High School Soccer Severe Injury Rates

Overall injury picture

Here's the big picture on high school sports injuries:

• Over 7 million students participate in high school athletics every years. 

• Nearly four out of ten of all non-fatal, unintentional injuries among high school students that result in emergency room visits are sports-related.

• High school athletes suffer an estimated 2 million injuries every year, resulting in 500,000 doctor visits and 30,000 hospitalizations.

• Of these injuries, an estimated 446,715 (14.9%) are severe enough to result in the loss of 21 or more days of sports participation, with almost 6 in 10 (56.8%) resulting in medical disqualification for the remainder of the season.

Boys' and girls' soccer

The severe injury rate for girls' soccer (.33 per "athletic exposure"; e.g. a high school athlete participating in one practice or competition) was the highest among the four girls' sports studied, but still less than half of the rate (.69 per AE) for football, the sport most likely to result in severe injury.  The severe injury rate for boys' soccer (.25 per AE) was slightly less but not statistically different.

Examining data from 100 nationally representative high schools on injuiries during the 2005 to 2007 school years, researchers at the Research Institute at Nationwide Children's Hospital's Center for Injury Research and Policy in Columbus, Ohio also found:

• the most commonly injured parts of the body were knee (38.9%), ankle (16.0%), and head/face (11.2%).

• a greater proportion of severe soccer injuries sustained by girls were to the knee (49.7%) compared to boys (23.3%).

• the most common diagnoses were fracture (30.3%), complete ligament sprain (20.3%, and incomplete ligament sprain (13.6%).

• the most commonly fractured body sites were the ankle (24.8%), foot/toe (15.9%), and the lower leg (15.0%). 

• boys sustained a greater proportion of fractures (42.0%) than girls (22.1%); girls sustained a greater proportion of ligament sprains (complete tear)(31.4%) than boys (10.9%).

• of all severe injuries in girls' soccer, 65% resulted in medical disqualification for the season.

Most dangerous activities

The soccer activities most frequently leading to severe injury were:

• ball handling/dribbling (15.4%)

• general play (15.0%)

• defending (13.6%), and

• chasing a loose ball (12.6%)

Boys were more likely to suffer severe injury than girls from heading a ball (13.7% v.1.5%).

The most common mechanisms leading to severe injuries were contact with another player (27.9%) and rotation around a planted foot/inversion (15.9%).

Gender differences

The study found three interesting gender trends:

1. Boys suffer a significantly greater proportions of fractures than girls in soccer, which the study suggested might be due to differences in size, speed and strength of athletes, or intensity of play.  Because pediatric sports-related fractures are expensive to treat and associated with a majority of hospitalizations and ER visits due to injury, the study suggested improvements/additions to protective equipment or changes in rules/rules enforcement to minimize collision forces during play. 

2. Girls suffered a greater proportion of severe knee injuries, as has been previously reported).

3. Girls suffered a greater proportion of severe injuries from ligament sprains. The study's authors recommended further study of the effectiveness of special conditioning programs, bracing and rehabilitation in preventing severe knee injuries in girls.

Created September 14, 2009