October 06, 2006
A recent review of injuries in more than 15,000 high school varsity athletes in North Carolina showed that a player who had ever sustained an injury was more than twice as likely as an uninjured player to be hurt again.

Photograph of Dr. Sarah Knowles

Photograph of Dr. Sarah Knowles

“This is clinically significant because these are young kids,” said Dr. Sarah Knowles, who led the study when she was a graduate student in epidemiology at the UNC School of Public Health. She is now a research and publications coordinator at the Palo Alto Medical Foundation Research Institute in Palo Alto, Calif.

“The goal would be that they’re not nagged by injuries for the rest of their lives. So many of them who had been injured in the past had been injured again,” Knowles said.

Knowles and other researchers combed through data on boys and girls participating in 12 varsity sports, in 100 high schools of all sizes. The data were collected from 1996 through 1999 as part of the North Carolina High School Athletic Injury Study. Findings are published in the current issue of the American Journal of Epidemiology.

The overall rate of injury was 2.08 per 1,000 “athlete exposures” – games or practices. This rate is similar to the rate of 2.4 per 1,000 exposures found in a 2005 to 2006 national study of high school athletes reported Sept. 29 by the Centers for Disease Control and Prevention. In athletes with a prior injury, the adjusted rate of reinjury was 1.94 per 1,000 exposures; for those without a prior injury it was 1 per 1,000.

Photograph of Dr. Stephen Marshall

Photograph of Dr. Stephen Marshall

“It’s shocking to me that high school kids have this rate of reinjury,” said Dr. Stephen Marshall, an associate professor of epidemiology in the UNC School of Public Health and a biostatistician in the UNC Injury Prevention Research Center.

Marshall points to inadequate medical attention and available resources at the time of injury and poor follow up as possible causes for reinjury. “Less than half of all high schools in the United States have even one certified athletic trainer,” he said.

Knowles said that the rate of reinjury also begs questions about pressures for kids to return to play and compete for starter roles. “It’s something that needs to be looked at in addition to clinical management,” she said.

Injuries were counted in practices and in games if they resulted in loss of play the day after the injury or required medial attention. Concussions, fractures and eye injuries were reported regardless of severity.

Researchers looked at boys’ injuries in football, baseball and wrestling; girls injuries in softball, cheerleading and volleyball; and in both boys’ and girls’ in soccer, basketball and track. Football accounted for the largest number of injuries, by far, followed by soccer.

In addition to prior-injury, other risk factors included the athletes’ body mass index, age, years of experience, competitive level and participation in multiple sports, and the coaches’ experience, qualifications and training.

When researchers looked at gender-comparable sports (basketball, soccer, softball and baseball), boys were 33 percent more likely to sustain injuries. Injuries were almost four times more likely to occur in games compared to practices. No other measures, when adjusted, showed a significant risk of injury.

The research was funded by National Institute of Arthritis and Musculoskeletal and Skin Disorders of the National Institutes of Health.


For the complete study, go to: http://aje.oxfordjournals.org/cgi/reprint/kwj337.
Knowles can be reached at (650) 853-6605 or sbknowles@gmail.com.
Marshall can be reached at (919) 966-1320 or smarshall@unc.edu.

School of Public Health contact: Ramona DuBose, (919) 966-7467 or rjdubose@email.unc.edu.
News Services contact: Clinton Colmenares, (919) 843-1991 or clinton_colmenares@unc.edu.



Gillings Admissions: 233 Rosenau Hall, (919) 445-1170
Student Affairs: 263 Rosenau Hall, (919) 966-2499
Dean's Office: 170 Rosenau Hall, (919) 966-3215
Business and Administration: 170 Rosenau Hall, (919) 966-3215
Academic Affairs: 307 Rosenau Hall, (919) 843-8044
Inclusive Excellence: 207B Rosenau Hall, (919) 966-7430
Room Reservations

135 Dauer Drive
Chapel Hill, NC 27599-7400