Epidemiology of Knee
Injuries Among US High School Athletes, 2005/06 – 2010/11

DM, Collins CL, Best TM, Flanigan DC, Fields SK, & Comstock RD. Medicine
& Science in Sports & Exercise. Published ahead of Print. doi

injury risk increases with greater participation and competitiveness that is
occurring at the high school level. 
Previous reports have demonstrated that the prevalence of knee injuries
is high among the US high school population, however, there is a lack of
information reported regarding gender and sport.  The purpose of this observational epidemiologic study was to report knee injury rates in the high school athletic
population (including sport & the injured structure).  One hundred schools were randomly selected across
varying sizes and socioeconomic status to participate in this injury
surveillance study.  High school athletic
trainers reported athletic exposure and injury information to the National High
School Sports Related Injury Surveillance System, High School Reporting
Information Online.  Fifteen percent of
all athletic injuries reported between 2005/06 – 2010/11 seasons were knee
injuries, with approximately half of these being ligamentous in nature.  Nationally, it was extrapolated that there
were over 1.2 million knee injuries in high school athletics during this time
frame.  Highest knee injury rates
occurred in football (6.29), girls’ soccer (4.53) and girls’ gymnastics (4.23),
while the average was 2.98 (knee injuries per 10,000 athletic exposures).  The highest injury rates occurred in
competition over practice and in females over males in gender comparable
sports.  The most commonly injured
structure was the medial collateral ligament, and 21.2% of all knee injuries
were treated with surgery.     

there is a need for sport specific injury prevention programs at the high
school level.  It appears that this study
is mirroring some similar findings at the collegiate level (higher number of
knee injuries in males, greater rates in females, and significant number
treated with surgery).  However, many of
the injury prevention programs focus on preventing non-contact ACL injuries,
and there may need to be prevention programs more appropriately designed for
contact ACL injuries.  Also, athletes in
contact sports who may be more susceptible to contact ACL injuries could
possibly benefit from a protective brace of some sort.  On another note, these early knee injuries
pose a significant financial burden in the short-term, however, could severely
affect quality of life in the long-term. 
Evidence demonstrates that injuries to the anterior cruciate ligament or
meniscus can result in osteoarthritic changes within 10 years of injury.  High school athletes range from the ages of
13 – 18, and as a result of suffering a knee injury so early in life, could be
physically hampered in their mid to late twenties.  This could adversely affect their collegiate
athletic career or their normal active lifestyles.  Prevention is key.  Does anyone have any ideas of any existing
programs that may be successful or where these programs should be worked into a
young athlete’s training?  How early
should we start trying to utilize any prevention programs?  Does anyone have any opinions on the
possibility of a preventative bracing for contact ACL injuries?        

by: Nicole Cattano 
by: Stephen Thomas


Swenson DM, Collins CL, Best TM, Flanigan DC, Fields SK, & Comstock RD (2012). Epidemiology of Knee Injuries Among US High School Athletes, 2005/06-2010/11. Medicine and Science in Sports and Exercise PMID: 23059869