Patterns of recurrent injuries among US high school athletes, 2005-2008

Am J Sports Med. 2009 Aug;37(8):1586-93. doi: 10.1177/0363546509332500. Epub 2009 Apr 16.


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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Athletic Injuries / classification
  • Athletic Injuries / epidemiology*
  • Athletic Injuries / etiology
  • Female
  • Humans
  • Male
  • Population Surveillance / methods*
  • Recurrence
  • United States / epidemiology