Epidemiology of overuse injuries among high-school athletes in the United States

J Pediatr. 2015 Mar;166(3):600-6. doi: 10.1016/j.jpeds.2014.09.037. Epub 2014 Oct 25.


Objective: To examine high school overuse injury rates and patterns by sex and sport.

Study design: High school athletes participating in the High School Reporting Information Online study were examined in a descriptive epidemiologic study. Overuse injury data for the 2006/2007-2011/2012 academic years collected via High School Reporting Information Online from a large national sample of US high schools where certified athletic trainers completed detailed injury reports were evaluated.

Results: From 2006/2007 to 2011/2012, a total of 2834 overuse injuries were reported during 18 889 141 athletic exposures (1.50 per 10 000 athletic exposures). Girls had greater rates of overuse injury (1.88) than boys (1.26) (rate ratio 1.50, 95% CI 1.39-1.61). The greatest rates were in girls' track and field (3.82) and girls' field hockey (2.93). Overuse injuries represented 7.7% of all injuries, ranging from a low of 1.4% of all boys' ice hockey injuries to a high of 55.7% of all boys' swimming and diving injuries. Overall, overuse injuries were evenly distributed across athletes in each year of high school (freshman, 25.6%; sophomore, 25.3%; junior, 24.9%; senior, 24.3%). However, there were distinct differences by sex. The most frequent site of injury was the lower leg (21.8%). Injuries most frequently resulted in time loss of less than 1 week (50.0%), with only 7.6% resulting in time loss greater than 3 weeks.

Conclusions: Overuse injury patterns differed by sex and sport. A better understanding of overuse injury patterns and criteria for return to play may help direct preventative measures and injury management.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Comment

MeSH terms

  • Brain Concussion / rehabilitation*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Schools*
  • Students / statistics & numerical data*