Prevent Knee Injuries in High School Athletes

Healthnotes Newswire (May 12, 2005)—High school athletes can reduce their risk of sustaining sports injuries by using knee pads in sports that do not require them, according to the American Journal of Epidemiology (2005;161:511–9).

Approximately seven million high school students in the United States participate in organized sports each year. These activities are widely promoted as beneficial for health, but many students experience sports-related injuries that interfere with their ability to be active for short or long periods of time. It is estimated that 41 to 61% of high school football players, 40 to 46% of wrestlers and gymnasts, and 31 to 37% of basketball players sustain sports-related injuries each year. Protective equipment, such as helmets, shin guards, knee pads, and mouth guards, is required in many high school sports. Some student athletes use additional nonrequired equipment, though whether or not the use of discretionary protective equipment can prevent injuries is not clear.

In the current study, high school student athletes participating in 12 organized sports—boys’ and girls’ soccer, track, and basketball; boys’ baseball, wrestling, and football; and girls’ softball, volleyball and cheerleading—were observed for three years. In all, 19,728 student-seasons (one student participating in one season of a sport is equivalent to one student-season) were evaluated for this study. Their use of protective gear worn from the hips to the toes that is not required by the rules of the sport (lower-extremity discretionary protective equipment) and incidence of sports-related injuries were monitored through questionnaires given weekly during each season. General information about the students was collected using a questionnaire filled out before each season began.

Knee and ankle injuries were the most common lower extremity injuries reported. Student athletes using lower extremity discretionary protective equipment had a 9% reduced risk of lower extremity injury overall. The use of knee pads was linked to a 56% decrease in risk of knee injury. Furthermore, the severity of knee injuries incurred while using knee pads was significantly lower than those incurred while not using knee pads. Athletes using knee and ankle braces, however, experienced increased rates of injury: the risk of knee injury was 61% higher in those using knee braces and the risk of ankle injury was 74% higher in those using ankle braces. When athletes who had experienced a prior injury were considered separately from those who had not, the increased risk of injury associated with knee and ankle brace use was significant in both groups.

These results suggest that the use of knee pads can protect against sports-related knee injuries in high school athletes. Some sports that do not currently require knee pads, but in which knee injuries are known to occur, might reconsider their rules in light of these findings. Furthermore, the use of knee and ankle braces during sports should be discouraged until more is known about their effects on sports-related injuries.

Maureen Williams, ND, received her bachelor’s degree from the University of Pennsylvania and her Doctorate of Naturopathic Medicine from Bastyr University in Seattle, WA. She has a private practice in Quechee, VT, and does extensive work with traditional herbal medicine in Guatemala and Honduras. Dr. Williams is a regular contributor to Healthnotes Newswire.

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