A new study recently released at the 2021 National Athletic Trainer’s Association Virtual Clinical Symposia & AT Expo offers a clearer understanding of the most frequent injuries in high school and college sports as well as which sports have more serious injuries.
Male Football Riskiest High School Sport, Female Basketball 2nd
The new analysis of more than 26,000 injuries found evidence that the sports with the most injuries were male football (25.6%), female basketball (8.5%), female soccer (8.1%), male basketball (7.1%) and female volleyball (6.5%).
The researchers also found that while gymnastics and lacrosse accounted for overall fewer injuries, those injuries were more likely to require more doctor visits and longer duration of care.
“Although injury incidence and risk are primary factors in assessing medical staffing needs, other clinical practice components, such as treatment characteristics, may further inform these important patient care decisions,” said Kenneth C. Lam, ScD, ATC, lead author and professor of clinical research at A.T. Still University.
“For example, sports associated with fewer injuries but higher amount and duration of care, such as in gymnastics or lacrosse, may result in similar or even higher demand on the clinician than sports with more injuries, but lower amount and duration of care. Our findings suggest that sport-specific treatment patterns should be considered when determining appropriate medical staffing needs.”
Overall, the top five injuries document were concussion (12.2%), ankle sprain/strain (10.8%), hip and groin sprain/strain (7.4%), distal thigh sprain/strain (3.6%), and knee pain (3.2%).
Across all injuries the median number of doctor visits was five. However, male gymnastics needed 19 visits, female gymnastics needed 7 visits and male lacrosse also needed 7 visits.
The median male gymnastics duration of care was 66 days; for female gymnastics and male lacrosse it was 16 days.
The study was also published in the Journal of Athletic Training, the scientific journal of the National Athletic Trainers’ Association.
Data on 26,162 sport-related injuries and 162,025 services reported in the Athletic Training Practice-Based Research Network between 2013 and 2020 were included in the analysis. Patient records were created by 368 athletic trainers practicing in 317 athletic training clinics (252 high schools, 40 colleges, 25 other) across 34 states.

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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