Background Despite the worldwide popularity of football, research on epidemiology of high school injury is sparse.
Objective To describe high school football injury rates and patterns by type of athletic exposure and gender.
Design This descriptive epidemiologic study used retrospective analysis of high school sports injury data from a multi-year US surveillance program capturing data from a large national cohort of schools.
Setting Annually, this prospective surveillance study recruits 100 US high schools with National Athletic Trainers' Association affiliated, athletic trainers to report exposure and injury data for athletes participating in school-sanctioned high school sports.
Participants Student football players from these nationally representative high schools from 2005–06 through 2013–14.
Assessment of Risk Factors Independent variables included gender, mechanism of injury, playing position, and field location.
Main Outcome Measurements Rates and patterns of football-related injuries.
Results Overall 6154 football injuries occurred during 2,985,991 athlete exposures (AEs); injury rate of 2.06 per 1000 AEs. This corresponded to a national estimate of 3,381,189 US high school football-related injuries. Injury rates were higher in girls (2.33) than boys (1.83) (RR=1.27, 95% CI 1.21–1.34). Player-player contact more commonly resulted in competition injuries (injury proportion ratio [IPR]=2.87; 95% CI 2.57–3.21), while noncontact mechanisms were more common among practice injuries (IPR=2.10; 95% CI 1.86–2.38). Most injuries occurred to midfielders (37.6%), followed by forwards (28.9%), and defenders (23.6%).. The most common activities leading to injuries were general play (24%), defending (13%), and chasing a loose ball (11%). Injury patterns were similar between genders with respect to position played and location on the field at the time of injury.
Conclusions High school football injury rates vary by gender and type of exposure while injury patterns are more similar across genders. These findings should drive additional research into development, implementation, and evaluation of targeted injury prevention efforts.