Subsequent injury patterns in girls' high school sports.
BACKGROUND
Girls' participation in high school sports has increased 79.5% since 1975-1976. The incidence of injury among boys in high school sports has been well documented, but information regarding the incidence, severity, and type of injury among girls in high school sports is limited.


OBJECTIVE
To examine the effects of subsequent injuries among high school girls in 5 sports.


METHODS
Observational cohort.


METHODS
Existing data from the 1995-1997 National Athletic Trainers' Association High School Injury Surveillance database.


METHODS
Girl athletes (n = 25 187 player-seasons) participating in 5 varsity high school sports: basketball, field hockey, soccer, softball, and volleyball.


METHODS
Injury status, body location, injury type, time lost from injury, and number of players at risk for injury as recorded by athletic trainers and submitted to the Sports Injury Monitoring System.


RESULTS
Overall, 23.3% of the athletes had 2 or more injuries within a sport; basketball and soccer athletes were most vulnerable. Overall, the probability of an athlete sustaining 3 or more injuries was 38.6%, and the risk was highest for field hockey players (61.9%). The risk of subsequent injury at a new body location was almost 2 times higher than reinjury at the same body location (risk ratio = 1.7, 95% confidence interval = 1.6, 1.8) and was similar for all sports except volleyball. Only in softball was the proportion of reinjuries causing 8 or more days lost from participation greater than the proportion of new injuries causing similar time loss. Softball and volleyball had the highest proportion of reinjuries at the shoulder, especially rotator cuff strains. The proportion of knee reinjuries was significantly higher than new injuries for all sports except soccer. The proportion of anterior cruciate ligament injuries was significantly higher for volleyball players only. Overall, the proportion of reinjuries was significantly higher for stress fractures and musculoskeletal condition injuries.


CONCLUSIONS
Patterns of subsequent injury risk appear to vary among these 5 sports. Almost one quarter of the athletes incurred 2 or more injuries over a 3-year period, so the effects of subsequent injuries deserve more consideration.
Rauh
Mitchell J
MJ
Graduate Program in Orthopaedics & Sports Physical Therapy, Rocky Mountain University of Health Professions, Provo, UT 84601, USA. mrauh@rmuohp.edu
Macera
Caroline A
CA
Ji
Ming
M
Wiksten
Denise L
DL
D000293:Adolescent; D001265:Athletic Injuries / Q000453:epidemiology*; D001484:Baseball / Q000293:injuries*; D001490:Basketball / Q000293:injuries*; D015984:Causality; D016001:Confidence Intervals; D005260:Female; D006688:Hockey / Q000293:injuries*; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012574:Schools; D012916:Soccer / Q000293:injuries*; D013177:Sports / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology