Linda Little

October 12, 2005

Oct. 12, 2005 (Washington) — Female high school athletes have higher injury rates and risks of injury than their male counterparts, researchers reported here at the American Academy of Pediatrics (AAP) National Conference and Exhibition.

Two million high school athletes are injured in this country each year at a cost of $1.8 million. Previous studies have been sport- or school-specific, reporting conflicting conclusions about sex differences in sports injuries.

This prospective study of more than 6,000 varsity athletes compared boys and girls participating in the same sports and found that female athletes are more prone to injury.

"Female varsity athletes had greater injury rates and greater injury risk than male varsity athletes overall," said Theodore J. Ganley, MD, orthopedic director in the sports medicine department at Children's Hospital in Philadelphia, Pennsylvania.

The study included 3,003 female and 3,105 male athletes from 15 high schools who participated in baseball, softball, basketball, soccer, track/cross country, tennis, or lacrosse, and were followed for one year. Researchers collected data on age, sex, sport, skill level, injured body part, type of injury, and days lost from the sport. Data from athletic trainers were submitted for statistical analysis to detect significant differences between male and female athletes with respect to injury risk and injury rate both within and across the sports. The athletes were followed for 884,339 athlete hours of exposure.

Overall, 966 injuries occurred; the girls had 515 injuries and the boys had 451 injuries.

In terms of more minor injuries (only one or two days lost from the sport), girls had more injuries than boys. Of the more major injuries (seven or more days lost), girls had more injuries in basketball and soccer, but boys had more baseball/softball injuries.

The researchers found that there were significantly different injury rates between the boys and girls for each injury location. Girls were more apt to injure the ankle, knee, and tibia, while boys had a higher rate of injuries to the tendoachilles complex, Dr. Ganley said.

Basketball and soccer were the sports in which girls had the greatest risk and rate of injury (primarily to the knee and ankle), the researchers reported.

It has been shown that female athletes are at a three to eight times higher risk of injuring the anterior cruciate ligament, Dr. Ganley said. "There probably are mechanical structures at work here in women."

Although there are a number of preventive exercise programs that have been developed by medical groups to prevent ACL injuries, "we need to further develop and implement changes in hopes of ultimately reducing the injury rates in females," Dr. Ganley said. "We plan to use this data to correlate to emergency room and doctor's visits as well as surgical interventions to create prevention programs for the high school athlete."

"This is an important study," said Donald Shifrin, MD, a clinical professor of pediatrics at the University of Washington School of Medicine in Bellevue and chair of the AAP communications committee. "This is a fairly good study that explains the difference in injuries among athletes."

Dr. Shifrin added, "Based on the injury rate, we know that the lower extremities of females are more prone to injury. Now we need to develop prevention programs."

AAP 2005 National Conference and Exhibition: Oral session — Section on Orthopedics II. Presented Oct. 9, 2005.

Reviewed by Gary D. Vogin, MD

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