• Justin H Bartley, Monica F Murray, Matthew J Kraeutler, Lauren A Pierpoint, K Linnea Welton, Eric C McCarty, and R Dawn Comstock.
• Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA.
• Orthop J Sports Med. 2017 Dec 1; 5 (12): 2325967117740887.

BackgroundLacrosse and ice hockey are quickly growing in popularity, while football remains the most popular sport among high school student-athletes. Injuries remain a concern, given the physical nature of these contact sports.PurposeTo describe the rates and patterns of injuries sustained as a result of intentional player contact in United States high school boys' football, ice hockey, and lacrosse.Study DesignDescriptive epidemiology study.MethodsWe conducted a secondary analysis of High School RIO (Reporting Information Online) data, including exposure and injury data collected from a large sample of high schools in the United States from 2005-2006 through 2015-2016. Data were analyzed to calculate rates, assess patterns, and evaluate potential risk factors for player-to-player contact injuries.ResultsA total of 34,532 injuries in boys' football, ice hockey, and lacrosse occurred during 9,078,902 athlete-exposures (AEs), for a rate of 3.80 injuries per 1000 AEs in the 3 contact sports of interest. The risk of injuries was found to be greater in competition compared with practice for all 3 sports, with the largest difference in ice hockey (rate ratio, 8.28) and the smallest difference in lacrosse (rate ratio, 3.72). In all 3 contact sports, the most commonly injured body site in competition and practice caused by both tackling/checking and being tackled/checked was the head/face. However, a significantly greater proportion of concussions sustained in football were the result of tackling compared with being tackled (28.2% vs 24.1%, respectively). In addition, a significantly greater proportion of concussions were sustained in competition compared with practice for all 3 sports.ConclusionThis study is the first to collectively compare injury rates and injury patterns sustained from intentional player-to-player contact in boys' high school football, ice hockey, and lacrosse. Notably, there was a relatively high risk of injuries and concussions during football practices.

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