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.


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


METHODS
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%).


CONCLUSIONS
Overuse injuries can impose a significant burden on college and high school athletes. Interventions addressing prevention of overuse injury are needed.
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA kroos@email.unc.edu.
Karen G
KG
Roos
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Stephen W
SW
Marshall
Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA.
Zachary Y
ZY
Kerr
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Yvonne M
YM
Golightly
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Kristen L
KL
Kucera
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Joseph B
JB
Myers
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Wayne D
WD
Rosamond
Colorado School of Public Health, Aurora, Colorado, USA.
R Dawn
RD
Comstock
D056352:Athletes; D001265:Athletic Injuries / Q000453:epidemiology*; D012090:Cumulative Trauma Disorders / Q000453:epidemiology*; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000293:injuries*; D008297:Male; D012574:Schools; D013334:Students; D014481:United States / Q000453:epidemiology; D014495:Universities
HS RIO; NCAA ISS; college; epidemiology; high school; injury; overuse; sport; surveillance