Shoulder injuries among United States high school athletes during the 2005-2006 and 2006-2007 school years

Abstract

Context: The shoulder is one of the most commonly injured body sites among athletes. Little previous research describes shoulder injury patterns in high school athletes.

Objective: To describe and compare shoulder injury rates and patterns among high school athletes in 9 sports (football, soccer, basketball, baseball, and wrestling for boys and soccer, volleyball, basketball, and softball for girls).

Design: Prospective injury surveillance study.

Setting: Injury data were collected from 100 nationally representative US high schools via High School Reporting Information Online.

Patients or other participants: Athletes from participating high schools injured while involved in a school-sanctioned practice or competition in 1 of the above sports during the 2005-2006 and 2006-2007 school years.

Main outcome measure(s): Shoulder injury rates, diagnoses, severity, and mechanisms.

Results: During the 2005-2006 and 2006-2007 school years, athletes in this study sustained 805 shoulder injuries during 3 550 141 athlete-exposures (AEs), for an injury rate of 2.27 shoulder injuries per 10 000 AEs. This corresponds to an estimated 232 258 shoulder injuries occurring nationwide during this time. Shoulder injuries were more likely to occur during competition than practice (rate ratio = 3.01, 95% confidence interval = 2.62, 3.46). Shoulder injury rates per 10 000 AEs were highest in football (5.09), wrestling (4.34), and baseball (1.90). Common shoulder injury diagnoses included sprains/strains (39.6%), dislocations/separations (23.7%), contusions (11.5%), and fractures (6.6%). Although 44.8% of athletes sustaining a shoulder injury returned to play in less than 1 week, 22.9% were out of play for more than 3 weeks, and 6.2% of shoulder injuries required surgery. Common mechanisms of shoulder injury included player-to-player contact (57.6%) and contact with the playing surface (22.8%).

Conclusions: High school shoulder injury rates and patterns varied by sport. Continued surveillance is warranted to understand trends and patterns over time and to develop and evaluate evidence-based preventive interventions.

Keywords: epidemiology; injury surveillance.

Figure 1. Diagnoses of athletes with shoulder injuries by sport and sex, National High School Sports–Related Injury Surveillance Study, United States, 2005–2006 and 2006–2007 school years. Data are based on weighted national estimates and include competition and practice exposures. ^a Caution should be used when interpreting national estimates for girls' soccer, because they are based on small case counts and have a relative standard error greater than 30%.

Figure 2. Time loss due to shoulder injury by sport and sex, National High School Sports–Related Injury Surveillance Study, United States, 2005–2006 and 2006–2007 school years. Data are based on weighted national estimates and include competition and practice exposures. ^a Includes season-ending and career-ending injuries. ^b Includes injuries with which the athlete continued playing and for which the athlete had surgery after the season or injuries with which the athlete continued playing, but with modified activities to accommodate the injury. ^c Caution should be used when interpreting national estimates for girls' soccer, because they are based on small case counts and have a relative standard error greater than 30%.