BMUS: The Burden of Musculoskeletal Diseases in the United States
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Sports Injuries

VII.B.6.0
Children & Adolescents

Lead Author(s): 

Scott B. Rosenfeld, MD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD
Athletic participation by children and adolescents increased dramatically between 1997 and 2008,1 with participation declining slightly since the 2008 peak.2 Since the late 1990's, athletic specialization has increased, resulting in earlier focus on single sports. As a result, there has been a commensurate increase in pediatric sports-related injuries, both acute and related to chronic overuse.3 Pediatric and adolescent athletes are anatomically and physiologically different from adult athletes and therefore are at risk to sustain different injuries. Coordination and mechanics are less developed in pediatric athletes, placing them at greater risk for injuries related to falls and collisions. Growing athletes are at risk for most of the same injuries as adult athletes, but are uniquely susceptible to injuries about the physes and growth cartilage. Not only do these physeal (growth plate) and apophyseal injuries4 require unique treatments, but they may also result in growth derangement that can have long-term consequences. Adolescent female athletes also have been shown to have a two- to nine-fold greater risk of knee injuries, which may be related to age and gender-specific differences in anatomy, neuromuscular control, and hormone levels.5 Common pediatric sports-related injuries include anterior cruciate ligament (ACL) and meniscal tears, tibial eminence fractures, osteochondritis desiccans lesions, patellofemoral instability, Osgood Schlatter syndrome, little league shoulder and elbow, pelvic avulsion fractures, and distal radius epiphysitis.
  • 1. National Council on Youth Sports (NCYS) Report on Trends and Participation in Organized Youth Sports Available at: http://www.ncys.org/publications/2008-sports-participation-study.php [1]. Accessed February 21, 2015.
  • 2. Physical Activity Council. 2014 Activity Report: The Physical Activity Council’s annual study tracking sports, fitness and recreation participation in the USA. Available at: http://www.physicalactivitycouncil.com/pdfs/current.pdf [2]. Accessed February21, 2015.
  • 3. Caine D, Caine C, Maffulli N: Incidence and distribution of pediatric sport-related injuries. Clin J Sport Med 2006 Nov;16(6):500-513.
  • 4. Apophyseal injuries, unique in the adolescent athlete, cause inflammation at the site of a major tendinous insertion onto a growing bony prominence.
  • 5. Ireland ML: The female ACL: Why is it more prone to injury? Ortho Clin NA 2002 Oct;33(4):637-651.

Edition: 

  • 2014

Prevalence

VII.B.6.1
Children & Adolescents Sports Injuries

Lead Author(s): 

Scott B. Rosenfeld, MD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

On average across the years from 2011 to 2013, 1.8 million injuries per year related to team or individual sport activities occurred to children and adolescents age 20 years and younger. Data reported is from consumer product-related injuries occurring in the United States from a statistically valid sample of emergency departments collected by the United States Consumer Product Safety Commission, National Electronic Injury Surveillance System. Data shown for sports injuries are not included in the overall total for musculoskeletal conditions among children and adolescents, on the assumption it duplicates numbers found in the emergency department database based on ICD-9-CM codes and used in the trauma injuries [3] section.

Males report injuries at twice the number as females, with the highest number of injuries occurring in the junior high (11 to 13 years) and high school (14 to 17 years) ages. (Reference Table 7.7.1 PDF [4] CSV [5])

Sports Injuries Among Children and Adolescents Age 20 and Under, by Sex and Age, United States 2012

Edition: 

  • 2014

Team Sports Injuries

Vii.B.6.2
Children & Adolescents Sports Injuries

Lead Author(s): 

Scott B. Rosenfeld, MD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

Team sports, both organized and informal, accounted for just under one-half (47%, or 853,100 injuries) of all sports-related injuries reported. Basketball had the highest number of team sport related injuries at 33%, and was closely followed by football at 32%.

Team sport injuries to males were three times the number reported for females. The only sport in which female injuries outnumber male injuries is volleyball. Nearly half (45%) of team sport injuries to children and adolescents occurred during the high school years (age 14 to 17 years), with another 28% in the junior-high age range of 11 to 13 years. (Reference Table 7.7.1 PDF [4] CSV [5])

Team Sports Injuries for Children and Adolescents Age 20  and Under, United States 2012

The most common musculoskeletal injury incurred was a sprain or strain, accounting for 46% of team sport injuries. Volleyball had the highest proportion of sprains and strains, followed by basketball. Baseball led in contusion injuries, while fractures occurred most frequently in football, hockey (including field, ice, and roller hockey), and soccer. (Reference Table 7.7.2 PDF [6] CSV [7])

Type of Musculoskeletal Injuries From Team1 Sport Activities Treated in Emergency Departments (ED), United States 2011-2013

Only 1% of team sport injuries were serious enough to result in hospitalization.

Edition: 

  • 2014

Individual Sports Injuries

VII.B.6.3

Lead Author(s): 

Scott B. Rosenfeld, MD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

Individual sports injuries accounted for 53% of total injuries reported (970,500). One in five injuries occurred while riding bicycles or other nonmotorized wheeled equipment such as tricycles and scooters. These injuries occurred most frequently to children ages 6 to 10 years, but were common at all ages. Injuries on playground equipment were the second highest type of individual sport injuries, accounting for 15% of all injuries. Playground equipment injuries occurred almost exclusively to children age 10 years or younger. Skating injuries, which includes roller and ice skates, inline skates, and skateboards, were the cause of 11% of individual sport injuries.

Females accounted for a larger share of individual sport injuries (43%) than in team sports. Still, the only activity in which females had a significantly higher number of injuries than males was in gymnastics/cheerleading/dancing. (Reference Table 7.7.1 PDF [4] CSV [5])

Individual Sports Injuries for Children and Adolescents Age 20  and Under, United States 2012

Fractures and sprains/strains each accounted for one-third of all individual sport activity injuries. However, the type of musculoskeletal injury varied substantially with the type of activity. Fractures resulted from playground equipment injuries one-half the time, and there were a higher share of fractures in snow sports and skating injuries as well. Sprains/strains occurred in two-thirds of track and field injuries, and there were a higher share of sprains/strains occurring in gymnastics/cheerleading/dancing and fitness training injury category as well. The most common type of injury reported from bicycle/wheeled equipment were contusions. (Reference Table 7.7.2 PDF [6] CSV [7])

Type of Musculoskeletal Injuries From Individual Sports Activities Treated in Emergency Departments (ED), United States 2011-2013

Nearly 3% of individual sport injuries resulted in hospitalization.

Edition: 

  • 2014
The Burden of Musculoskeletal Diseases in the United States - Copyright © 2014.

Source URL: https://bmus.latticegroup.com/2013-report/workforce-implications/vii3d

Links:
[1] http://www.ncys.org/publications/2008-sports-participation-study.php
[2] http://www.physicalactivitycouncil.com/pdfs/current.pdf
[3] http://www.boneandjointburden.org/2013-report/research-funding-care-and-prevention/vii3a-0
[4] https://bmus.latticegroup.com/docs/T7.7.1.pdf
[5] https://bmus.latticegroup.com/docs/T7.7.1.csv
[6] https://bmus.latticegroup.com/docs/T7.7.2.pdf
[7] https://bmus.latticegroup.com/docs/T7.7.2.csv