Comparison of Soccer-Related Injuries at US Emergency Departments Between High School-Aged and College-Aged Athletes: A 10-Year NEISS Analysis, 2015-2024
Gill Efron, John R. Tyler, Mark Gamadia, Ran Atzmon, Shai Shemesh, Matan Rotchild, Nata ParnesBackground:
Soccer is widely played in the United States (US), yet contemporary national data comparing soccer-related emergency department (ED) injuries between high school-aged and college-aged athletes remain limited.
Purpose:
To provide a comparative assessment of soccer-related injuries among high school-aged and college-aged athletes and to characterize the burden of these injuries on US EDs.
Study Design:
Descriptive epidemiological study.
Methods:
The National Electronic Injury Surveillance System was queried for soccer-related injuries among patients aged 14 to 23 years from 2015 to 2024. Patients aged 14 to 18 years were categorized as high school-aged and those aged 19 to 23 years as college-aged. Weighted national estimates were calculated using National Electronic Injury Surveillance System (NEISS) sampling weights. Participation denominators were derived from National Federation of State High School Associations boys’ and girls’ soccer participation for the high school-aged group and National Collegiate Athletic Association men’s and women’s soccer participation across Divisions I, II, and III for the college-aged group. Incidence rates were expressed per 100 participants, and incidence rate ratios (IRRs) with 95% CIs were calculated.
Results:
A total of 29,144 NEISS cases corresponded to a weighted national estimate of 877,548 soccer-related injuries treated in US EDs. High school-aged athletes accounted for 687,302 injuries, whereas college-aged athletes accounted for 190,246. The incidence rate was 8.19 per 100 participants among high school-aged athletes and 34.73 among college-aged athletes (IRR, 4.24; 95% CI, 4.22-4.26), indicating an approximately 4-fold higher per-participant rate among college-aged athletes. Per-participant rates were higher in the college-aged group in every study year and across all body region, diagnosis, and disposition categories. The ankle (157,321 injuries; 17.9%), knee (137,030; 15.6%), head (127,695; 14.6%), and wrist (52,940; 6%) were the most frequently injured body regions; strains and sprains were the most common diagnosis (262,189; 29.9%). Most injuries were treated and discharged (96.8%), whereas transfers or admissions were uncommon (1.9%).
Conclusion:
College-aged athletes had over a 4-fold higher rate of soccer-related ED injury than high school-aged athletes, despite high school-aged athletes accounting for most total ED visits. These findings highlight important differences between absolute ED burden and participation-indexed injury rates. They may help inform injury-prevention priorities, ED counseling, and postinjury follow-up strategies across scholastic and collegiate soccer populations.