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

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.