Risky Business
A few months ago, the national media carried a story you may have seen regarding an interesting study on high school athletic injuries. Dr. Steven Rice, a pediatrician and sports medicine specialist at the University of Washington in Seattle, collected data from coaches at 20 high schools in the Puget Sound area from 1979 to 1992, involving more than 60,000 athletes in 18 team sports. The goal of the study was to determine which athletes were at highest risk of injury during training or competition.
I suspect if you took an informal survey to discover which sport the average person would guess carries the highest risk, most people would say football. Beyond that, sports such as basketball, hockey or other “contact” activities most likely would head the list.
The actual “most dangerous” sport: Girls’ Cross-country! Football only ranks second, while wrestling, girls’ soccer and boys’ cross-country place third through fifth respectively. The injury rate in girls’ X-C was 61.4 per 100 runners, but since multiple injuries are included in this statistic, it’s really not quite that bad. Still, one out of three female cross-country runners is injured in some way during training or competition. The overall rate of significance was 17.3 injuries per 1,000 “athletic exposures,” defined as one athlete participating in one practice or competition. (Football’s rate was 12.7 per 1,000.) Dr. Rice found tendinitis of the knee, shin splints, ankle sprains and stress fractures to be the most common injuries.
Dr. Rice lists several possible reasons for this surprising statistic. First, he notes the differences in male and female skeletal structure, particularly with respect to the hips. Girls’ wider hips often result in increased angular relationships at the knees or ankles, which in turn cause biomechanical problems during running. Second, poor nutrition among girls with eating disorders may cause hormonal (estrogen) imbalances which affects bone density. Training then becomes too stressful for the bones, resulting in stress fractures. (Some experts believe heavy training itself may cause failure to menstruate, which keeps estrogen levels low. Recent evidence, however, seems to indicate poor nutrition as the primary factor here.) And third, the fact that x-country (boys’ and girls’) as well as football and soccer are fall sports suggests that kids may not be participating in enough summer fitness activities to ensure they are in shape for rigorous training or competition when they return to school.
These are all plausible explanations for the study’s findings. I would add only that the nature of cross-country — i.e., the uneven running surface, not to mention hazards such as water, fallen trees, woodchuck holes, etc. — places additional stress on the developing bones and muscles. Therefore, even girls who run during the summer, but do so primarily on the roads, are at higher risk of injury once they start running hard on grass or dirt.
Coaches and parents would be wise to pay heed to the findings of Dr. Rice by: (1) making certain that runners (girls and boys) are well-conditioned and strong before X-C season officially begins; (2) monitor closely the nutritional habits of teen runners, and; (3) attending immediately to the first sign of injury. Young girls especially should not be pushed to “run through” any ache or pain, no matter how innocuous it may seem, until it has been thoroughly checked and cleared by a physician or trainer.