Epidemiology of Chest, Rib, Thoracic Spine, and Abdomen Injuries Among United States High School Athletes, 2005/06 to 2013/14

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Describe chest and abdominal injury epidemiology among US high school athletes.


Retrospective analysis of longitudinal surveillance data.


Injury data from 2005/06 to 2013/14 academic years were collected using an internet-based surveillance system.


A large sample of US high schools.

Assessment of Risk Factors:

Injuries sustained as a function of sport.

Main Outcome Measures:

Chest, rib, thoracic spine, and abdominal injuries sustained during high school athletic events.


Overall 1487 chest, rib, thoracic spine, and abdominal injuries occurred during 30 415 179 athletic exposures (AEs); an injury rate of 4.9 injuries per 100 000 AEs. Over half (56.8%) of injured athletes were evaluated by another medical provider in addition to the athletic trainer, and 34 injuries (2.3%) required surgery. Diagnostic techniques, including x-ray, magnetic resonance imaging or computed tomography were used in 729 (49.0%) injuries. The injury rate was higher in boys' (6.8) than girls' (2.0) sports [rate ratio (RR), 3.43; 95% CI, 3.04-4.10]. Football (47.7%) accounted for the highest proportion of injuries followed by wrestling (18.5%), boys' soccer (4.6%), and girls' soccer (3.7%). The rate of injury was higher in competition than practice, (RR, 2.86; 95% CI, 2.59-3.23). Only 57.7% of injured athletes were able to return to play within 1 week.


Chest and abdominal injuries in high school sports although relatively rare, can result in loss of playing time and frequently prompt medical evaluation. Thus, they present a physical and economic burden. To optimize prevention, further studies can focus on subgroup risk factor identification to drive development of targeted prevention strategies.

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