The association between body mass index, age and severity of musculoskeletal injuries sustained during high school contact sports: A 15-year epidemiological study.

Abstract

Quantify the association between athlete-specific characteristics (body mass index [BMI] and age) and severity of musculoskeletal (MSK) injuries among high school sport participants. De-identified, national high school sports injury data for boys' and girls' soccer, boys' and girls' basketball, boys' wrestling and football were obtained from the High School Reporting Information Online (RIO) Study, capturing injury information from participating high schools from years 2005/06-2018/19. The primary outcome was injury severity, measured by time to return to preinjury activity (RTA). A sport-specific logistic regression model was applied to assess the relationship between BMI and age and time to RTA that controlled for anatomic region of injury, type of injury (e.g., dislocation or fracture), level (e.g., varsity or JV), geographic region, event type (competition vs. practice) and timing of injury during season. From 2005/06-2018/19, 33,486 MSK injuries were reported (N = 11,068,855 injuries nationwide weighted) with boys' football players sustaining over 50% of reported injuries (n = 17,753 unweighted; N = 5,100,845 weighted). The most frequently reported injuries were knee (18.1%) and ankle (22.8%) injuries. Regression models showed that lower BMI in boys' football (odds ratio [OR] = 0.99, 95% confidence interval [CI] 0.98-0.99, P = 0.003) and higher BMI in girls' basketball (OR = 1.04, 95% CI 1.01-1.08, p = 0.017) were significantly associated with RTA greater than 6 days, although effect sizes were almost negligible. Player age was not associated with RTA of 6 days or less. Given the absence of statistically or clinically meaningful associations across all sports in our study, neither BMI nor age appears to be a clinically useful predictor of MSK injury severity in these populations. Level III.