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

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

Author information

Ohio State University College of Medicine, Columbus, OH. Electronic address:
Department of Epidemiology, Colorado School of Public Health and Emergency Medicine, Pediatrics, University of Colorado School of Medicine, Aurora, CO.
Center for Injury Research and Policy, Nationwide Children's Hospital, Columbus, OH.
Department of Orthopedics, The Ohio State University, Columbus, OH.
Department of Family Medicine, The Ohio State University, Columbus, OH.



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


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.


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.


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.

[Indexed for MEDLINE]

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