating high schools injured while involved in a school-sanctioned practice or competition in 1 of the above sports during the 2005–2006 and 2006–2007 school years. Main Outcome Measure(s): Shoulder injury rates, diagnoses, severity, and mechanisms. Results: During the 2005–2006 and 2006–2007 school years, athletes in this study sustained 805 shoulder injuries during 3 550 141 athlete-exposures (AEs), for an injury rate of 2.27 shoulder injuries per 10 000 AEs. This corresponds to an estimated 232 258 shoulder injuries occurring nationwide during this time. Shoulder injuries were more likely to occur during competition than practice (rate ratio  =  3.01, 95% confidence interval  =  2.62, 3.46). Shoulder injury rates per 10 000 AEs were highest in football (5.09), wrestling (4.34), and baseball (1.90). Common shoulder injury diagnoses included sprains/strains (39.6%), dislocations/separations (23.7%), contusions (11.5%), and fractures (6.6%). Although 44.8% of athletes sustaining a shoulder injury returned to play in less than 1 week, 22.9% were out of play for more than 3 weeks, and 6.2% of shoulder injuries required surgery. Common mechanisms of shoulder injury included player-to-player contact (57.6%) and contact with the playing surface (22.8%). Conclusions: High school shoulder injury rates and patterns varied by sport. Continued surveillance is warranted to understand trends and patterns over time and to develop and evaluate evidence-based preventive interventions.


2019 ◽  
Vol 7 (8) ◽  
pp. 232596711986250
Author(s):  
Nathaniel S. Jones ◽  
Kyle Wieschhaus ◽  
Brendan Martin ◽  
Pietro M. Tonino

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.


2019 ◽  
Vol 7 (5) ◽  
pp. 232596711984563 ◽  
Author(s):  
David P. Trofa ◽  
Kyle K. Obana ◽  
Hasani W. Swindell ◽  
Brian Shiu ◽  
Manish S. Noticewala ◽  
...  

Background: Youth athletes are starting sports earlier and training harder. Intense, year-round demands are encouraging early sports specialization under the perception that it will improve the odds of future elite performance. Unfortunately, there is growing evidence that early specialization is associated with increased risk of injury and burnout. This is especially true of pediatric and adolescent baseball players. Purpose/Hypothesis: The purpose of this investigation was to analyze national injury trends of youth baseball players. We hypothesized that while the total number of baseball injuries diagnosed over the past decade would decrease, there would be an increase in adolescent elbow injuries seen nationally. A further hypothesis was that this trend would be significantly greater than other injuries to the upper extremity and major joints. Study Design: Descriptive epidemiology study. Methods: Injury data from the National Electronic Injury Surveillance System, a United States Consumer Product Safety Commission database, were analyzed between January 1, 2006, and December 31, 2016, for baseball players aged ≤18 years. Data were collected on the location of injury, diagnosis, and mechanism of injury. Results: Between 2006 and 2016, an estimated 665,133 baseball injuries occurred nationally. The mean age of the injured players was 11.5 years. The most common injuries diagnosed included contusions (26.8%), fractures (23.6%), and strains and sprains (18.7%). Among major joints, the ankle (25.6%) was most commonly injured, followed by the knee (21.3%), wrist (19.2%), elbow (17.7%), and shoulder (16.2%). The incidence of the ankle, knee, wrist, and shoulder injuries decreased over time, while only the incidence of elbow injuries increased. A linear regression analysis demonstrated that the increasing incidence of elbow injuries was statistically significant against the decreasing trend for all baseball injury diagnoses, as well as ankle, knee, wrist, hand, and finger injuries ( P < .05). Additionally, the only elbow injury mechanism that increased substantially over time was throwing. Conclusion: The current investigation found that while the incidence of baseball injuries sustained by youth players is decreasing, elbow pathology is becoming more prevalent and is more commonly being caused by throwing. Given that the majority of elbow injuries among adolescent baseball players are overuse injuries, these findings underscore the importance of developing strategies to continue to ensure the safety of these youth athletes.


2017 ◽  
Vol 10 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Matthew J. Kraeutler ◽  
Dustin W. Currie ◽  
Zachary Y. Kerr ◽  
Karen G. Roos ◽  
Eric C. McCarty ◽  
...  

Background: Shoulder dislocations occur frequently in athletes across a variety of sports. This study provides an updated descriptive epidemiological analysis of shoulder dislocations among high school and college athletes and compares injury rates and patterns across these age groups. Hypothesis: There would be no difference in injury rates/patterns between high school and college athletes. Study Design: Descriptive epidemiology study. Level of Evidence: Level 3. Methods: Shoulder dislocation data from the High School Reporting Information Online (RIO) and the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) databases were analyzed from the 2004/2005 through 2013/2014 (NCAA) or 2005/2006 through 2013/2014 (RIO) academic years in 11 different sports. Rate ratios (RRs) and injury proportion ratios (IPRs) were calculated to make comparisons between age groups. Results: During the study period, 598 shoulder dislocations were reported during 29,249,482 athlete-exposures (AEs) among high school athletes, for an overall shoulder dislocation rate of 2.04 per 100,000 AEs; 352 shoulder dislocations were reported during 13,629,533 AEs among college athletes, for an overall injury rate of 2.58 per 100,000 AEs. College athletes had a higher rate of shoulder dislocation than high school athletes (RR, 1.26; 95% CI, 1.11-1.44). However, the injury rate in football was lower in collegiate than high school athletes (RR, 0.52; 95% CI, 0.43-0.62). Surgery was performed to correct 28.0% of high school and 29.6% of college shoulder dislocations. Shoulder dislocations resulted in longer return-to-play times than other shoulder injuries. Conclusion: Overall, shoulder dislocation rates were higher among collegiate than high school athletes. This may be due to greater contact forces involved in sports at higher levels of play, although the increased rate in high school football warrants additional research. Clinical Relevance: Higher shoulder dislocation rates within collegiate athletics are likely due to the higher level of intensity at this level of play, with stronger and faster athletes resulting in more forceful collisions.


2008 ◽  
Vol 43 (6) ◽  
pp. 624-630 ◽  
Author(s):  
Elizabeth A. Huffman ◽  
Ellen E. Yard ◽  
Sarah K. Fields ◽  
Christy L. Collins ◽  
R. Dawn Comstock

Abstract Context: Although more than 7 million athletes participate in high school sports in the United States, to date no nationally representative studies of rare injuries and conditions (RICs) exist. Rare injuries and conditions include eye injuries, dental injuries, neck and cervical injuries, and dehydration and heat illnesses. Objective: To describe the epidemiology of RICs sustained by high school athletes during the 2005–2006 and 2006–2007 school years. Design: Prospective cohort study. Setting: A nationally representative sample of 100 US high schools using an injury surveillance system, High School Reporting Information Online. Patients or Other Participants: Athletes participating in football, boys' soccer, girls' soccer, volleyball, boys' basketball, girls' basketball, wrestling, baseball, or softball at one of the 100 participating high schools. Main Outcome Measure(s): We reviewed all RICs to calculate injury rates and to identify potential risk factors and preventive measures. Results: A total of 321 RICs were sustained during 3 550 141 athlete-exposures (AEs), for an injury rate of 9.04 RICs per 100 000 AEs. This represents an estimated 84 223 RICs sustained nationally. The RICs accounted for 3.5% of all high school athletes' injuries. The most common diagnoses were neck and cervical injuries (62.0%, n  =  199) and dehydration and heat illnesses (18.7%, n  =  60). Football had the highest RIC rate per 100 000 AEs (21.2), followed by wrestling (15.2) and baseball (7.60). The RICs occurred at a higher rate in boys (12.4) than in girls (2.51) (rate ratio  =  4.93; 95% confidence interval  =  3.39, 7.18). The majority of RICs (67.3%, n  =  216) permitted athletes to return to play within 1 week of diagnosis. Conclusions: The RIC injury rates varied by sport and sex and represented almost 100 000 potentially preventable injuries to high school athletes. Because of the potentially serious consequences, future researchers must develop and implement more effective preventive measures to aid certified athletic trainers in decreasing the RIC incidence among high school athletes.


2017 ◽  
Vol 10 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Andrew V. Pytiak ◽  
Matthew J. Kraeutler ◽  
Dustin W. Currie ◽  
Eric C. McCarty ◽  
R. Dawn Comstock

Background: Pitching is a common mechanism of injury in baseball, with known risk factors for elbow injuries among adolescent pitchers. Hypothesis: Elbow injury rates and mechanisms will differ between high school baseball and softball players. Study Design: Descriptive epidemiology study. Level of Evidence: Level 3. Methods: Baseball- and softball-related injury data from the 2005-2006 through 2014-2015 academic years were collected from the High School Reporting Information Online (RIO) Internet-based data collection tool. Athlete-exposure (AE) and injury data were collected by certified athletic trainers. Rate ratios (RRs) were calculated comparing injury rates in the 2 populations. Injury proportion ratios (IPRs) comparing elbow injuries in pitchers and nonpitchers were calculated as the proportion of all elbow injuries in pitchers divided by the proportion of all elbow injuries in nonpitchers. Results: A total of 214 elbow injuries in male baseball players occurred over 2,327,774 AEs, for an overall elbow injury rate of 0.92 per 10,000 AEs. A total of 75 elbow injuries were reported in female softball players over 1,731,644 AEs, for an overall rate of 0.43 per 10,000 AEs. The rate of elbow injury was significantly higher for baseball than softball (RR, 2.12; 95% CI, 1.64-2.77). A significantly greater proportion of elbow injuries in baseball were pitching-related compared with those from softball, with 50.2% occurring while pitching in baseball versus 11.0% in softball (IPR, 4.58; 95% CI, 2.35-8.93). If all injuries occurring during pitching were removed from both sports, the difference in elbow injury rate for baseball and softball would no longer be significant (RR, 1.19; 95% CI, 0.88-1.62). Conclusion: The rate of elbow injuries is significantly higher in baseball than softball. This is attributable to differences in rates of pitching-related injuries between these 2 groups. Clinical Relevance: These results demonstrate that overhand pitching increases risk of elbow injury in high school athletes.


2021 ◽  
Author(s):  
Daniel C. Herman ◽  
Shane V. Caswell ◽  
Patricia M. Kelshaw ◽  
Heather K. Vincent ◽  
Andrew E. Lincoln

AbstractObjectivesThe use of headgear is a controversial issue in girls’ lacrosse. We compared concussion rates among high school lacrosse players wearing versus not wearing lacrosse headgear.MethodsStudy participants included a sample of convenience of high schools with girls’ lacrosse from across the United States. Certified athletic trainers reported athlete exposure and injury data via the National Athletic Treatment, Injury and Outcomes Network during the 2019 through 2021 seasons. The Headgear cohort was inclusive of high schools from the state of Florida, which mandate the use of ASTM standard F3137 headgear, while the Non-Headgear cohort was inclusive of the remaining states, none of which have headgear mandates. Incidence Rate Ratios (IRR) and 95% Confidence Intervals (CI) were calculated. IRRs with corresponding CIs that excluded 1.00 were deemed statistically significant.Results141 concussions (Headgear: 25; Non-Headgear: 116) and 357,225 Athlete Exposures (AE) were reported (Headgear: 91,074AE; Non-Headgear: 266,151AE) across all games and practices. Overall, the concussion injury rate per 1000AE was significantly higher in the Non-Headgear cohort (0.44) than the Headgear Cohort (0.27) (IRR=1.59, 95% CI:1.03 - 2.45). The IRR was significantly higher for the Non-Headgear cohort during games (1.74, 95% CI: 1.00, 3.02) but not for practices (1.42, 95% CI: 0.71, 2.83).ConclusionsThese findings indicate that concussion rates among high school girls’ lacrosse players not wearing headgear were 59% higher than those wearing headgear. These data support the use of protective headgear to reduce the risk of concussion among high school female lacrosse athletes.SummaryWhat are the new findingsThe use of lacrosse headgear meeting the ASTM F3137 standard was associated with a lower risk of experiencing a concussion injury among high school girls’ lacrosse players.How might these findings impact clinical practice in the future?Lacrosse headgear may be warranted for use for concussion risk mitigation among high school girls’ lacrosse players.Lacrosse headgear may be considered for concussion risk mitigation at other levels of play such as the youth or collegiate levels; further study is warranted.


2007 ◽  
Vol 35 (8) ◽  
pp. 1295-1303 ◽  
Author(s):  
Prasad R. Shankar ◽  
Sarah K. Fields ◽  
Christy L. Collins ◽  
Randall W. Dick ◽  
R. Dawn Comstock

Background Football, one of the most popular sports among male high school students in the United States, is a leading cause of sports-related injuries, with an injury rate almost twice that of basketball, the second most popular sport. Hypothesis Injury patterns will vary between competition and practice exposures and between levels of play (ie, high school vs. National Collegiate Athletic Association [NCAA]). Study Design Descriptive epidemiology study. Methods Football-related injury data were collected over the 2005-2006 school year from 100 nationally representative high schools via High School RIO™ (Reporting Information Online) and from 55 Division I, II, and III colleges via the NCAA Injury Surveillance System. Results Nationally, an estimated 517 726 high school football-related injuries (1881 unweighted injuries) occurred during the 2005-2006 season. The rate of injury per 1000 athlete-exposures was greater during high school competitions (12.04) than during practices (2.56). The rate of injury per 1000 athlete-exposures was also greater during collegiate competitions (40.23) than during practices (5.77). While the overall rate of injury per 1000 athlete-exposures was greater in the NCAA (8.61) than in high school (4.36), high school football players sustained a greater proportion of fractures and concussions. Running plays were the leading cause of injury, with running backs and linebackers being the positions most commonly injured. Conclusion Patterns of football injuries vary, especially by type of exposure and level of play. Future studies should continue to compare differences in injury patterns in high school and collegiate football, with particular emphasis placed on high-risk plays (running plays) and positions (running backs and linebackers).


2013 ◽  
Vol 10 (2) ◽  
pp. 160-169 ◽  
Author(s):  
Marcus A. Badgeley ◽  
Natalie M. McIlvain ◽  
Ellen E. Yard ◽  
Sarah K. Fields ◽  
R. Dawn Comstock

Background:With more than 1.1 million high school athletes playing annually during the 2005−06 to 2009−10 academic years, football is the most popular boys’ sport in the United States.Methods:Using an internet-based data collection tool, RIO, certified athletic trainers (ATs) from 100 nationally representative US high schools reported athletic exposure and football injury data during the 2005−06 to 2009−10 academic years.Results:Participating ATs reported 10,100 football injuries corresponding to an estimated 2,739,187 football-related injuries nationally. The injury rate was 4.08 per 1000 athlete-exposures (AEs) overall. Offensive lineman collectively (center, offensive guard, offensive tackle) sustained 18.3% of all injuries. Running backs (16.3%) sustained more injuries than any other position followed by linebackers (14.9%) and wide receivers (11.9%). The leading mechanism of injury was player-player contact (64.0%) followed by player-surface contact (13.4%). More specifically, injury occurred most commonly when players were being tackled (24.4%) and tackling (21.8%).Conclusions:Patterns of football injuries vary by position. Identifying such differences is important to drive development of evidence-based, targeted injury prevention efforts.


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