Which High School Sports Cause Kids the Most Injuries?

Fewer high school athletes are getting hurt playing sports, but those who do are more likely to suffer severe injuries that require surgery or a timeout from their chosen sport, new research shows.

Which teens are most at risk? Those who participate in football, girls’ soccer and boys’ wrestling, the study authors found. Knee and ankle sprains and strains, along with head injuries such as concussions, were the most common injuries seen.

Exactly why injuries are becoming more severe isn’t fully understood, but having kids specialize in sports too early may play a role. That can lead to an increase in overuse injuries, overtraining and burnout, said study co-author Jordan Pizzarro, a medical student at George Washington University School of Medicine and Health Sciences, in Washington, D.C.

Still, the new data isn’t a reason for kids to stop playing sports.

“Sports build endurance and stamina and help with growth and maturity,” Pizzarro said. Instead, parents should talk to the school or coach about pre-season training programs that may help stave off injuries among young athletes.

For the study, the researchers tapped into 2015 to 2019 injury data from 100 high schools. These schools have athletic trainers who report injuries for five boys’ and four girls’ sports.

Overall, there were 15,531 injuries that occurred during 6.8 million athletic exposures. (An athletic exposure is defined as one athlete participating in one practice or competition during which an injury could potentially occur.) This equals an overall rate of nearly 2.3 injuries per 1,000 athletic exposures, which can be extrapolated to 5.2 million sports-related injuries among high schoolers nationally.

Most injuries took place during games. Overall, the injury rate was higher in boys’ sports compared to girls’ sports, and 3.5% of all injuries were fractures, and these mainly occurred in boys’ baseball, basketball and football. Overall, just over 6% of injuries — most often from wrestling, girls’ basketball and boys’ baseball — required surgery.

In total, 39% of sports injuries resulted in athletes taking less than one week off from their sport, while 34% of injuries required taking up to three weeks off to heal. Seven percent of injuries required athletes to take more than three weeks off to heal, and nearly 21% of injuries led to medical disqualification for the season or career.

The new research was scheduled for presentation at the American Academy of Orthopaedic Surgeons (AAOS) annual meeting, held in Las Vegas from March 7 to 11. Research presented at medical conferences should be considered preliminary until published in a peer-reviewed journal.

Knowledge is power, said study co-author Dr. Sean Tabaie, an orthopedic surgeon at Children’s National Hospital in Washington, D.C.

“Now, we have data to present to families to say ‘Soccer may have a higher risk of injuries, and these are possibilities, but even though the rate is higher than other sports, it’s still relatively low in the grand scheme of things,’” he said.

There’s also a role for prevention, to help kids stay in the game longer, Tabaie noted.

“The majority of high school sports are recreational, so the players may be under-conditioned and not prepared for the grinds of organized sports, making them more prone to muscle strains and other soft tissue injuries,” Tabaie said.

His advice? “Start early and introduce kids to a lot of different sports. Rotating the sports that kids play throughout the seasons is really important. Don’t focus on one sport, as that will leave you prone to overuse of specific muscles,” Tabaie explained.

It’s also important to ease into play by taking part in skills and drills training before games and scrimmages, he suggested.

Injuries are always a possible consequence of sports participation, but sports also provide numerous physical, emotional and social benefits, said Dr. Matthew Matava, a professor of orthopedic surgery and physical therapy at Washington University School of Medicine in St. Louis, and an AAOS spokesperson.

“Parents should remember that the primary purpose of kids’ sports is to have fun,” Matava said. “Far too many kids actually play too much, which can increase the risk for injury as well as burnout.”

Kids should play a variety of sports throughout the year to develop different skill sets, allow some muscles and joints to rest, and meet new friends. They should also stretch and do an appropriate warm-up before play to reduce the risk of injury, he advised.

The good news from the study is that the vast majority of sports injuries in kids resolve within three weeks, Matava said.

“These overuse conditions usually respond to rest and appropriate conservative treatment involving ice, compression and elevation of the involved area, if possible,” he said.

If a young athlete complains of joint-specific pain that is associated with swelling, locking or giving way, they should be evaluated by an orthopedic surgeon before returning to sports activities, Matava added.

More information

Learn more about high school sports injuries and how to prevent them at the American Academy of Orthopaedic Surgeons.

SOURCES: Jordan Pizzarro, MD, medical student, George Washington University School of Medicine and Health Sciences, Washington, D.C.; Sean Tabaie, MD, orthopedic surgeon, Children’s National Hospital, Washington, D.C.; Matthew Matava, MD, professor, orthopedic surgery, physical therapy, Washington University School of Medicine, St. Louis; American Academy of Orthopaedic Surgeons annual meeting, Las Vegas, March 7 to 11, 2023