Shoulder Injuries Among US High School Athletes, 2005/2006–2011/2012 WHAT’S KNOWN ON THIS SUBJECT: Shoulder injuries are common among high school athletes. These injuries, both traumatic and overuse, contribute to significant time loss from athletic activity. Understanding sport-specific injury patterns is critical for development of targeted injury prevention programs. WHAT THIS STUDY ADDS: This study is the most comprehensive analysis of high school shoulder injuries to date, providing national injury estimates while examining injury rates, diagnoses, severity, and mechanisms of injury in 9 interscholastic sports. abstract OBJECTIVES: The objective of this study was to describe shoulder injuries in a nationally representative sample of high school athletes playing 9 sports. A national estimate of shoulder injuries among high school athletes was subsequently calculated. METHODS: Injury data were collected in 9 sports (boys’ football, soccer, basketball, wrestling, and baseball; girls’ soccer, volleyball, basketball, and softball) during the 2005–2006 through 2011–2012 academic years from a nationally representative sample of high schools via High School Reporting Information Online. RESULTS: During the 2005–2006 through 2011–2012 academic years, high school athletes in this study sustained 2798 shoulder injuries during 13 002 321 athlete exposures, for an injury rate of 2.15 per 10 000 athlete exposures. This corresponds to a nationally estimated 820 691 injuries during this time period. Rates of injury were higher in competition as compared with practice (rate ratio = 3.17 [95% con- fidence interval: 2.94–3.41]). The highest rate of injury was in football (4.86) and the lowest in girls’ soccer (0.42). The most common types of injury were strain/sprain (37.9%) and dislocation/separation (29.2%). Boys were more likely than girls to sustain their injuries after contact with another person or with the playing surface. Surgical repair was required for 7.9% of the injuries. Time loss from athletic participation varied among sports, with 40.7% of athletes returning within 1 week, whereas 8.2% were medically disqualified for their season/career. CONCLUSIONS: High school shoulder injury rates and patterns varied by sport and gender. Prospective epidemiologic surveillance is war- ranted to discern trends and patterns to develop evidence-based interventions to prevent shoulder injuries. Pediatrics 2014;133:272– 279 AUTHORS: T. Walker Robinson, MD, MPH, a Jill Corlette, MS, ATC, b Christy L. Collins, MA, b and R. Dawn Comstock, PhD c b Center for Injury Research and Policy, The Research Institute, a Nationwide Children’ s Hospital, Columbus, Ohio; and c Colorado School of Public Health and University of Colorado School of Medicine, Aurora, Colorado KEY WORDS shoulder injuries, epidemiology, high school athletes ABBREVIATIONS AE—athlete exposure AT—athletic trainer CI—confidence interval GC—gender-comparable IPR—injury proportion ratio RIO—Reporting Information Online RR—rate ratio Dr Robinson conceptualized the study, analyzed and interpreted the data, drafted the initial manuscript, and coordinated manuscript revisions; Ms Corlette provided the study file, helped with data analysis, critically reviewed the manuscript, and contributed to manuscript revisions; Ms Collins helped with data analysis, critically reviewed the manuscript, and contributed to manuscript revisions; Dr Comstock designed the nationwide data collection system of high school athletic injuries from which this study is drawn, provided access to the data set, critically reviewed the manuscript, and contributed to manuscript revisions; and all authors approved the final manuscript as submitted. www.pediatrics.org/cgi/doi/10.1542/peds.2013-2279 doi:10.1542/peds.2013-2279 Accepted for publication Nov 15, 2013 Address correspondence to T. Walker Robinson, MD, MPH, Chapel Hill Pediatrics & Adolescents, 205 Sage Rd, Suite 100, Chapel Hill, NC 27514. E-mail: twalkerrobinson@gmail.com PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). Copyright © 2014 by the American Academy of Pediatrics FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose. FUNDING: The content of this report was funded in part by the Centers for Disease Control and Prevention grants R49/CE000674-01 and R49/CE00172-01. The authors also acknowledge the generous research funding of the National Federation of State High School Associations, the National Operating Committee on Standards for Athletic Equipment, DonJoy Orthotics, and EyeBlack. POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. 272 ROBINSON et al by guest on September 21, 2017 http://pediatrics.aappublications.org/ Downloaded from