An 11-year analysis of peripheral nerve injuries in high school sports

Introduction: Sports surveillance databases provide valuable information regarding common ailments, yet fewer studies have focused on more rare peripheral nerve injuries. Our objective was to characterize peripheral nerve injuries in high school athletics with respect to incidence, time loss, mechanism, and diagnoses. Methods: Sport-related nerve injury data on high school athletes were collected during the 2005/2006 through 2015/2016 academic years via the High School Reporting Information Online (RIO) database. All injuries were reported by certified athletic trainers (ATs). Descriptive statistics were performed. Results: A total of 588 peripheral nerve injuries were recorded during the 2005/06–2015/16 academic years, with an overall incidence of 1.46/100,000 athlete-exposures (AE; 95%CI: 1.34, 1.58). Boys’ football had the majority of injuries (71.3%) and the highest injury rate (5.46/100,000AE; 95%CI: 4.93, 5.98), followed by boys’ wrestling (7.1%) and boys’ baseball (3.4%). Over half (50.3%) of peripheral nerve injuries resulted in time loss < 1 week, while 9.4% resulting in the athletes prematurely ending their seasons. The most common mechanisms were player contact (67.3%), overuse (10.0%), and surface contact (9.7%). A specific diagnosis was available for 40 (6.8%) injuries, including upper extremity stinger (n = 26), spinal cord neurapraxia (n = 3), subacromial nerve impingement (n = 2) neuroma (n = 2), axillary nerve palsy (n = 1), sciatic nerve impingement (n = 1), femoral nerve impingement (n = 1), tarsal tunnel syndrome (n = 1), peroneal neuropathy (n = 1), thoracic outlet syndrome (n = 1), and ulnar nerve subluxation (n = 1). Discussion: Recognized peripheral nerve injuries are rare among high school athletes, occurring most commonly in boys’ football. While most are minor, approximately 1:10 were season-ending. Specific diagnoses were available for 7% of injuries, with upper extremity stingers being the most commonly reported diagnosis. Working with ATs to identify and implement methods to obtain more specific diagnostic information via surveillance will help researchers better understand the epidemiology of peripheral nerve injuries.