Epidemiology of Overuse Injuries in Collegiate and High School Athletics in the United States.

BACKGROUND

Overuse injuries result from microtrauma due to repetitive loading combined with insufficient tissue recovery time and can result in both immediate and long-term time loss from sports.

HYPOTHESIS

Overuse injury rates and patterns differ across college and high school populations, sport, and sex.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

Surveillance data for 16 sports from the National Collegiate Athletic Association's Injury Surveillance System (NCAA ISS; 2004-2005 through 2008-2009) and 14 sports from High School Reporting Information Online (High School RIO; 2006-2007 through 2012-2013) were analyzed. All reported injuries had an injury mechanism of overuse/gradual onset (college) or overuse/chronic (high school). Overuse injury incidence rates were calculated, and rate ratios with 95% CIs were used to compare subgroups.

RESULTS

The rate of overuse injury was 3.28 times higher in college than high school sports (95% CI, 3.12-3.44). The rate of overuse injury among sex-comparable sports was higher in female than male athletes in both populations (college rate ratio, 1.25; 95% CI, 1.16-1.35; high school rate ratio, 1.55; 95% CI, 1.43-1.68). The lower extremity was the most commonly injured body site (college, 69.4%; high school, 70.4%). A larger proportion of overuse injuries among college athletes resulted in time loss of more than 21 days (college, 20.4%; high school, 7.7%) and surgery (college, 5.2%, high school, 2.5%).

CONCLUSION

Overuse injuries can impose a significant burden on college and high school athletes. Interventions addressing prevention of overuse injury are needed.