scholarly journals Epidemiology of overuse injuries in U.S. secondary school athletics from 2014–2015 to 2018–2019 using the National Athletic Treatment, Injury and Outcomes Network Surveillance Program.

2021 ◽  
Author(s):  
Eric G. Post ◽  
Janet E. Simon PhD ◽  
Hannah Robison ◽  
Sarah N. Morris ◽  
David R. Bell
Keyword(s):  
High School ◽  
Overuse Injury ◽  
Injury Rate ◽  
Track And Field ◽  
Surveillance Program ◽  
High School Sports ◽  
Injury Rates ◽  
School Sports ◽  
Network Surveillance ◽  
Cross Country

ABSTRACT Context: With 8 million annual participants in the United States, the epidemiology of sports-related injuries in high school athletics has garnered significant interest. The most recent studies examining overuse injury rates in high school sports reported data from 2012–2013 and therefore may not reflect current overuse injury rates in high school sports. Objective: To 1) to determine overuse time-loss (TL) and non-time-loss (NTL) injury rates among high school student athletes using NATION-SP data collected from 2014–2015 to 2018–2019 and 2) compare overuse injury rates based on student-athlete gender defined by sport, sport, and injury location. Design: Descriptive epidemiology study. Setting: Online injury surveillance from 211 high schools (345 individual years of high school data). Patients or Other Participants: Athletes participating in secondary school-sponsored boys' and girls' sports. Main Outcome Measures: Boys' and girls' overuse injury data from the National Athletic Treatment, Injury and Outcomes Network Surveillance Program (NATION-SP) from the 2014–2015 to 2018–2019 school years were analyzed. Overuse injuries were identified using a combination of reported injury mechanism and diagnosis. TL injuries resulted in restriction from participation beyond the day of injury; a NTL injury did not result in restriction from participation beyond the day of injury or lost no time due to the injury. Injury counts, rates, and rate ratios (IRRs) were reported with 95% confidence intervals (CIs). Results: The overall overuse injury rate was 5.3/10,000 AEs (95%CI=5.1, 5.7), the NTL overuse injury rate was 3.4/10,000 AEs (95%CI=3.1, 3.6), and the TL overuse injury rate was 2.0/10,000 AEs (95%CI=1.8, 2.2). The overuse injury rate was greater in girls' sports compared to boys' sports (IRR=1.9; 95%CI=1.7, 2.1). The highest rates of overuse injury were reported in girls' cross-country (19.2/10,000 AEs; 95%CI=15.0, 24.2), girls' track and field (16.0/10,000 AEs; 95%CI=13.5, 18.8), and girls' field hockey (15.1/10,000 AEs; 95%CI=10.2, 21.6). Overuse injury rates were highest for the lower extremity compared to the upper extremity (IRR=5.7; 95%CI=4.9, 6.7) and for the lower extremity compared to the trunk and spine (IRR=8.9; 95%CI=7.3, 10.8). Conclusions: Awareness of overuse injury risk as well as prevention and intervention recommendations are necessary and should be specifically targeted towards cross-country, field hockey, and track and field athletes.

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.

scholarly journals Incidence of Injuries in High School Softball and Baseball Players

2011 ◽  
Vol 46 (6) ◽  
pp. 648-654 ◽  
Author(s):  
Ellen Shanley ◽  
Mitchell J. Rauh ◽  
Lori A. Michener ◽  
Todd S. Ellenbecker
Keyword(s):  
High School ◽  
South Carolina ◽  
High Schools ◽  
Upper Extremity ◽  
Injury Rate ◽  
Baseball Players ◽  
Injury Rates ◽  
School Sports ◽  
Initial Injury ◽  
Subsequent Injury

Context: Participation in high school sports has grown 16.1% over the last decade, but few studies have compared the overall injury risks in girls' softball and boys' baseball. Objective: To examine the incidence of injury in high school softball and baseball players. Design: Cohort study. Setting: Greenville, South Carolina, high schools. Patients or Other Participants: Softball and baseball players (n = 247) from 11 high schools. Main Outcome Measure(s): Injury rates, locations, types; initial or subsequent injury; practice or game setting; positions played; seasonal trends. Results: The overall incidence injury rate was 4.5/1000 athlete-exposures (AEs), with more injuries overall in softball players (5.6/1000 AEs) than in baseball players (4.0/1000 AEs). Baseball players had a higher initial injury rate (75.9/1000 AEs) than softball players (66.4/1000 AEs): rate ratio (RR) = 0.88, 95% confidence interval (CI) = 0.4, 1.7. The initial injury rate was higher than the subsequent injury rate for the overall sample (P < .0001) and for softball (P < .0001) and baseball (P < .001) players. For both sports, the injury rate during games (4.6/1000 AEs) was similar to that during practices (4.1/1000 AEs), RR = 1.22, 95% CI = 0.7, 2.2. Softball players were more likely to be injured in a game than were baseball players (RR = 1.92, 95% CI = 0.8, 4.3). Most injuries (77%) were mild (3.5/1000 AEs). The upper extremity accounted for the highest proportion of injuries (63.3%). The incidence of injury for pitchers was 37.3% and for position players was 15.3%. The rate of injury was highest during the first month of the season (7.96/1000 AEs). Conclusions: The incidence of injury was low for both softball and baseball. Most injuries were minor and affected the upper extremity. The injury rates were highest in the first month of the season, so prevention strategies should be focused on minimizing injuries and monitoring players early in the season.

scholarly journals 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)

2019 ◽  
Vol 54 (1) ◽  
pp. 30-41 ◽  
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.

scholarly journals Trends in US High School Football Concussion Reporting, 2012-2017

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0030
Author(s):  
Scott O. Burkhart ◽  
Dustin M. Loveland ◽  
Troy M. Smurawa ◽  
John Polousky
Keyword(s):  
High School ◽  
High Schools ◽  
Student Athletes ◽  
Incidence Rates ◽  
Event Type ◽  
High School Football ◽  
Convenience Sample ◽  
High School Sports ◽  
Injury Rates ◽  
School Sports

Objectives: Football has been a sport with high concussion rates when examined independently (Rosenthal et al., 2014). Accurately describing injury trends in high school sports is necessary to identify student-athletes at the greatest risk of injury and where potential injury reduction interventions should be focused. With increased reported high school concussion injuries and associated state legislative requirements, increased incidence rates are needed. The purpose of this study was to provide updated high-school football concussion incidence rates. Methods: Data Source and Study Period This study used data from the Rank One Health Injury Surveillance Database (ROH ISD). Data for the current study were analyzed across 6 calendar years (2012 through 2017) from 1,999 high schools. Data from the current study examined high school football concussion data in males ages 14 to 18. The ROH ISD consists of a convenience sample of participating schools from 2012 to 2017. Exposure and injury data represent a convenience sample of US high schools. For the current study, only data provided across all 1,999 high schools were included. All 1,999 high schools included in the current study logged practice and game participation events for each individual athlete participating in football at the respective high school and athletic exposures (AEs) are an accurate representation of rostered athletes participating in either practices or games by age and calendar year. The ROH ISD was deemed Category 4 IRB exempt. Statistical Analysis Injury counts, practice exposures, game exposures, and distributions by event type (practice or game), age, and injury mechanism were examined. Injury rates per 1,000 AEs and injury rate ratios (IRRs) were calculated by event type. Injury proportion ratios (IPRs) were used to examine differences by calendar year. Risk ratios (RRs) were calculated to compare event type by calendar year. All 95% confidence intervals (CIs) not containing 1.0 were considered statistically significant. Results: 997,308 male student-athletes participated in high school football. ATs recorded a total of 14,103 concussions in high school football from a total of 235,134 total injuries across all high school sports. High school football concussions accounted for 6% of all injuries in high school sports from 2012-2017. More concussions occurred in games (51.8%) than practices (48.2%). Decreases were found in annual injury rates for practices in high school football student-athletes from 2012 to 2016 with an increase in 2017. Decreases were found in annual injury rates for games from 2012 to 2016 with an increase in 2017. IPR decreased by year from 2012 to 2016 (with an increase in 2017. IRR and RR comparisons for games versus practices were significant from 2012 to 2017 (Table 1). Conclusion: This study marks the largest epidemiological high school football concussion incidence investigation to date. The findings from this study provide updated high school football concussion incidence rates and provide further evidence of differences in injury rates when comparing practices and games. The higher rates of concussions occurring in games relative to practices emphasize prior trends of injury risk relative to the level of competition. Overall, results highlight a decline in injury rates over time and lower rates of injury compared to prior high school football epidemiological concussion studies. [Table: see text]

scholarly journals 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)

2018 ◽  
Vol 53 (8) ◽  
pp. 738-751 ◽  
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.

Rankings of High School Sports Injury Rates Differ Based on Time Loss Assessments

2017 ◽  
Vol 27 (6) ◽  
pp. 548-551 ◽  
Author(s):  
Zachary Y. Kerr ◽  
Karen G. Roos ◽  
Aristarque Djoko ◽  
Thomas P. Dompier ◽  
Stephen W. Marshall
Keyword(s):  
High School ◽  
Sports Injury ◽  
Time Loss ◽  
High School Sports ◽  
Injury Rates ◽  
School Sports

scholarly journals Epidemiology of Injuries in National Collegiate Athletic Association Men's Track and Field: 2014–2015 Through 2018–2019

2021 ◽  
Vol 56 (7) ◽  
pp. 788-794
Author(s):  
Adrian J. Boltz ◽  
Patricia R. Roby ◽  
Hannah J. Robison ◽  
Sarah N. Morris ◽  
Christy L. Collins ◽  
...  
Keyword(s):  
National Collegiate Athletic Association ◽  
Injury Rate ◽  
Lower Leg ◽  
Track And Field ◽  
Surveillance Program ◽  
Surveillance Systems ◽  
Injury Incidence ◽  
Injury Rates ◽  
Leg Injuries ◽  
Rate Ratios

Context College athletes have been competing in championship track and field events since 1921; the numbers of competing teams and participating athletes have expanded considerably. Background Monitoring injuries of men's track and field athletes using surveillance systems is critical in identifying emerging injury-related patterns. Methods Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014–2015 through 2018–2019 academic years were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics; injury rate ratios were used to examine differential injury rates. Results Overall, men's track and field athletes were injured at a rate of 2.37 per 1000 athlete-exposures; injuries occurred at a higher rate during competition compared with practice. Most injuries were to the thigh (26.2%), lower leg (17.3%), or knee (10.7%) and were caused by noncontact (37.2%) or overuse (31.5%) mechanisms. The most reported injury was hamstring tear (14.9%). Summary The etiologies of thigh and lower-leg injuries warrant further attention in this population. Future researchers should also separately examine injury incidence during indoor and outdoor track and field seasons.

scholarly journals Epidemiology of Lower Leg Soft Tissue Injuries in High School Athletes

2022 ◽  
Vol 7 (1) ◽  
pp. 247301142110578
Author(s):  
Michael J. Spitnale ◽  
Candler G. Mathews ◽  
Allen J. Barnes ◽  
Zachary T. Thier ◽  
J. Benjamin Jackson
Keyword(s):  
High School ◽  
Young Adults ◽  
Case Series ◽  
Injury Rate ◽  
The United States ◽  
Lower Leg ◽  
Surveillance Program ◽  
Leg Injuries ◽  
Children And Young Adults ◽  
Cross Country

Background Annually there are an estimated 4.5 million sports- and recreation-related injuries among children and young adults in the United States. The most common sports-related injuries are to the lower extremities, with two-thirds occurring among children and young adults (age range 5-24 years). The objective is to describe the epidemiology of lower leg injuries across 27 high school (HS) sports over a 3-year period. Methods The Datalys Center for Sports Injury Research and Prevention provided lower leg injury data for 27 sports in 147 high schools for 2011-2012 through 2013-2014 academic years from National Athletic Treatment, Injury and Outcomes Network (NATION) HS Surveillance Program. Results The overall rate of lower leg injuries over this 3-year period was 1.70 per 10 000 acute events (AEs) (95% CI, 1.59-1.82). In men, the highest number of lower leg injuries was in football (n=181), but indoor track had the highest rate of injury at 2.80 per 10 000 AEs (95% CI, 2.14-3.58). In women, the highest number of lower leg injuries and the highest rate of injury were in cross-country (n=76) at 3.85 per 10 000 AEs (95% CI, 3.03-4.81). The practice injury rate was 0.91 times the competition injury rate (95% CI, 0.78-1.07). Conclusion An improved understanding of the most common sports in which lower leg injuries are seen may help direct appropriate resource utilization. Our data would suggest efforts toward prevention of these overuse injuries, especially in football, track, and cross-country may have the greatest impact on the health of student athletes. Level of Evidence: Level IV, case series.

Patterns of Recurrent Injuries among US High School Athletes, 2005-2008

2009 ◽  
Vol 37 (8) ◽  
pp. 1586-1593 ◽  
Author(s):  
David M. Swenson ◽  
Ellen E. Yard ◽  
Sarah K. Fields ◽  
R. Dawn Comstock
Keyword(s):  
High School ◽  
Confidence Interval ◽  
Injury Rate ◽  
Sports Participation ◽  
Shoulder Injuries ◽  
Injury Patterns ◽  
High School Sports ◽  
School Sports ◽  
Recurrent Injury ◽  
Recurrent Injuries

Background High school sports participants sustain millions of injuries annually; many are recurrent injuries that can be more severe than new injuries. Hypothesis Recurrent injury patterns differ from new injury patterns by sport and gender. Study Design Descriptive epidemiology study. Methods High school sports injury data for the 2005 through 2008 academic years were collected via High School Reporting Information Online (RIO) from a nationally representative sample of 100 US high schools. Results From 2005 through 2008, certified athletic trainers reported 13 755 injuries during 5 627 921 athlete exposures (24.4 injuries per 10 000 athlete exposures). Recurrent injuries accounted for 10.5% of all injuries. Football players had the highest rate of recurrent injury (4.36 per 10 000 athlete exposures). Girls had higher rates of recurrent injuries than boys in soccer (injury rate ratio = 1.39; 95% confidence interval, 1.07-1.82). Recurrent injuries most often involved the ankle (28.3%), knee (16.8%), head/ face (12.1%), and shoulder (12.0%), and were most often ligament sprains (incomplete tears) (34.9%), muscle strains (incomplete tears) (13.3%), and concussions (11.6%). A greater proportion of recurrent injuries than new injuries resulted in the student choosing to end participation (recurrent = 2.4%, new = 0.7%). Recurrent shoulder injuries were more likely to require surgery than new shoulder injuries (injury proportion ratio = 4.51; 95% confidence interval, 2.82-7.20). Conclusion Recurrent injury rates and patterns differed by sport. Because recurrent injuries can have severe consequences on an athlete's health and future sports participation, injury prevention must be a priority. Knowledge of injury patterns can drive targeted preventive efforts.

scholarly journals An Epidemiologic Comparison of High School Sports Injuries Sustained in Practice and Competition

2008 ◽  
Vol 43 (2) ◽  
pp. 197-204 ◽  
Author(s):  
Julie A. Rechel ◽  
Ellen E. Yard ◽  
R. Dawn Comstock
Keyword(s):  
High School ◽  
High School Students ◽  
High Schools ◽  
Sports Injuries ◽  
School Students ◽  
High School Sports ◽  
Injury Rates ◽  
School Year ◽  
School Sports ◽  
Nationally Representative

Abstract Context: More than 7 million US high school students play sports. Objective: To compare practice and competition injury rates and patterns in 5 boys' sports (football, soccer, basketball, wrestling, and baseball) and 4 girls' sports (soccer, volleyball, basketball, and softball) during the 2005–2006 school year. Design: Prospective injury surveillance study. Setting: Injury data were collected from 100 nationally representative United States high schools via High School RIO (Reporting Information Online). Patients or Other Participants: Athletes from participating high schools injured while participating in a school-sanctioned practice or competition in one of the above sports. Main Outcome Measure(s): Practice and competition injury rates, body site, diagnosis, and severity. Results: High school athletes participating in these 9 sports at participating schools sustained 4350 injuries during the 2005–2006 school year, which corresponds to an estimated 1 442 533 injuries nationally. The rate of injury per 1000 athlete-exposures was higher in competition (4.63) than in practice (1.69) (rate ratio [RR]  =  2.73, 95% confidence interval [CI]  =  2.58, 2.90). Of all sports, football had the highest competition (12.09) and practice (2.54) injury rates per 1000 athlete-exposures. Compared with injuries sustained during practice, higher proportions of competition injuries were head/face/neck injuries (proportion ratio [PR]  =  1.61, 95% CI  =  1.34, 1.94), particularly in boys' soccer (PR  =  7.74, 95% CI  =  2.53, 23.65) and girls' basketball (PR  =  6.03, 95% CI  =  2.39, 15.22). Competition injuries were more likely to be concussions (PR  =  2.02, 95% CI  =  1.56, 2.62), especially in boys' soccer (PR  =  6.94, 95% CI  =  2.01, 23.95) and girls' basketball (PR  =  5.83, 95% CI  =  2.06, 16.49). Higher proportions of competition injuries caused the athlete to miss more than 3 weeks of play (PR  =  1.28, 95% CI  =  1.08, 1.52), particularly in baseball (PR  =  3.47, 95% CI  =  1.48, 8.11) and volleyball (PR  =  2.88, 95% CI  =  1.01, 8.24). Conclusions: Rates and patterns of high school sport injuries differed between practice and competition. Providing athletic trainers with this information is a crucial step in developing the targeted, evidence-based interventions required to effectively reduce injury rates among the millions of high school student-athletes.

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