Sex-Specific Differences in Perceived Injury Management and Prevention in High School Student-Athletes

2021 ◽  
Vol 1 (1) ◽  
pp. 30-37
Author(s):  
Eve Kantaros ◽  
Haylee Borgstrom

BACKGROUND: Sport-related injuries are common among high school student-athletes with specific sex disparities in injury risk. Many of these injuries may be avoidable with the use of injury prevention programs (IPPs). Sex differences in injury management and return to sport are not well understood. PURPOSE: To determine sex-specific differences in self-reported injury management and prevention strategies in high school student-athletes. DESIGN: Cross-sectional, survey-based study. METHODS: An anonymous 13-item electronic survey was distributed to all students in a private high school in December 2019 with responses recorded over a one-month study period. Primary outcomes were sex-specific differences in self-reported outcome measures assessing student-athlete experience during injury recovery and familiarity with IPPs. Groups were evaluated via descriptive statistics and differences between groups were compared. RESULTS: From a total of 190 responses, 106 were included in the analysis (63F, 43M, mean age 16.7 years). Female athletes reported decreased exposure to injury prevention training (44.4% vs 69.8%, p=0.01) and practice-based utilization of IPPs (23.8% vs 55.8%, p=0.001) compared to male athletes. Overall, reported utilization of IPPs was low regardless of sex at less than 40% for all athletes. Nearly 85% of female athletes compared to 51% of male athletes felt they could benefit from IPPs (p=0.001), yet fewer than half of female athletes reported ever having training in injury prevention. There were no statistically significant differences in measures of injury management or return to sport between sexes. Females reported similar major impact of injury on life and future plans compared to male athletes. CONCLUSIONS: Male athletes were 1.6x more likely to report injury prevention training and 2.4x more likely to report practice-based utilization of IPPs compared to female athletes. Sex-specific differences in injury management and return to sport were not identified. Better incorporation of IPPs, specifically at the high-school level, may help to address sex disparities in preventable sport-related injuries and allow student-athletes to maximize the myriad benefits of sport participation.

2021 ◽  
pp. 036354652110200
Author(s):  
Aaron J. Zynda ◽  
Kyle M. Petit ◽  
Morgan Anderson ◽  
Christopher P. Tomczyk ◽  
Tracey Covassin

Background: Research has demonstrated that female athletes are more likely to report their sports-related concussion (SRC) symptoms compared with male athletes; however, it is unknown if these reporting behaviors correspond to immediate removal from activity in sex-comparable sports. Purpose: To compare the incidence of high school student-athletes removed and not removed from activity after SRC in sex-comparable sports in Michigan. Study Design: Descriptive epidemiology study. Methods: Participants included student-athletes diagnosed with SRC participating in Michigan High School Athletic Association–sponsored athletic activities (22 sex-comparable sports) between 2016 and 2019. All SRCs were recorded in the association’s Head Injury Reporting System (HIRS) by certified athletic trainers, administrators, or coaches. Removal from activity indicated that the student-athlete was removed from play at the time of an injury event. If the student-athlete reported that his or her suspected injury event occurred earlier during activity or if symptom onset was delayed, “not removed from activity” was entered into the HIRS. Incidence proportions were calculated by dividing SRCs not removed by total SRCs in each sport. Risk ratios were calculated by dividing the incidence proportions of girls not removed by boys not removed in each sport. Results: A total of 4418 (2773 female, 1645 male) SRCs were reported, with the most occurring in female soccer players (n = 1023). Overall, 515 girls and 243 boys were not removed from activity, resulting in incidences of 0.19 (95% CI, 0.17-0.20) and 0.15 (95% CI, 0.13-0.17), respectively. Across all sports, girls were 1.26 (95% CI, 1.09-1.45) times as likely to not be removed from activity compared with boys. Of the sports with the most SRCs—soccer, basketball, baseball/softball, and lacrosse—girls had 1.37 (95% CI, 1.09-1.72), 1.15 (95% CI, 0.89-1.47), 1.19 (95% CI, 0.77-1.84), and 1.35 (95% CI, 0.94-1.95) times the risk of not being removed, respectively. Conclusion: Girls were at greater risk of not being removed from activity compared with boys in sex-comparable sports. Results from this study should be incorporated into SRC education in Michigan and potentially elsewhere to inform affiliated personnel of potential sex differences and protect female student-athletes from further harm.


2018 ◽  
Vol 46 (9) ◽  
pp. 2263-2269 ◽  
Author(s):  
Abigail C. Bretzin ◽  
Tracey Covassin ◽  
Meghan E. Fox ◽  
Kyle M. Petit ◽  
Jennifer L. Savage ◽  
...  

Background: Sports-related concussion (SRC) injury rates are well established in collegiate athletics through epidemiological studies using the National Collegiate Athletic Association Injury Surveillance System. However, few studies have examined sex differences, time loss, and missed school days in high school athletes, especially at the state level. Purpose: To identify sex differences in the clinical incidence of SRCs, missed school days, and time loss in high school student-athletes. Study Design: Descriptive epidemiological study. Methods: A total of 193,757 (116,434 male and 77,323 female) student-athletes (10th grade ± 1.1) participating in Michigan High School Athletic Association (MHSAA)–sponsored athletic activities were recorded in the Head Injury Reporting System. Certified athletic trainers, school athletic administrators, and coaches from MHSAA high schools reported SRC data and overall participation for the 2015-2016 academic year. Total concussive injuries, as well as missed school days and time loss for each concussive injury, were reported. The clinical incidence was calculated by dividing the number of SRCs in a particular category by the number of participants in that category and presented with 95% CIs. Relative risk ratios (RRs) were determined for sex-comparable sports. Results: The overall clinical incidence for all sports was 1.7 per 100 player-seasons (95% CI, 1.6-1.8) and 1.9 (95% CI, 1.8-2.0) for male sports and 1.5 (95% CI, 1.4-1.6) for female sports. Female athletes were at a 1.9 (95% CI, 1.8-2.2) times greater risk for enduring SRCs than male athletes in sex-comparable sports, with a greater risk in baseball/softball (RR, 2.7 [95% CI, 1.9-3.8]), basketball (RR, 2.5 [95% CI, 2.1-2.9]), and soccer (RR, 1.6 [95% CI, 1.4-1.9]). Female student-athletes had significantly longer time loss than male student-athletes ( P < .001). The mean number of missed school days did not differ between sexes ( P = .70). Conclusion: High school female student-athletes have a higher risk for an SRC in all sex-comparable sports except lacrosse. This may be because of biomechanical differences of the head-neck segment, hormonal differences, and the fact that female athletes are more likely to report symptoms after a suspected SRC. Clinical Relevance: Despite sex differences in the clinical incidence of SRCs and time loss from participation in high school sports, the numbers of missed school days are relatively similar between sexes.


2013 ◽  
Vol 52 (2) ◽  
pp. S15
Author(s):  
Heather L. McCauley ◽  
Daniel Tancredi ◽  
Jay Silverman ◽  
Michele Decker ◽  
Maria Catrina Virata ◽  
...  

2014 ◽  
Vol 63 (14) ◽  
pp. 1455-1456 ◽  
Author(s):  
Jonathan A. Drezner ◽  
Kimberly G. Harmon ◽  
Joseph C. Marek

2021 ◽  
pp. 194173812110438
Author(s):  
Rachel K. Straub ◽  
Francesco Della Villa ◽  
Bert Mandelbaum ◽  
Christopher M. Powers

Background: After anterior cruciate ligament reconstruction (ACLR), diminished quadriceps strength symmetry and reduced psychological readiness to return to play (RTP) increase the risk for subsequent injury. Although the relationship between quadriceps strength symmetry and psychological readiness to RTP has been reported to be influenced by injury mechanism in female athletes, it is unclear whether such a relationship exists in male athletes. Hypothesis: Quadriceps strength symmetry would be positively associated with greater psychological readiness to RTP after ACLR, regardless of injury mechanism. Study Design: Retrospective cohort. Level of Evidence: Level 3 (cohort study). Methods: Sixty male patients completed strength testing and the Injury-Psychological Readiness to Return to Sport Scale (I-PRRS) at an outpatient clinical facility as part of return to sport testing after ACLR. Linear regression analysis was used to assess the relationship between the I-PRRS and the independent variables of interest (quadriceps strength symmetry and injury mechanism). Results: For all patients combined, no symmetry × mechanism interaction was found ( P = 0.11). A significant positive relationship was found between quadriceps strength symmetry and the I-PRRS score ( P < 0.001, R2 = 0.31), after adjusting for time post-ACLR and injury mechanism. Conclusion: Greater quadriceps strength symmetry was associated with greater psychological readiness to RTP after ACLR in male athletes. In contrast to what has been reported in female athletes, this relationship was independent of injury mechanism. Clinical Relevance: Given the potential negative consequences of quadriceps strength deficits on one’s confidence to RTP, the need to restore quadriceps symmetry during the postoperative period is readily apparent. Low confidence or low psychological readiness to RTP may be indicative of quadriceps strength asymmetry or poor physical function in general.


2020 ◽  
pp. 004723792097665
Author(s):  
Callon M. Williams ◽  
Linda M. Reynolds ◽  
Nadine R. Mastroleo

As student athletes exhibit unique alcohol use patterns based on being in- versus out-of-season and biological sex, we aimed to explore student athlete ( N = 442) alcohol use, pregaming behaviors, and associated negative outcomes. Results suggest being out-of-season and male are positively associated with negative alcohol-related consequences, and male athletes report greater numbers of pregame specific alcohol-related consequences than female athletes ( p <  .05). Female athletes indicated significantly higher estimated blood alcohol concentrations than male athletes on pregaming nights. No differences emerged between in- and out-of-season athletes on pregame consequences. Results suggest that further emphasis on the role season status and sex has on pregaming behaviors and experiencing negative outcomes may be an important next step toward enhancing prevention and intervention approaches.


2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0000
Author(s):  
Aaron D. Gray ◽  
Scott M. Miller ◽  
Samuel Galloway ◽  
Seth Sherman ◽  
Emily Leary ◽  
...  

Background: The purpose of this study was to investigate the incidence of anterior cruciate ligament (ACL) injuries in Missouri high school female and male soccer players during the 2011-2013 seasons, using a single postseason survey sent to coaches. Our hypothesis is a single postseason survey be a feasible method to measure a large number of athletic exposures (AEs) and ACL injuries. We also hypothesize that “traditional” methods for calculating athletic exposures likely underestimate the actual burden of ACL injuries in high school soccer matches. Methods: The study was IRB approved through the University of Missouri. A web-based survey was developed and sent to every girls and boys high school soccer coach in Missouri using a Missouri State High School Activities Association (MSHSAA) database. In order to calculate AEs, questions were asked about the average number of athletes who participated in tryouts, practices, and matches along with the specific number of tryouts, practices, and matches for the 2011-2012 and 2012-2013 seasons. Coaches were also asked the number of ACL injuries their team suffered. No medical personnel were involved in filling out the surveys. Athletic exposures (AEs) were calculated using the formulas below. Match athletic exposures were calculated using a “traditional” method and also an “athlete at risk” method. The primary outcome measure was ACL injuries. Formulas for Calculation of Athletic Exposures (AEs) Tryouts & Practice= (a*A) + (b*B) Match (Traditional)= (c*C) Match (Athlete at Risk)= (11*C) a = average number of players participating in tryouts A = number of tryout sessions b = average number of players participating in practices B = number of practices in a season c = average number of players participating in matches C = number of matches in a season Results: In total, 885 coaches were sent surveys and 160 (18.1%) coaches responded, with 84 coaches representing girls soccer teams and 76 representing boys teams. A total of 323,010 AEs (160,756 female and 162,254 male) were reported of which 228,608 AEs (71%) took place in practices. 94,402 AEs occurred in matches using the “traditional” method and 61,963 AEs in matches using the “athlete at risk” method. 36 ACL injuries (28 female and 8 male) were reported. Of the 28 female ACL injuries, 25 happened during high school soccer activities (23 match, 2 practice). 3 ACL injuries occurred outside of high school soccer activities (1 club soccer, 1 volleyball, 1 unknown.) All 8 male ACL injuries were suffered during a high school match. Female athletes had an ACL injury rate of 0.16/1000 AEs compared to male athletes 0.05/1000 AEs (Table 1). Female athletes had a practice ACL injury rate of 0.02/1000 AEs and there were no ACL injuries suffered by male athletes in practice. Female athletes had a match ACL injury rate of 0.47/1000 AEs using “traditional” method and 0.70/1000 AEs by the “athlete at risk” method. Male athletes had a match ACL injury rate of 0.18/1000 AEs “traditional” method and 0.28/1000 AEs “athlete at risk” method (Figure 1). Female high school soccer athletes had a 3.2x greater risk of ACL tear than male high school soccer athletes. Female athletes were 26x more likely to tear their ACL in a match compared to practice. ACL match injury rates were 50-55% higher using the “athlete at risk” method compared to “traditional” methods for calculating match injury rates. Conclusion/Significance: A single postseason survey sent to coaches was successful in measuring AEs and ACL injury rates for a large population of high school soccer athletes. This represents an economical and feasible mechanism compared to previous studies (Table 2) to measure ACL injury rates for a high number of teams. It also allows ACL injury rates to be measured for schools and teams that do not have certified athletic trainers. “Traditional” methods for calculating match ACL injury rates greatly under represent ACL injuries compared to the “athlete at risk” method which is more representative of true injury risk exposure. A very high percentage of ACL injuries occurred during matches even though matches were responsible for only 29% of AEs. If future studies have limited resources, they should consider not recording practice AEs and ACL injuries since the likelihood of an ACL injury occurring during practice is very low compared to a match. [Table: see text][Table: see text][Figure: see text]


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