Search

Although the return to sports during COVID-19 has been associated with improvements in mental health and quality of life (QOL), whether these benefits are primarily due to increases in physical activity (PA) is unknown. To determine whether PA increases were responsible for the improvements in mental health and QOL among adolescents who returned to sport during the COVID-19 pandemic. Cross-sectional study. Wisconsin secondary schools. A total of 559 adolescent athletes (age = 15.7 + 1.2 years, females = 43.6%) from 44 schools completed a survey in October 2020. Demographic information, whether they had returned to sport participation, school instruction type, anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), QOL (Pediatric Quality of Life Inventory 4.0), and PA (Hospital for Special Surgery Pediatric Functional Activity Brief Scale). Mediation analysis was used to assess whether the relationships between sport status and anxiety, depression, and QOL were mediated by PA. At the time of the study, 171 (31%) had returned to play and 388 (69%) had not. Athletes who had returned to play had less anxiety (3.6 ± 0.4 versus 8.2 ± 0.6, P <.001) and depression (4.2 ± 0.4 versus 7.3 ± 0.6, P <.001) and higher QOL (88.1 ± 1.0 versus 80.2 ± 1.4, P <.001) and more PA (24.0 ± 0.5 versus 16.3 ± 0.7, P <.001). Physical activity explained a significant, but small, proportion of the difference in depression (22.1%, P =.02) and QOL (16.0%, P =.048) but not anxiety (6.6%, P =.20) between athletes who had and those who had not returned to play. Increased PA was responsible for only a small portion of the improvements in depression and QOL among athletes who returned to sports. This suggests that most of the mental health benefits of sport participation for adolescents during the COVID-19 pandemic were independent of the benefits of increased PA. [ABSTRACT FROM AUTHOR]

Girls' high school volleyball is very popular across the United States. Prospective data are limited regarding the incidence and risk factors of time-loss (TL) and non–time-loss (NTL) injuries sustained in this population. To estimate the incidence and describe the characteristics of injuries (TL and NTL) sustained in a girls' high school volleyball season. Descriptive epidemiology study. Convenience sample of 78 high school interscholastic volleyball programs. Female high school volleyball players participating during the 2018 interscholastic season. Injury rates, proportions, and rate ratios were measured for TL and NTL injuries with 95% CIs. A total of 2072 girls enrolled in the study, and 468 participants (22.5%) sustained 549 injuries (TL = 71.6%, NTL = 28.4%) for an overall injury rate of 5.31 (95% CI = 4.89, 5.79) per 1000 athlete-exposures. The competition injury rate was greater than the practice injury rate for all injuries (injury rate ratio [IRR] = 1.19; 95% CI = 1.00, 1.41) and TL injuries (IRR = 1.31; 95% CI = 1.07, 1.60). Players with a previous musculoskeletal injury had a higher rate of TL than NTL injuries (IRR = 1.36; 95% CI = 1.12, 1.65). Ankle injuries accounted for the greatest proportion of TL injuries (n = 110, 28%), while the greatest proportion of NTL injuries occurred in the hand or fingers (n = 34, 22%). Ligament sprains accounted for 40% of TL injuries (n = 156), whereas muscle or tendon strains (n = 79, 51%) accounted for more than half of all NTL injuries. Although most injuries sustained by adolescent girls' volleyball athletes were TL in nature, nearly a third of all injuries were NTL injuries. Injury characteristics differed widely between TL and NTL injuries. Understanding the most common types and characteristics of injuries among high school volleyball players is critical for the development of effective injury-prevention programs. [ABSTRACT FROM AUTHOR]

Sport cancellations early in the COVID-19 pandemic had a significant negative effect on the health of US adolescents. The effect of restarting sports during the pandemic has not been described. To identify the effect of sport participation on the health of adolescents before and during the COVID-19 pandemic. Cross-sectional study. Sample recruited via social media. Wisconsin adolescent athletes. Participants provided information regarding their age, sex, and sport(s) involvement and completed the Patient Health Questionnaire-9 Item to assess depression symptoms, the Hospital for Special Surgery Pediatric Functional Activity Brief Scale to measure physical activity, and the Pediatric Quality of Life Inventory 4.0 to measure quality of life (QoL). Data were collected in spring 2021 (Spring21; n = 1906, age = 16.0 ± 1.2 years, females = 48.8%), when interscholastic sports had fully resumed, and were compared with similar cohorts of adolescent athletes at 2 time points: (1) spring 2020 (Spring20; n = 3243, age = 16.2 ± 1.2 years, females = 57.9%) when sports were cancelled and (2) 2016–2018 (PreCOVID-19) before the pandemic (n = 5231, age = 15.7 ± 1.1 years, females = 65.0%). Comparisons were conducted via analysis-of-variance models and ordinal regressions with age and sex as covariates. The prevalence of moderate to severe depression was lower in Spring21 than in Spring20 but higher than in PreCOVID-19 (PreCOVID-19 = 5.3%, Spring20 = 37.8%, Spring21 = 22.8%; P <.001). Physical activity scores (mean [95% CI]) were higher in Spring21 than in Spring20 but lower than in PreCOVID-19 (PreCOVID-19 = 23.1 [22.7, 23.5], Spring20 = 13.5 [13.3, 13.7], Spring21 = 21.9 [21.6, 22.2]). Similarly, QoL scores were higher in Spring21 than in Spring20 but lower than in PreCOVID-19 (PreCOVID-19 = 92.8 [92.5, 93.1], Spring20 = 80.7 [80.3, 81.1], Spring21 = 84.3 [83.8, 84.8]). Although sports have restarted, clinicians should be aware that physical activity, mental health, and QoL are still significantly affected in adolescent athletes by the ongoing pandemic. [ABSTRACT FROM AUTHOR]

The relationships among different sports, face mask use, and COVID-19 risk among high school athletes remain unknown. To evaluate the influence of sport characteristics and face mask use on the COVID-19 incidence among high school athletes. Descriptive epidemiology study. US high school athletic departments. Athletic directors. Surveys were completed regarding sport reinitiation, COVID-19 cases, and risk-reduction procedures in fall 2020. Separate mixed-effects Poisson regression models were developed to evaluate the associations between the reported COVID-19 incidence and (1) sport characteristics (indoor versus outdoor, individual versus team, contact versus noncontact) and (2) face mask use while playing (yes or no). A total of 991 schools had restarted fall sports, representing 152 484 athletes on 5854 teams. There were 2565 reported cases of COVID-19, representing a case rate of 1682 cases per 100 000 athletes and an incidence rate of 24.6 cases per 100 000 player-days. The COVID-19 incidence was lower for outdoor versus indoor sports (incidence rate ratio [IRR] = 0.54; 95% CI = 0.49, 0.60; P <.001) and noncontact versus contact sports (IRR = 0.78; 95% CI = 0.70, 0.87; P <.001), but not team versus individual sports (IRR = 0.96; 95% CI = 0.84, 1.1; P =.49). Face mask use was associated with a decreased incidence in girls' volleyball (IRR = 0.53; 95% CI = 0.37, 0.73; P <.001), boys' basketball (IRR = 0.53; 95% CI = 0.33, 0.83; P =.008), and girls' basketball (IRR = 0.36; 95% CI = 0.19, 0.63; P <.001) and approached statistical significance in football (IRR = 0.79; 95% CI = 0.59, 1.04; P =.10) and cheer or dance (IRR = 0.75; 95% CI = 0.53, 1.03; P =.081). In this nationwide survey of high school athletes, a lower COVID-19 incidence was independently associated with participation in outdoor versus indoor and noncontact versus contact sports but not team versus individual sports. Face mask use was associated with a decreased COVID-19 incidence among indoor sports and may be protective in outdoor sports with prolonged close contact among participants. [ABSTRACT FROM AUTHOR]

To describe the incidence of COVID-19 in Wisconsin high school athletes and investigate the relationship of COVID-19 incidence with sport and face mask use. Retrospective survey. High schools across Wisconsin during September 2020. Athletic directors representing 30 074 high school athletes with or without SARS-CoV-2. The COVID-19 rates among athletes, counties, states, as well as school instruction type (virtual versus in person), sport type, and face mask use were assessed. Reported athlete case rates were compared with the county's general population and associations between COVID-19 incidence and sport type and face mask use, adjusting for each school's county incidence using multivariable negative binomial regression models. The COVID-19 incidence rates for 207 of 244 responding schools were 32.6 cases per 100 000 player-days. Reported case rates for athletes in each county were positively correlated with the county's general population case rates (β = 1.14 ± 0.20, r = 0.60, P <.001). One case (0.5%) was attributed to sport contact by the reporting schools. No difference was identified between team and individual sports (incidence rate ratio [IRR] = 1.03 [95% CI = 0.49, 2.2], P =.93) or between noncontact and contact sports (IRR = 0.53 [0.23, 1.3], P =.14). Outdoor sports had a lower incidence rate than indoor sports, although this finding did not reach statistical significance (IRR = 0.52 [0.26, 1.1], P =.07). No significant associations were found between COVID-19 incidence and face mask use during play for those sports with greater than 50 schools reporting on face mask use (P values >.05). The incidence of reported COVID-19 among high school athletes was related to the county incidence, and most cases were attributed to nonsport contact. A lower COVID-19 incidence in outdoor sports approached statistical significance. The lack of a significant benefit demonstrated for face mask use may be due to relatively low rates of COVID-19 in Wisconsin during September 2020. Further research is needed to better define COVID-19 transmission risk factors during adolescent sport participation. [ABSTRACT FROM AUTHOR]

During the fall of 2020, some high schools across the United States allowed their students to participate in interscholastic sports while others cancelled or postponed their sport programs due to concerns regarding COVID-19 transmission. What effect this has had on the physical and mental health of adolescents is unknown. To identify the effect of playing a sport during the COVID-19 pandemic on the health of student-athletes. Cross-sectional study. Sample recruited via email. A total of 559 Wisconsin high school athletes (age = 15.7 ± 1.2 years, female = 43.6%, male = 56.4%) from 44 high schools completed an online survey in October 2020. A total of 171 (30.6%) athletes played (PLY) a fall sport, while 388 (69.4%) did not play (DNP). Demographic data included sex, grade, and sport(s) played. Assessments were the General Anxiety Disorder-7 Item for anxiety, Patient Health Questionnaire-9 Item for depression, the Hospital for Special Surgery Pediatric Functional Activity Brief Scale for physical activity, and the Pediatric Quality of Life Inventory 4.0 for quality of life. Univariable comparisons between the 2 groups were made via t tests or χ2 tests. Means for each continuous outcome measure were compared between groups using analysis-of-variance models that controlled for age, sex, teaching method (virtual, hybrid, or in person), and the percentage of students eligible for free or reduced-price lunch. The PLY group participants were less likely to report moderate to severe symptoms of anxiety (PLY = 6.6%, DNP = 44.1%, P <.001) and depression (PLY = 18.2%, DNP = 40.4%, P <.001). They also demonstrated higher (better) Pediatric Functional Activity Brief Scale scores (PLY = 23.2 [95% CI = 22.0, 24.5], DNP = 16.4 [95% CI = 15.0, 17.8], P <.001) and higher (better) Pediatric Quality of Life Inventory total scores (PLY = 88.4 [95% CI = 85.9, 90.9], DNP = 79.6 [95% CI = 76.8, 82.4], P <.001). Adolescents who played a sport during the COVID-19 pandemic described fewer symptoms of anxiety and depression and had better physical activity and quality-of-life scores compared with adolescent athletes who did not play a sport. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has affected almost every aspect of life, including youth sports. Few data exist on COVID-19 incidences and risk-mitigation strategies in youth club sports. To determine the incidence of reported COVID-19 cases among youth club sport athletes, describe the reported sources of infection for reported cases, and identify the information sources used to develop COVID-19 risk-mitigation procedures. Cross-sectional study. Online surveys. Soccer and volleyball youth club directors. Surveys were completed by directors of youth soccer and volleyball clubs across the country in October 2020. Surveys addressed the self-reported date of re-initiation, number of players, player COVID-19 cases, sources of infection, COVID-19 mitigation strategies, and information sources for the development of COVID-19 mitigation strategies. The total number of cases reported, number of players, and days since club re-initiation were used to calculate an incidence rate of cases per 100 000 player-days. To compare reported incidence rates between soccer and volleyball, a negative binomial model was developed to predict player cases with sport and state incidence as covariates and log (player-days) as an offset. Estimates were exponentiated to yield a reported incidence rate ratio with Wald CIs. A total of 205 136 athletes (soccer = 165 580; volleyball = 39 556) were represented by 437 clubs (soccer = 159; volleyball = 278). Club organizers reported 673 COVID-19 cases (soccer = 322; volleyball = 351), for a reported incidence rate of 2.8 cases per 100 000 player-days (soccer = 1.7, volleyball = 7.9). Volleyball had a higher reported COVID-19 incidence rate than soccer (reported incidence rate ratio = 3.06 [95% CI = 2.0, 4.6], P <.001). Out of 11 possible mitigation strategies, the median number of strategies used by all clubs was 7, with an interquartile range of 2. The incidence of self-reported cases of COVID-19 was lower in soccer clubs than in volleyball clubs. Most clubs reported using many COVID-19 mitigation strategies to reduce the risk of infection. [ABSTRACT FROM AUTHOR]

In spring 2020, schools closed to in-person teaching and sports were cancelled to control the transmission of COVID-19. The changes that affected the physical and mental health among young athletes during this time remain unknown. To identify changes in the health (mental health, physical activity, and quality of life) of athletes that occurred during the COVID-19 pandemic. Cross-sectional study. Sample recruited via social media. A total of 3243 Wisconsin adolescent athletes (age = 16.2 ± 1.2 years, 58% female) were surveyed in May 2020 (During COVID-19). Measures for this cohort were compared with previously reported data for Wisconsin adolescent athletes (n = 5231; age = 15.7 ± 1.2 years, 47% female) collected in 2016 to 2018 (PreCOVID-19). Demographic information included sex, grade, and sport(s) played. Health assessments included the Patient Health Questionnaire-9 Item to identify depression symptoms, the Pediatric Functional Activity Brief Scale to gauge physical activity, and the Pediatric Quality of Life Inventory 4.0 to evaluate health-related quality of life. Univariable comparisons of these variables between groups were conducted via t or χ2 tests. Means and 95% CIs for each group were estimated using survey-weighted analysis-of-variance models. Compared with preCOVID-19 participants, a larger proportion of During COVID-19 participants reported moderate to severe levels of depression (9.7% versus 32.9%, P <.001). Scores of the During COVID-19 participants were 50% lower (worse) on the Pediatric Functional Activity Brief Scale (mean [95% CI] = 12.2 [11.9, 12.5] versus 24.7 [24.5, 24.9], P <.001) and the Pediatric Quality of Life Inventory 4.0 compared with the PreCOVID-19 participants (78.4 [78.0, 78.8] versus 90.9 [90.5, 91.3], P <.001). During the COVID-19 pandemic, adolescent athletes described increased symptoms of depression, decreased physical activity, and decreased quality of life compared with adolescent athletes in previous years. [ABSTRACT FROM AUTHOR]

As sports are reinitiated around the United States, the incidence of COVID-19 among youth soccer athletes remains unknown. To determine the incidence of COVID-19 among youth soccer athletes and the risk-mitigation practices used by youth soccer organizations. Cohort study. Survey distributed to Elite Clubs National League member clubs. Youth soccer club directors throughout the United States. Surveys were completed in late August 2020 regarding the club's current phase of return to soccer (individual only, group noncontact, group contact), date of reinitiation, number of players, cases of COVID-19, and risk-reduction procedures being implemented. Case and incidence rates were compared with national pediatric data and county data from the prior 10 weeks. A negative binomial regression model was developed to predict club COVID-19 cases using the local incidence rate and phase of return as covariates and the log of club player-days as an offset. A total of 124 respondents had reinitiated soccer, representing 91 007 players with a median duration of 73 days (interquartile range = 53–83 days) since restarting. Of the 119 clubs that had progressed to group activities, 218 cases of COVID-19 were reported among 85 861 players. Youth soccer players had a lower case rate and incidence rate than children in the United States (254 versus 477 cases per 100 000; incidence rate ratio = 0.511, 95% CI = 0.40, 0.57; P <.001) and the general population in the counties where data were available (268 versus 864 cases per 100 000; incidence rate ratio = 0.202, 95% CI = 0.19, 0.21; P <.001). After adjusting for the local COVID-19 incidence, we found no relationship between the club COVID-19 incidence and the phase of return (noncontact: b = 0.35 ± 0.67, P =.61; contact: b = 0.18 ± 0.67, P =.79). Soccer clubs reported using a median of 8 (interquartile range = 6–10) risk-reduction procedures. The incidence of COVID-19 among youth soccer athletes was relatively low when compared with the background incidence among children in the United States during the summer of 2020. No relationship was identified between the club COVID-19 incidence and the phase of return to soccer. [ABSTRACT FROM AUTHOR]

Background: Sports-related concussions may have a neurobiological recovery period that exceeds the period of clinical recovery, and one consequence of an extended neurobiological recovery may be the risk of subsequent musculoskeletal injuries. Most literature citing an increased risk of musculoskeletal injury after a sports-related concussion has been reported in populations other than adolescent athletes. Purpose/Hypothesis: The purpose was to prospectively determine if incidence rates of musculoskeletal injury differ between adolescent athletes with and without a previous sports-related concussion, while controlling for sex, sport, and age. A secondary aim was to determine if this relationship differs between male and female athletes of the same sport. Our hypotheses were that acute-noncontact injury rates would be higher in athletes with a previous sports-related concussion when compared with athletes without a previous sports-related concussion, and that this relationship would exist only in female athletes and not male athletes. Study Design: Cohort study; Level of evidence, 2. Methods: High school soccer and volleyball players were recruited in 2 prospective cohort studies that observed 4837 athletes during their sporting season (females, 80%; soccer, 57%; mean [SD] age, 15.6 [1.1] years). At preseason, all participants self-reported demographics and previous sports-related concussion within the past 12 months. During the sport season, team athletic trainers electronically recorded athlete exposures and injury data, including injury characteristics. Injury rates per 1000 athlete exposures and injury rate ratios (IRRs) with 95% confidence intervals were calculated. All injury rates and IRRs were adjusted for sex, age, and sport. Results: The rate of acute-noncontact lower extremity injury was 87% greater (IRR, 1.87; 95% CI, 1.29-2.74) in participants with a previous sports-related concussion versus those without one. The acute-noncontact lower extremity injury rates (IRRs) for females and males with a previous sports-related concussion were 1.76 (95% CI, 1.19-2.59) and 2.83 (95% CI, 0.85-9.50), respectively. No difference was detected in acute-contact (IRR, 0.98; 95% CI, 0.56-1.73) or overuse (IRR, 1.09; 95% CI, 0.51-2.37) lower extremity injury rates by previous sports-related concussion. Conclusion: Female adolescent athletes who reported a sports-related concussion within the past 12 months were more likely to sustain an acute-noncontact lower extremity injury during their high school sports season when compared with female athletes without a previous sport-related concussion. [ABSTRACT FROM AUTHOR]

In the spring of 2020, US schools closed to in-person teaching and sports were cancelled to control the transmission of coronavirus disease 2019 (COVID-19). It is critical to understand the mental and physical health of adolescent athletes during this time. To describe the health of athletes during COVID-19–related school closures and sport cancellations. Cross-sectional study. A national sample recruited via social media. A total of 13 002 US adolescent athletes (age = 16.3 ± 1.2 years, females = 52.9%, males = 47.0%) completed an anonymous online survey. Demographic information collected was sex, grade, sport(s) played, and zip code. Assessments used were the General Anxiety Disorder 7-Item for anxiety, Patient Health Questionnaire 9-Item for depression, the Pediatric Functional Activity Brief Scale for physical activity, and the Pediatric Quality of Life Inventory 4.0 for quality of life. Mental health, physical activity, and health-related quality-of-life variables were compared among sex, grade, sport(s) played, and poverty level using means and 95% confidence intervals (CIs) from the survey-weighted analysis of variance. Females reported a higher prevalence of moderate to severe anxiety symptoms (females = 43.7% versus males = 28.2%). The Pediatric Functional Activity Brief Scale score was highest (best) for grade 9 (mean = 14.5, 95% CI = 14.0, 15.0) and lowest for grade 11 (mean = 10.9, 95% CI = 10.5, 11.3). The prevalence of depression symptoms was highest in team sport (74.1%) and lowest in individual sport (64.9%) participants. The total Pediatric Quality of Life Inventory score was lowest (worst) for athletes from counties with the highest poverty levels (high: mean = 74.5, 95% CI = 73.7, 75.3; middle: mean = 78.9, 95% CI = 78.0, 79.8; and low: mean = 78.3, 95% CI = 77.4, 79.1). The health of US adolescents during the COVID-19–related school closures and sport cancellations varied to differing degrees depending on sex, grade level, type of sport participation, and level of poverty. Health policy experts should consider these findings in the future when creating and implementing policies to improve the health of adolescents in the United States. [ABSTRACT FROM AUTHOR]

Background: Sport specialization is associated with an increased risk of musculoskeletal lower extremity injuries (LEIs) in adolescent athletes presenting in clinical settings. However, sport specialization and the incidence of LEIs have not been investigated prospectively in a large population of adolescent athletes. Purpose: To determine if sport specialization was associated with an increased risk of LEIs in high school athletes. Study Design: Cohort study; Level of evidence, 2. Methods: Participants (interscholastic athletes in grades 9-12) were recruited from 29 Wisconsin high schools during the 2015-2016 school year. Participants completed a questionnaire identifying their sport participation and history of LEIs. Sport specialization of low, moderate, or high was determined using a previously published 3-point scale. Athletic trainers reported all LEIs that occurred during the school year. Analyses included group proportions, odds ratios (ORs) and 95% CIs, and days lost due to injury (median and interquartile range [IQR]). Multivariate Cox proportional hazard ratios (HRs) with 95% CIs were calculated to investigate the association between the incidence of LEIs and sport specialization level. Results: A total of 1544 participants (50.5% female; mean age, 16.1 6 1.1 years) enrolled in the study, competed in 2843 athletic seasons, and participated in 167,349 athlete-exposures. Sport specialization was classified as low (59.5%), moderate (27.1%), or high (13.4%). Two hundred thirty-five participants (15.2%) sustained a total of 276 LEIs that caused them to miss a median of 7.0 days (IQR, 2.0-22.8). Injuries occurred most often to the ankle (34.4%), knee (25.0%), and upper leg (12.7%) and included ligament sprains (40.9%), muscle/tendon strains (25.4%), and tendinitis/tenosynovitis (19.6%). The incidence of LEIs for moderate participants was higher than for low participants (HR, 1.51 [95% CI, 1.04-2.20]; P = .03). The incidence of LEIs for high participants was higher than for low participants (HR, 1.85 [95% CI, 1.12-3.06]; P = .02). Conclusion: Athletes with moderate or high sport specialization were more likely to sustain an LEI than athletes with low specialization. Sports medicine providers need to educate coaches, parents, and interscholastic athletes regarding the increased risk of LEIs for athletes who specialize in a single sport. [ABSTRACT FROM AUTHOR]

Background: Recommendations exist to encourage safe youth participation in sport. These recommendations include not specializing in 1 sport, limiting participation to less than 8 months per year, and limiting participation to fewer hours per week than a child’s age. However, limited evidence exists to support or refute these recommendations. Hypothesis: High levels of specialization will be associated with a history of injuries and especially overuse injuries, independent of age, sex, or weekly sport training hours. Athletes who exceed current sport volume recommendations will be more likely to have a history of injuries and overuse injuries. Study Design: Case-control study; Level of evidence, 3. Methods: Youth athletes (n = 2011; 989 female and 1022 male; 12-18 years of age) completed a questionnaire regarding their specialization status, yearly and weekly sport participation volume, and injury history. Specialization was classified as low, moderate, or high using a previously utilized 3-point scale. Athletes were classified into groups based on either meeting or exceeding current volume recommendations (months per year and hours per week). Odds ratios (ORs) and 95% CIs were calculated to investigate associations of specialization and volume of participation with a history of sport-related injuries in the past year (P ≤ .05). Results: Highly specialized athletes were more likely to report a previous injury of any kind (P < .001; OR, 1.59; 95% CI, 1.26-2.02) or an overuse injury (P = .011; OR, 1.45; 95% CI, 1.07-1.99) in the previous year compared with athletes in the low specialization group. Athletes who played their primary sport more than 8 months of the year were more likely to report an upper extremity overuse injury (P = .04; OR, 1.68; 95% CI, 1.06-2.80) or a lower extremity overuse injury (P = .001; OR, 1.66; 95% CI, 1.22-2.30). Athletes who participated in their primary sport for more hours per week than their age (ie, a 16-year-old athlete who participated in his or her primary sport for more than 16 h/wk) were more likely to report an injury of any type (P = .001; OR, 1.34; 95% CI, 1.12-1.61) in the previous year. Conclusion: High levels of specialization were associated with a history of injuries, independent of age, sex, and weekly organized sport volume. Athletes who exceeded volume recommendations were more likely to have a history of overuse injuries. Clinical Relevance: Parents and youth athletes should be aware of the risks of specialization and excessive sport volume to maximize safe sport participation. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the association of protective equipment and player characteristics with the incidence of sport-related concussion (SRC) in high school football players. Results show that there was no difference in the incidence of SRC for players wearing helmets while the rate of SRC was higher in those who wore a custom mouth guard. It concluded that SRC incidence is similar regardless of the brand of helmets used.

Background: Although ankle injuries occur frequently in high school football players, no prospective studies have been performed to determine if wearing lace-up ankle braces will reduce the incidence and severity of ankle and other lower extremity injuries in these athletes.Purpose: This study was conducted to determine if lace-up ankle braces reduce the incidence and severity of lower extremity injuries sustained by high school football players.Design: Randomized controlled trial; Level of evidence, 1.Methods: A total of 2081 players from 50 high schools were randomly assigned to a braced or control group. Braced group players wore lace-up ankle braces during the 2010 football season. Athletic trainers recorded brace compliance, athlete-exposures, and injuries. Cox proportional hazards models were utilized to compare injury rates between groups. Injury severity (days lost) was tested with Wilcoxon rank sum.Results: The rate of acute ankle injury (per 1000 exposures) was 0.48 in the braced group compared with 1.12 in the control group (Cox hazard ratio [HR] = 0.39; 95% confidence interval [CI], 0.24-0.65; P < .001). The severity (median days lost) of acute ankle injuries was the same (5 days) in both groups (P = .985). The rate of acute knee injury was 0.70 in the braced group compared with 0.69 in the control group (HR = 0.92; 95% CI, 0.57-1.47; P = .721). There was no difference (P = .242) in the severity of knee injuries between the groups (controls = 11.5 days, braced = 17 days). The rate of other lower extremity injuries was 0.95 in the braced group and 1.32 in the control group (HR = 0.72; 95% CI, 0.48-1.09; P = .117), while the severity was similar in both groups (6 days vs 7 days; P = .295).Conclusion: Players who used lace-up ankle braces had a lower incidence of acute ankle injuries but no difference in the incidence of acute knee or other lower extremity injuries. Braces did not reduce the severity of ankle, knee, or other lower extremity injuries. [ABSTRACT FROM PUBLISHER]

Background: Ankle injuries are the most common injury in basketball players. However, no prospective studies have been performed to determine if wearing lace-up ankle braces will reduce the incidence of ankle injuries in high school athletes.Purpose: This trial was undertaken to determine if lace-up ankle braces reduce the incidence and severity of acute first-time and recurrent ankle injuries sustained by high school basketball players.Design: Randomized controlled trial; Level of evidence, 1.Methods: A total of 1460 male and female basketball players from 46 high schools were randomly assigned to a braced or control group. The braced group players wore lace-up ankle braces during the 2009-2010 basketball season. Athletic trainers recorded brace compliance, athlete exposures, and injuries. Cox proportional hazards models (adjusted for demographic covariates), accounting for intracluster correlation, were utilized to compare time to first acute ankle injury between groups. Injury severity (days lost) was tested with the Wilcoxon rank-sum test.Results: The rate of acute ankle injury (per 1000 exposures) was 0.47 in the braced group and 1.41 in the control group (Cox hazard ratio [HR] 0.32; 95% confidence interval [CI] 0.20, 0.52; P < .001). The median severity of acute ankle injuries was similar (P = .23) in the braced (6 days) and control group (7 days). For players with a previous ankle injury, the incidence of acute ankle injury was 0.83 in the braced group and 1.79 in the control group (Cox HR 0.39; 95% CI 0.17, 0.90; P = .028). For players who did not report a previous ankle injury, the incidence of acute ankle injury was 0.40 in the braced group and 1.35 in the control group (Cox HR 0.30; 95% CI 0.17, 0.52, P < .001).Conclusion: Use of lace-up ankle braces reduced the incidence but not the severity of acute ankle injuries in male and female high school basketball athletes both with and without a previous history of an ankle injury. [ABSTRACT FROM AUTHOR]

Context: The female athlete triad describes the interrelatedness of energy availability, menstrual function, and bone density. Although associations between triad components and musculoskeletal injury (INJ) have been reported in collegiate athletes, limited information exists about menstrual irregularity (Ml) and INJ in the high school population. Objective: To determine the prevalence of and relationship between Ml and INJ in high school athletes. Design: Cross-sectional study. Setting: High schools. Patients or Other Participants: The sample consisted of 249 female athletes from 3 high schools who competed in 33 interscholastic, school-sponsored sport teams, dance teams, and cheerleading or pom-pon squad during the 2006-2007 school year. Each athlete remained on the roster throughout the season. Main Outcome Measure(s): Participants completed a survey regarding injury type, number of days of sport participation missed, and menstrual history in the past year. Results: The prevalences of Ml and INJ were 19.7% and 63.1%, respectively. Athletes who reported Ml sustained; higher percentage of severe injuries (missing >22 days of practice or competition) than did athletes who reported normal menses. Although the trend was not significant, athletes with Ml were almost 3 times more likely to sustain an injury resulting in 7 or more days of time lost from sport (odds ratio = 2.7, 9591 confidence interval = 0.8, 8.8) than those who sustained an in jury resulting in 7 or fewer days of time lost. Conclusions: The incidences of Ml and INJ in this high school population during the study period were high. Athlete; who reported Ml sustained a higher percentage of severe injuries than did athletes who reported normal menses. Education programs to increase knowledge and improve management o Ml and its potential effects on injury in female high school athletes are warranted. [ABSTRACT FROM AUTHOR]