The Hurt Locker - Inside the Data on Youth Sports Injuries

While youth baseball may have evolved from the Bud-swilling Coach Buttermaker, icing elbows is still a thing. It took 30 years from this movie scene until pitch counts were implemented for Little League (2006) in an effort to curb injuries to young arms. Across segments (youth, high school, and college) injuries are prevalent, costly, and influenced by trends like early specialization. That said, over the last 20 years, consistent common sense and progressive interventions have had impactful effects across the range of youth sports.

If you want one unburied takeaway, more than 50% of youth sports injuries are from overuse. So much so that the American Academy of Pediatrics has guidelines.

Spoiler alert: play different sports, one season at a time! 💡🤯

Without getting caught up in too much med-data lingo, here are a few terms to file away.

Athletic Exposures - a game or practice which becomes an instance of possible injury, displayed per 1000.

Time Loss - a way of understanding the cost or severity of an injury counted in weeks.

Apophysitis - correlated with numerous sports for youth, a painful inflammation at growth plate sites where a muscle or tendon attaches (heel, shin, elbow, hip, …).

Likely no surprise as the high school injury rate leader, football checks in at 13 per 1000 AEs with injuries. Most are identified to head/face, most diagnosed as sprain/strain and of note, 8.1% result in surgery.

Data can be sliced from numerous surveys in all sorts of ways. Clearly, injuries for all sports tend to increase under the intensity of games (vs. practices). Some policy is being implemented and pushed by NFHS to limit contact for football practices after studies revealed a drop in concussions. But with football’s outsized injury numbers, it is no surprise that flag football is very much on the rise for all ages being buoyed by safety concerns and a new opportunity for young girls. Expect visibility to trend upwards with inclusion in the 2028 Olympics and Tom Brady’s “return” to football with a flag based event in Saudi Arabia.

Here’s a detailed look at high school injuries by sport.

Sadly, there are about 70-100 catastrophic injuries each year for high school and college athletes. About 20+ of these are fatalities, and the others either non-fatal but permanent disability, or severe (e.g. neck fracture no paralysis).

These injuries fall into 2 major buckets: trauma and exertional/medical. Football leads the way because of several factors: high participation, lots of collision force, and high exertion. Cheerleading is the original offshoot to football dating back to Princeton University in 1877 and ironically today pairs as a very hazardous sport, second to football for traumatic events.

Although rare, soccer players have been the most at risk for lightening strikes. Don’t shelter under trees! ⚡️

A familiar youth sports coaching mantra is: more reps. Unfortunately, more reps is also a direct line to overuse. And overuse injuries tend to be more pronounced at younger ages. As athletes get bigger and stronger, injury types shift a bit and can increase in severity. Here are the hot sports broken out by sport.

The key point to remember when going through these laundry lists is that exercise is essential for kids at all ages for overall health, mental health, and building social skills.

There have been numerous interventions to reduce all manner of injuries and they must be done in a skillful manner to avoid driving kids away from sports.

We mentioned pitch counts and fewer full-contact practices earlier. Let’s add equipment/helmet regulations and improvements, coach training and awareness for concussion and SCA, concussion protocols, rule changes such as heading in soccer for youth (banned for under 10 and limited for 11-13).

Fortunately, there are a lot of eyes on injury prevention.

The blind spot remains pressure to specialize early and to compete too much in one sport. If you have an interest in a good read/listen on the subject 👉🏻 Range: Why Generalists Triumph in a Specialized World.

Until next time.