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Article appeared in the Coloradoan on Friday, July 20, 2012.
Written by Matt L. Stephens

High School Sports Injury Rates
Sport Injuries per 1,000 AE*

Football 3.61
Boys ice hockey 2.21
Wrestling 2.18
Girls soccer 2.11

*Athlete exposure (AE) defined as one player participating in one practice or game. For example, John Doe practices four times in a week and plays one game, he has five AE.

Injuries By Sex

Sport Sex Injuries per 1,000 AE
Soccer Girls 2.11
Soccer Boys 2.67
Basketball Girls 1.81
Basketball Boys 1.37
Lacrosse Girls 1.4
Lacrosse Boys 1.9
Softball Girls 0.97
Baseball Boys 0.83
Volleyball Girls 0.93
Volleyball Boys 0.81
Track Girls 0.9
Track Boys 0.57
             
What's an AE? Athlete exposure (AE) defined as one player participating in one practice or game. For example, John Doe practices four times in a week and plays one game, he has five AE.

Injuries for boys

Research from a recent study indicates the older a male high school athlete becomes, the more likely he is to be injured. Football has the highest per player injury rate at 3.61 injuries per 1,000 athletic exposures. Boys hockey is next followed by wrestling, soccer and basketball.
Source: The National High School Sports-Related Injury Surveillance System

Injuries for girls

Research from a recent study indicates that, opposite of trends for boys, freshmen girls get hurt most often. Injury to females is higher than males in six out of the seven sports which they both compete. Soccer has the highest injury rate per athletic exposure at 2.21 per 1,000 for girls.
Source: The National High School Sports-Related Injury Surveillance System

It’s no shock more injuries happen in football than any other high school sport. With its inherent physical nature, bodies repeatedly pay a physical toll.
What is surprising is the difference in wounds between male and female high school athletes. Injury to female athletes is more likely than their male counterparts in six of the seven sports which they both compete.
According to the latest study by the National High School Sports-Related Injury Surveillance System, which collects data on athletic injuries that require immediate medical attention, football has the highest per player injury rate at 3.61 injuries per 1,000 athletic exposures. In comparison, soccer has the highest injury rate per athletic exposure at 2.21 per 1,000 for girls.
Research from last year’s study indicates the older a male high school athlete becomes, the more likely he is to be injured. But the trend goes in the opposite direction for female athletes, with freshmen getting hurt most often.
There are a few reasons for this, said Chad Smidt, sports medicine director at Orthopaedic & Spine Center of the Rockies, with strength and coordination playing the biggest roles.
With maturation, primal instinct takes a bigger role for males. In the competitive atmosphere of a sporting event, there’s an opportunity to exude male dominance. An alpha-male type of mentality means bigger hits on the field or ice or harder pins on the mat. With maturity comes increased strength and coordination development, allowing those harder hits to take place.
For instance, a 14-year-old boy is likely going to get taller with age and build strength during that time. If he stays in shape, his body size and muscle weight will remain proportional to his height, allowing coordination to keep pace with growth.
For females, this usually isn’t the case. Females go through the height of puberty during their teenage years, which comes with more changes than the opposite sex.
“Some of the girls are going through changes at that point where their coordination might not be the same (as boys) because of body changes. Their hips tend to be widening at that age,” said Smidt, who has been an athletic training adviser for Colorado High School Activities Association since 1996. “If you look at a freshman girl running up the field she can look very uncoordinated, and that’s because she’s getting used to changes in her body. Think of a middle school boys basketball team running around the court with limbs flailing everywhere.
By the time a girl is a senior they’ve developed their coordination and muscle mass, so they’re getting hurt less.”
Strength key to reducing injuries
There are more than natural physiological differences that lead to common serious injuries with females. There’s also the matter of preparation.
Every high school sport commonly offered to both sexes (basketball, volleyball, soccer, swimming and track) sees more injuries on the girls side. Even fastpitch softball, despite the underhand pitching motion being anatomically natural, sees more injuries than baseball.
The most common injuries are sprains, strains, fractures (both bone and ligament tears) and deep bruises, all of which ultimately circle back to strength.
In Smidt’s experience, boys are inherently stronger than girls, and although an injury like a torn anterior cruciate ligament might not be thought of as muscular on the surface, it can be.
Veteran Fossil Ridge High wrestling coach Brian Killion said the sport he coaches is a prime example of why strong muscles are important to preventing athletic injuries.
During a wrestling match, bodies are constantly mashing together with opponents trying to stretch limbs in awkward positions. Just like an electrical wire will take longer to short out in poor conditions if it has better insulation, the same goes for a ligament wrapped in muscle.
“I think it could really surprise some people how many injuries happen in wrestling. We basically do the same thing as football, just without the high-speed collisions,” Killion said.
Proper training is imperative, and as female athletics have increased in popularity during the past 20 years so has the importance of balanced workouts for females. However, in the grand scheme of sports history, it hasn’t been as extensive as for males.
Katie Parsanko used to coach boys and girls soccer at Poudre High School and has been involved with soccer for two decades. Well aware of injuries happening more often to girls than boys, especially those around the joints, Parsanko feels the cause is derived from a historical difference in preparation.
“We’ve been slower with getting girls to do the preliminary work than we have with the boys for a while — like the weight room and the the agility training,” Parsanko said. “... Even some of my beset athletes aren’t prepared as well as they could be.”
New tests heal old wounds
New regiments are being designed to prepare athletes for whatever might be thrown at them, and the results have been favorable.
For coaches, Poudre School District is holding a mandatory concussions symposium Aug. 12 and is flying in former NFL Europe head athletic trainer, Mayfield Armstrong, to speak on athlete health. Individual players are working on refined exercise models, like jump training where they try to build muscle memory to prevent limbs from landing in dangerous locations after leaving the ground. Doctors are studying symmetry tests to ensure strength built in the left side of the body is equal to that of the right, countering overuse.
“It’s impossible to eliminate injuries from sports,” Smidt said. “But through education and proper training, our goal is to reduce the frequency.”
Athletic participation will always entail risk. However, every coach wants to keep players unharmed, and athletes want to stay out of the hospital. There will realistically never be a football season without a broken arm or a spring when no soccer player blows an ACL. The more data available to players, coaches, doctors and parents the better preventative measures can be taken to keep the numbers to a minimum.