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Good news and bad news

Double Digit Decline In Youth Sports Injuries Over Last Decade, New Study Finds

Of top 8 sports/activities only football and soccer injuries increased from 2000 to 2010

There is good news and bad news on the youth sports injury front. The good news is that sports and recreation musculoskeletal injuries declined 12.4 percent in the U.S. over the past 10 years for children ages 5 to 14 years.  The bad news: injuries in football and soccer went up, says a new study. 

Father helping son with bike helmet

Reviewing injury data from the National Electronic Injury Surveillance System in the eight activities identified by the U.S. Centers for Disease Control (CDC) in 2000 as being responsible for the most injuries to children ages 5 to 14 (bicycling, basketball, football, roller sports, playground equipment, baseball/softball, soccer and trampolines), researchers found, among the approximately 41 million in this age group, that:

  • Musculoskeletal-specific injuries (broken bones, sprained joints, torn ligaments, etc.) declined 12.4 percent; 
  • Injuries declined in six of the eight sport/activity categories, including bicycle (38.1 percent), roller sports (20.8 percent) and trampolines (17.5 percent); 
  • Football and soccer injuries increased by 22.8 and 10.8 percent, respectively; and 
  • As a group, sports deemed "recreational" (bike, roller sports, trampoline and playground) decreased by 24.9 percent, and "ball" or organized sport activity injuries increased 5.9 percent. 

The findings were presented at the 2013 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).  

"These (outcomes) may reflect the changing pattern of childhood activities in the U.S. as organized sports are encouraged, often at the cost of free play," said orthopaedic surgeon Shital Parikh, MD, from Cincinnati Children's Hospital Medical Center, who conducted the research. The specific decrease in bicycle, roller sport and trampoline injuries "may reflect the efficacy of preventive programs that focus on helmet use, adult supervision, protective gear and education."

According to the Bicycle Helmet Safety Institute, states and localities began adopting helmet laws for children under age 18 in 1987. In addition, helmet safety campaigns were launched by federal health agencies and national nonprofit health organizations. The AAOS published position statements recommending helmet use when riding a motorcycle or bicycle, skiing and/or participating in roller sports. The AAOS position statement on Trampolines and Trampoline Safety recommends that children not use trampolines for unsupervised recreational activity.

Higher injury rates for soccer and football 


  • Total injuries increased from 185,736 in 2000 to 240,879 in 2010. 
  • Total musculoskeletal injuries increased from 124,163 in 2000 to 154,240 in 2010.  Since the population of children ages 5 to 14 years has not changed much, the 24.2% increase in musculoskelatal injuries, from 4.52 per 1,000 kids to 5.87 per 1,000 kids was deemed by researchers to be statistically significant, which means it was not due to chance.
  • Though concussions doubled from 4,138 in 2000 to 10,759 in 2010, concussions constituted less than 5% of all injuries, compared to 61,399 fractures and 72,483 sprains, of which 94.9% injuries were among boys.


  • Total injuries increased from 85,428 in 2000 to 95,854 in 2010. 
  • Total musculoskeletal injuries increased from 49,045 in 2000 to 53,451 in 2010. This was a 10.8% increase in total injuries and 8.9% increase in musculoskeletal injuries. 
  • There were 30,782 sprains, 25,074 fractures and 17,969 contusions. The injury incidence rate increased from 2.07/1000 kids in 2000 to 2.33/1000 kids in 2010, with 51.3% of the injuries sustained by boys.

For both, the 10-14 year age group sustained significantly more injuries than 5-9 year age group.  

The study did not pinpoint the reasons for these increases, but, based on other studies, Dr. Parikh suggested that they "may be due to increased participation, increased competitiveness, increased awareness about injuries, increased diagnosis by health care providers and improper use of protective gear."  He noted, however, that, "irrespective of the trend, injuries from all sports can be decreased by education and awareness." 

STOP campaign 

In 2010, AAOS joined seven other health advocacy organizations in supporting the American Orthopaedic Society for Sports Medicine's (AOSSM) STOP (Sports Trauma and Overuse Prevention) Sports Injuries campaign in youth sports. The goal of the program is to curb the number of youth injuries from overuse and trauma in all sports. The campaign offers sport-specific resources for athletes, parents, coaches and health care providers, including tip sheets, videos, podcasts, posters, community presentations and coaches' curriculum. All are available at the interactive website: STOPSportsInjuries.org. 

"The trend of childhood injuries needs to be better understood to promote safe play to counter the increase in childhood obesity, physical inactivity and emotional disturbances in children, all of which are on the rise in the U.S.," said Dr. Parikh.

Source: American Academy of Orthopaedic Surgeons

Posted March 19, 2013;. revised March 20, 2013