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. 2022 Jan 11;7(1):24730114211057886.
doi: 10.1177/24730114211057886. eCollection 2022 Jan.

Epidemiology of Lower Leg Soft Tissue Injuries in High School Athletes

Michael J Spitnale  1 , Candler G Mathews 3rd  2 , Allen J Barnes  2 , Zachary T Thier  3 , J Benjamin Jackson 3rd  1
Affiliations

Epidemiology of Lower Leg Soft Tissue Injuries in High School Athletes

Michael J Spitnale et al. Foot Ankle Orthop. .

Abstract

Background: Annually there are an estimated 4.5 million sports- and recreation-related injuries among children and young adults in the United States. The most common sports-related injuries are to the lower extremities, with two-thirds occurring among children and young adults (age range 5-24 years). The objective is to describe the epidemiology of lower leg injuries across 27 high school (HS) sports over a 3-year period.

Methods: The Datalys Center for Sports Injury Research and Prevention provided lower leg injury data for 27 sports in 147 high schools for 2011-2012 through 2013-2014 academic years from National Athletic Treatment, Injury and Outcomes Network (NATION) HS Surveillance Program.

Results: The overall rate of lower leg injuries over this 3-year period was 1.70 per 10 000 acute events (AEs) (95% CI, 1.59-1.82). In men, the highest number of lower leg injuries was in football (n=181), but indoor track had the highest rate of injury at 2.80 per 10 000 AEs (95% CI, 2.14-3.58). In women, the highest number of lower leg injuries and the highest rate of injury were in cross-country (n=76) at 3.85 per 10 000 AEs (95% CI, 3.03-4.81). The practice injury rate was 0.91 times the competition injury rate (95% CI, 0.78-1.07).

Conclusion: An improved understanding of the most common sports in which lower leg injuries are seen may help direct appropriate resource utilization. Our data would suggest efforts toward prevention of these overuse injuries, especially in football, track, and cross-country may have the greatest impact on the health of student athletes.

Level of evidence: Level IV, case series.

Keywords: Achilles tendon injuries; epidemiology; high school athletes; non–time-loss injuries; soft tissue injuries.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. ICMJE forms for all authors are available online.

Figures

Figure 1.
Figure 1.
Types of lower leg soft tissue injuries among high school athletes in 27 sports from 2011 to 2012 through 2013 to 2014 academic years. ABI, Achilles bursitis; ATI, Achilles tendinitis; ATT, Achilles tendon tear; GMT, gastrocnemius muscle tear; MLP, minor leg problem; PMT, peroneal muscle tear; PTT, posterior tibial tendonitis; TAMT, tibialis anterior muscle tear; TATT, tibialis anterior tendon tear; TPMT, tibialis posterior muscle tear; TPTT, tibialis posterior tendon tear.
Figure 2.
Figure 2.
Time loss due to lower leg soft tissue injuries among high school student athletes in different sports from 2011 to 2012 through 2013 to 2014 academic years. Excluded were sports with lower leg soft tissue injury numbers totaling less than 10 (ie, men’s basketball, baseball, golf, lacrosse, rowing, swimming, tennis, indoor track, and wrestling and women’s field hockey, golf, gymnastics, rowing, soccer, swimming, and tennis).
Figure 3.
Figure 3.
Proportion of lower leg soft tissue injuries that were recurrent among high school student athletes in different sports from 2011 to 2012 through 2013 to 2014 academic years. Excluded were sports with recurrent lower leg soft tissue injury numbers totaling less than 5 (ie, men’s basketball, baseball, golf, lacrosse, rowing, swimming, tennis, indoor track, and wrestling and women’s field hockey, golf, gymnastics, rowing, soccer, swimming, and tennis).
Figure 4.
Figure 4.
Types of lower leg soft tissue injuries among high school athletes in 27 sports from 2011 to 2012 through 2013 to 2014 academic years excluding minor leg problems. ABI, Achilles bursitis; ATI, Achilles tendinitis; ATT, Achilles tendon tear; GMT, gastrocnemius muscle tear; PMT, peroneal muscle tear; PTT, posterior tibial tendonitis; TAMT, tibialis anterior muscle tear; TATT, tibialis anterior tendon tear; TPMT, tibialis posterior muscle tear; TPTT, tibialis posterior tendon tear.
Figure 5.
Figure 5.
Time loss based on type of lower leg soft tissue injury among both female and male high school student-athletes across all sports from 2011 to 2012 through 2013 to 2014 academic years.
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