FAIR PLAY AS AN INJURY PREVENTION INTERVENTION: DO YELLOW CARD ACCUMULATION POLICIES REDUCE HIGH SCHOOL SOCCER INJURIES?

Background: Pediatric sports-related injuries are common, yet prevention efforts too often go unevaluated. Collins et al. studied nine U.S. high school (HS) sports during 2005/06-2006/07, finding boys’ and girls’ soccer had the highest injury rates related to illegal activity. Several states have implemented yellow card accumulation policies (YCPs) in an effort to prevent injuries. Hypothesis/Purpose: Purpose: Evaluate the effectiveness of YCPs in reducing HS soccer competition injuries by comparing injury rates and patterns in states with and without YCPs. Hypotheses: Athlete-athlete contact injury rates are lower in states with YCPs Severe injuries (concussion, fracture, ACL, injury requiring surgery, injury resulting in > 3 weeks’ time loss) are less prevalent in states with YCPs Gender differences influence the effectiveness of YCPs Methods: Retrospective cohort study of NHFS member state association HS soccer players injured during competition in 2005/06-2017/18. Athlete exposure (AEs) and injury data collected from a national sports injury surveillance system, High School RIO. Poisson regression assessed the effects of YCPs on injury rates and patterns. Results: Of 50 NFHS member states associations, high schools from 47 were represented. Overall, 901 athlete-athlete contact injuries occurred during 352,775 competition AEs in states with YCPs and 3,525 during 1,459,708 AEs in states without YCPs. There was no significant difference in overall contact injury rates (rate ratio [RR] 1.06; 95% confidence interval [CI]: 0.98-1.14) between schools in states with and without YCPs. A small, significant increase in overall contact injury rates was discernable after states’ adoption of YCPs (RR 1.17; 95% CI: 1.03, 1.34), particularly in boys’ soccer (RR 1.32; 95% CI 1.08-1.62). A significantly lower proportion of injuries resulting in > 3 weeks’ time loss occurred in states with YCPs (injury proportion ratio [IPR] 0.81; p=0.047), while other severe injuries did not differ. There were no significant differences in YCPs’ effect by gender (p=0.319). Conclusion: Among HS boys’ and girls’ soccer players, playing in states with YCPs did not lower athlete-athlete contact injury rates, although injuries resulting in > 3 weeks’ time loss were less prevalent in states with YCPs. Athlete-athlete contact injury rates were slightly higher in states following adoption of YCPs, particularly in boys’ soccer. Enactment of YCPs alone, without proper enforcement, may not be a sufficient injury prevention strategy. Further studies assessing the impact of HS soccer YCPs need to consider the effects of state level YCP enforcement, documented illegal activity/foul play, and Fair Play education. Tables/Figures: [Table: see text][Table: see text][Table: see text]

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EARLY RESULTS OF AN INJURY-PREVENTION PROGRAM IN HIGH SCHOOL TRACK ATHLETES

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00141 ◽

2019 ◽

Vol 7 (3_suppl) ◽

pp. 2325967119S0014

Author(s):

Celeste Quitiquit Dickason ◽

Whitney Marois ◽

Hannah Santos ◽

Sadie Grace ◽

Brian Krabak ◽

...

Keyword(s):

High School ◽

Injury Prevention ◽

Prevention Program ◽

Prevention Programs ◽

Years Of Experience ◽

Chi Square ◽

Injury Rates ◽

Injury Prevention Program ◽

Chi Square Analysis ◽

The Impact

Background Injury prevention programs have been shown to be effective for adolescent soccer, basketball, and handball athletes. Though injuries are common in high school runners, injury prevention programs have not been described for this population. Our objective was to trial an injury-prevention program styled after those found to be successful in other running and jumping sports to see if a group of running athletes sustained fewer and or less serious injuries during the course of a single high school track season. Methods Two suburban high school track coaches volunteered to participate in a program consisting of either injury-prevention exercises or no additional exercises as a part of pre-and in-season practice programs. All runners at each school were invited to participate, with informed consent obtained. The injury prevention program consisted of five jumping and plyometric exercises taught by a physical therapist, with a video of the exercises made available to the coach and team members throughout the season. Surveys pre- and post-season were collected which included demographic information, running history, diet, and injuries. Injuries were reported to coach and trainer at each school. Days of missed practice constituted an injured day, tallied for each runner and each team. A Chi-square analysis compared injury rates by team, and hence by intervention; injury rates by years of experience running; and injury rates by dietary preference. Results 24 runners, 13 from the intervention school and 11 from the control school participated. There was no significant difference in the number of running injuries reported when comparing the intervention group (4/13 runners) to the control group (3/11 runners, Chi-square = 0.035, p = 0.9). Runners with a greater number of years of competitive running experience trended towards having fewer injuries (p = 0.06). Those describing their diet as vegetarian (3/24) were significantly more likely to sustain an injury (p = 0.002). Conclusions / Significance With this limited comparison study examining the impact of an injury-prevention pre-season and in-season training program for running athletes participating on their high school track team, there was no evidence that the addition of a program of jumping and plyometric exercises had an impact on injury rates. However, combining the data from the two schools, we found a trend towards decreased injury likelihood in those with more years of experience running, and a significantly greater incidence of injuries in those who described their diet as vegetarian. These results suggest that novice runners should perhaps have a different set of expectations regarding the pre- and in-season training regimen, and that those whose diet is vegetarian consider review of their nutrition to optimize their energy level and reparative capacity with the increased activity of a high school track running program.

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Elite football teams that do not have a winter break lose on average 303 player-days more per season to injuries than those teams that do: a comparison among 35 professional European teams

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-099506 ◽

2018 ◽

Vol 53 (19) ◽

pp. 1231-1235 ◽

Cited By ~ 6

Author(s):

Jan Ekstrand ◽

Armin Spreco ◽

Michael Davison

Keyword(s):

Linear Regression ◽

The Other ◽

Climatic Region ◽

Time Loss ◽

Severe Injuries ◽

Injury Rates ◽

Level Data ◽

Injury Burden ◽

Or Team ◽

Individual Training

ObjectiveTo compare injury rates among professional men’s football teams that have a winter break in their league season schedule with corresponding rates in teams that do not.Methods56 football teams from 15 European countries were prospectively followed for seven seasons (2010/2011–2016/2017)—a total of 155 team-seasons. Individual training, match exposure and time-loss injuries were registered. Four different injury rates were analysed over four periods within the season, and linear regression was performed on team-level data to analyse the effect of winter break on each of the injury rates. Crude analyses and analyses adjusted for climatic region were performed.Results9660 injuries were reported during 1 447 011 exposure hours. English teams had no winter break scheduled in the season calendar: the other European teams had a mean winter break scheduled for 10.0 days. Teams without a winter break lost on average 303 days more per season due to injuries than teams with a winter break during the whole season (p<0.001). The results were similar across the three periods August–December (p=0.013), January–March (p<0.001) and April–May (p=0.050). Teams without a winter break also had a higher incidence of severe injuries than teams with a winter break during the whole season (2.1 severe injuries more per season for teams without a winter break, p=0.002), as well as during the period January–March (p=0.003). A winter break was not associated with higher team training attendance or team match availability. Climatic region was also associated with injury rates.ConclusionsThe absence of a scheduled winter break was associated with a higher injury burden, both before and during the two periods following the time that many European teams take a winter break. Teams without a winter break (English clubs) had a higher incidence of severe injuries following the time of the year that other teams (other European clubs) had their scheduled break.

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Eye Injuries in High School and Collegiate Athletes

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738117712425 ◽

2017 ◽

Vol 9 (5) ◽

pp. 444-449 ◽

Cited By ~ 10

Author(s):

Barry P. Boden ◽

Lauren A. Pierpoint ◽

Rebecca G. Boden ◽

R. Dawn Comstock ◽

Zachary Y. Kerr

Keyword(s):

High School ◽

College Athletes ◽

Age Groups ◽

Eye Injury ◽

Field Hockey ◽

Eye Injuries ◽

Time Loss ◽

Injury Rates ◽

Men's Basketball ◽

College Age

Background: Although eye injuries constitute a small percentage of high school and college sports injuries, they have the potential to be permanently debilitating. Hypothesis: Eye injury rates will vary by sport, sex, and between the high school and college age groups. Study Design: Descriptive epidemiology study. Level of Evidence: Level 3. Methods: Data from eye injury reports in high school and college athletes were obtained from the National High School Sports-Related Injury Surveillance System, High School Reporting Information Online (HS RIO) database over a 10-year span (2005-2006 through 2014-2015 school years) and the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) over an 11-year span (2004-2005 through 2014-2015 school years). Injury rates per 100,000 athlete-exposures (AEs), injury rate ratios (RRs), and 95% CIs were calculated. Distributions of eye injuries by diagnosis, mechanism, time loss, and surgery needs were also examined. Results: A total of 237 and 273 eye injuries were reported in the HS RIO and the NCAA ISP databases, respectively. The sports with the highest eye injury rates (per 100,000 AEs) for combined high school and college athletes were women’s basketball (2.36), women’s field hockey (2.35), men’s basketball (2.31), and men’s wrestling (2.07). Overall eye injury rates at the high school and college levels were 0.68 and 1.84 per 100,000 AEs, respectively. Eye injury rates were higher in competition than practice in high school (RR, 3.47; 95% CI, 2.69-4.48) and college (RR, 3.13; 95% CI, 2.45-3.99). Most injuries were contusions (high school, 35.9%; college, 33.3%) and due to contact (high school, 89.9%; college, 86.4%). Only a small percentage of injuries resulted in time loss over 21 days (high school, 4.2%; college, 3.0%). Conclusion: Eye injury rates and patterns vary by sport, sex, and between the high school and college age groups. Although severe injuries do occur, most eye injuries sustained by high school and college athletes are minor, with limited time loss and full recovery. Clinical Relevance: Additional focus needs to be placed on preventing eye injuries at the collegiate level in women’s and men’s basketball, women’s field hockey, and men’s wrestling.

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The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys' Lacrosse (2008–2009 Through 2013–2014) and National Collegiate Athletic Association Men's Lacrosse (2004–2005 Through 2013–2014)

Journal of Athletic Training ◽

10.4085/1062-6050-200-17 ◽

2019 ◽

Vol 54 (1) ◽

pp. 30-41 ◽

Cited By ~ 5

Author(s):

Lauren A. Pierpoint ◽

Andrew E. Lincoln ◽

Nina Walker ◽

Shane V. Caswell ◽

Dustin W. Currie ◽

...

Keyword(s):

High School ◽

National Collegiate Athletic Association ◽

Injury Rate ◽

Sports Injury ◽

Injury Surveillance ◽

Surveillance Program ◽

Time Loss ◽

Annual Average ◽

Injury Rates ◽

Web Based

ContextThe advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of boys' and men's lacrosse injury data.ObjectiveTo describe the epidemiology of injuries sustained in high school boys' lacrosse in the 2008–2009 through 2013–2014 academic years and collegiate men's lacrosse in the 2004–2005 through 2013–2014 academic years using Web-based sports injury surveillance.DesignDescriptive epidemiology study.SettingOnline injury surveillance from lacrosse teams of high school boys (annual average = 55) and collegiate men (annual average = 14).Patients or Other ParticipantsBoys' and men's lacrosse players who participated in practices and competitions during the 2008–2009 through 2013–2014 academic years in high school or the 2004–2005 through 2013–2014 academic years in college.Main Outcome Measure(s)Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated.ResultsHigh School Reporting Information Online documented 1407 time-loss injuries during 662 960 AEs. The National Collegiate Athletic Association Injury Surveillance Program documented 1882 time-loss injuries during 390 029 AEs. The total injury rate from 2008–2009 through 2013–2014 was higher in college than in high school (3.77 versus 2.12/1000 AEs; IRR = 1.78; 95% CI = 1.63, 1.94). Most injuries occurred during competitions in high school (61.4%) and practices in college (61.4%). Injury rates were higher in competitions compared with practices in high school (IRR = 3.59; 95% CI = 3.23, 4.00) and college (IRR = 3.38; 95% CI = 3.08, 3.71). Lower limb injuries, muscle strains, and ligament sprains were common at both levels. Concussion was the most frequent competition diagnosis for all high school player positions.ConclusionsRates of time-loss injury were higher in college versus high school and in competitions versus practices. Attention to preventing common lower leg injuries and concussions, especially at the high school level, is essential to decrease their incidence and severity.

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Injury prevention effects of stretching exercise intervention by physical therapists in male high school soccer players

Scandinavian Journal of Medicine and Science in Sports ◽

10.1111/sms.13777 ◽

2020 ◽

Vol 30 (11) ◽

pp. 2178-2192

Author(s):

Nobuhide Azuma ◽

Fujiko Someya

Keyword(s):

High School ◽

Injury Prevention ◽

Exercise Intervention ◽

Physical Therapists ◽

Soccer Players ◽

Male High School

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Changes in Sport Nutrition Knowledge, Attitudes/Beliefs and Behaviors Following a Two-Year Sport Nutrition Education and Life-Skills Intervention among High School Soccer Players

Nutrients ◽

10.3390/nu10111636 ◽

2018 ◽

Vol 10 (11) ◽

pp. 1636 ◽

Cited By ~ 8

Author(s):

Megan Patton-Lopez ◽

Melinda Manore ◽

Adam Branscum ◽

Yu Meng ◽

Siew Wong

Keyword(s):

High School ◽

Nutrition Education ◽

Life Skills ◽

Intervention Group ◽

Geographical Location ◽

Nutrition Knowledge ◽

Sport Nutrition ◽

Soccer Players ◽

Race Ethnicity ◽

The Impact

The purpose of this study was to examine the impact of a sport nutrition education and life-skills intervention on sport nutrition knowledge (SNK), attitudes/beliefs and dietary behaviors relevant to sport nutrition among high school (HS) soccer players. Three assessments were done over the 2-year intervention (baseline = time 1, end year 1 = time 2, end year 2 = time 3). Participants (n = 217; females = 64%; Latino = 47.5%; 14.9 ± 0.9-year; 46.5% National School Breakfast/Lunch Program) were assigned to an intervention group (IG, n = 153; 9 schools) or comparison group (CG, n = 64; 4 schools) based on geographical location. Differences over time were examined based on group, sex, socioeconomic status (SES) and race/ethnicity. The IG increased SNK scores by ~10% (time 1 = 51.6%; time 3 = 60.9%; p ≤ 0.001), with the greatest change in the female IG vs. CG and no differences in male IG vs. CG. Daily breakfast consumption was 53.7% in both groups. IG players were 3 times more likely (95%CI = 2.59, 7.77) to report trying to eat for performance (IG = 48.7% vs. CG = 30.2%). By time 3, IG players were less likely to report that ‘diet met nutritional requirements’ (31.6%) compared to CG (47.6%). For IG, the consumption of lunch (≥5-days/week) did not change (92.2–93.4%), but declined in the CG (90.6%) (p = 0.04). No other differences by sub-population (race/ethnicity, SES) were observed. Our findings indicate that HS athletes are motivated to learn and improve diet behaviors, and benefit from team-based nutrition interventions. Future interventions should consider delivery of curriculum/experiential learning during a defined training period, with messages reinforced with supports at home, school and athletic settings.

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The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls' Softball (2005–2006 Through 2013–2014) and National Collegiate Athletic Association Women's Softball (2004–2005 Through 2013–2014)

Journal of Athletic Training ◽

10.4085/1062-6050-206-17 ◽

2019 ◽

Vol 54 (2) ◽

pp. 212-225 ◽

Cited By ~ 2

Author(s):

Erin B. Wasserman ◽

Johna K. Register-Mihalik ◽

Eric L. Sauers ◽

Dustin W. Currie ◽

Lauren A. Pierpoint ◽

...

Keyword(s):

High School ◽

National Collegiate Athletic Association ◽

Injury Rate ◽

Sports Injury ◽

Injury Surveillance ◽

Time Loss ◽

Injury Rates ◽

Web Based ◽

High School Girls ◽

School Girls

Context The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of girls' and women's softball injury data. Objective To describe the epidemiology of injuries sustained in high school girls' softball in the 2005–2006 through 2013–2014 academic years and collegiate women's softball in the 2004–2005 through 2013–2014 academic years using Web-based sports injury surveillance. Design Descriptive epidemiology study. Setting Online injury surveillance from softball teams in high school girls (annual average = 100) and collegiate women (annual average = 41). Patients or Other Participants Girls' or women's softball players who participated in practices and competitions during the 2005–2006 through 2013–2014 academic years in high school and the 2004–2005 through 2013–2014 academic years in college. Main Outcome Measure(s) Athletic trainers collected time-loss injury and exposure data. Injury rates per 1000 athlete-exposures (AEs) were calculated. Injury rate ratios (IRRs) with 95% confidence intervals (CIs) compared injury rates by competition level, school size or division, event type, and time in season. Results The High School Reporting Information Online system documented 1357 time-loss injuries during 1 173 722 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 1848 time-loss injuries during 579 553 AEs. The injury rate was higher in college than in high school (3.19 versus 1.16/1000 AEs; IRR = 2.76; 95% CI = 2.57, 2.96). The competition injury rate was higher than the practice injury rate in high school (IRR = 2.02; 95% CI = 1.82, 2.25) and in college (IRR = 1.39; 95% CI = 1.27, 1.52). Softball players at both levels sustained a variety of injuries, with the most common being ankle sprains and concussions. Many injuries also occurred while fielding or running bases. Conclusions Injury rates were greater in collegiate versus high school softball and in competitions versus practices. These findings highlight the need for injury-prevention interventions, including strength-training and prevention programs to reduce ankle sprains and provide protection for batters from pitches and fielders from batted balls.

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Youth Football Injuries: A Prospective Cohort

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967116686784 ◽

2017 ◽

Vol 5 (2) ◽

pp. 232596711668678 ◽

Cited By ~ 7

Author(s):

Andrew R. Peterson ◽

Adam J. Kruse ◽

Scott M. Meester ◽

Tyler S. Olson ◽

Benjamin N. Riedle ◽

...

Keyword(s):

Proportional Hazards ◽

Injury Rate ◽

The United States ◽

Cox Proportional Hazards ◽

Time Loss ◽

Level Of Evidence ◽

Severe Injuries ◽

Injury Rates ◽

Youth Football ◽

Tackle Football

Background: There are approximately 2.8 million youth football players between the ages of 7 and 14 years in the United States. Rates of injury in this population are poorly described. Recent studies have reported injury rates between 2.3% and 30.4% per season and between 8.5 and 43 per 1000 exposures. Hypothesis: Youth flag football has a lower injury rate than youth tackle football. The concussion rates in flag football are lower than in tackle football. Study Design: Cohort study; Level of evidence, 3. Methods: Three large youth (grades 2-7) football leagues with a total of 3794 players were enrolled. Research personnel partnered with the leagues to provide electronic attendance and injury reporting systems. Researchers had access to deidentified player data and injury information. Injury rates for both the tackle and flag leagues were calculated and compared using Poisson regression with a log link. The probability an injury was severe and an injury resulted in a concussion were modeled using logistic regression. For these 2 responses, best subset model selection was performed, and the model with the minimum Akaike information criterion value was chosen as best. Kaplan-Meier curves were examined to compare time loss due to injury for various subgroups of the population. Finally, time loss was modeled using Cox proportional hazards regression models. Results: A total of 46,416 exposures and 128 injuries were reported. The mean age at injury was 10.64 years. The hazard ratio for tackle football (compared with flag football) was 0.45 (95% CI, 0.25-0.80; P = .0065). The rate of severe injuries per exposure for tackle football was 1.1 (95% CI, 0.33-3.4; P = .93) times that of the flag league. The rate for concussions in tackle football per exposure was 0.51 (95% CI, 0.16-1.7; P = .27) times that of the flag league. Conclusion: Injury is more likely to occur in youth flag football than in youth tackle football. Severe injuries and concussions were not significantly different between leagues. Concussion was more likely to occur during games than during practice. Players in the sixth or seventh grade were more likely to suffer a concussion than were younger players.

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The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in United States High School Football (2005–2006 Through 2013–2014) and National Collegiate Athletic Association Football (2004–2005 Through 2013–2014)

Journal of Athletic Training ◽

10.4085/1062-6050-144-17 ◽

2018 ◽

Vol 53 (8) ◽

pp. 738-751 ◽

Cited By ~ 10

Author(s):

Zachary Y. Kerr ◽

Gary B. Wilkerson ◽

Shane V. Caswell ◽

Dustin W. Currie ◽

Lauren A. Pierpoint ◽

...

Keyword(s):

High School ◽

National Collegiate Athletic Association ◽

Injury Rate ◽

Sports Injury ◽

Injury Surveillance ◽

Surveillance Program ◽

Time Loss ◽

High School Football ◽

Injury Rates ◽

Web Based

Context: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of football injury data.Objective: To describe the epidemiology of injuries sustained in high school football in the 2005–2006 through 2013–2014 academic years and collegiate football in the 2004–2005 through 2013–2014 academic years using Web-based sports injury surveillance.Design: Descriptive epidemiology study.Setting: Online injury surveillance from football teams of high school boys (annual average = 100) and collegiate men (annual average = 43).Patients or Other Participants: Football players who participated in practices and competitions during the 2005–2006 through 2013–2014 academic years in high school or the 2004–2005 through 2013–2014 academic years in college.Main Outcome Measure(s): Athletic trainers collected time-loss injury (≥24 hours) and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated.Results: The High School Reporting Information Online system documented 18 189 time-loss injuries during 4 539 636 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 22 766 time-loss injuries during 3 121 476 AEs. The injury rate was higher among collegiate than high school (7.29 versus 4.01/1000 AEs; IRR = 1.82; 95% CI = 1.79, 1.86) athletes. Most injuries occurred during competitions in high school (53.2%) and practices in college (60.9%). The competition injury rate was higher than the practice injury rate among both high school (IRR = 5.62; 95% CI = 5.46, 5.78) and collegiate (IRR = 6.59; 95% CI = 6.41, 6.76) players. Most injuries at both levels affected the lower extremity and the shoulder/clavicle and were diagnosed as ligament sprains and muscle/tendon strains. However, concussion was a common injury during competitions among most positions.Conclusions: Injury rates were higher in college than in high school and higher for competitions than for practices. Concussion was a frequent injury sustained during competitions, which confirms the need to develop interventions to mitigate its incidence and severity.

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