• Prasad R Shankar, Sarah K Fields, Christy L Collins, Randall W Dick, and R Dawn Comstock.
• The Ohio State University College of Medicine, Columbus, Ohio, USA.
• Am J Sports Med. 2007 Aug 1; 35 (8): 1295-303.

BackgroundFootball, one of the most popular sports among male high school students in the United States, is a leading cause of sports-related injuries, with an injury rate almost twice that of basketball, the second most popular sport.HypothesisInjury patterns will vary between competition and practice exposures and between levels of play (ie, high school vs. National Collegiate Athletic Association [NCAA]).Study DesignDescriptive epidemiology study.MethodsFootball-related injury data were collected over the 2005-2006 school year from 100 nationally representative high schools via High School RIO (Reporting Information Online) and from 55 Division I, II, and III colleges via the NCAA Injury Surveillance System.ResultsNationally, an estimated 517,726 high school football-related injuries (1881 unweighted injuries) occurred during the 2005-2006 season. The rate of injury per 1000 athlete-exposures was greater during high school competitions (12.04) than during practices (2.56). The rate of injury per 1000 athlete-exposures was also greater during collegiate competitions (40.23) than during practices (5.77). While the overall rate of injury per 1000 athlete-exposures was greater in the NCAA (8.61) than in high school (4.36), high school football players sustained a greater proportion of fractures and concussions. Running plays were the leading cause of injury, with running backs and linebackers being the positions most commonly injured.ConclusionPatterns of football injuries vary, especially by type of exposure and level of play. Future studies should continue to compare differences in injury patterns in high school and collegiate football, with particular emphasis placed on high-risk plays (running plays) and positions (running backs and linebackers).

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