Those macho football players, so the stereotype goes, are the most likely high school athletes to land on the injured list.
Not so, says a Seattle physician who has been studying high school athletic injuries since 1979.
At highest risk? The girls' cross-country team, says Dr. Stephen Rice, director of the Athletic Health Care System, a high school sports-injury-prevention and management program at the University of Washington, Seattle. (Football players are in second place.)
But there's good news as well from Rice and other experts, who say many injuries are preventable if athletes train correctly and follow other suggestions.
Gender Gap: Exactly why girls are injured more often is not known, says Rice, who presented his research earlier this year at the annual meeting of the American College of Sports Medicine (ACSM). Girls might have inadequate calcium and calorie intake, he speculates, setting themselves up for bone fractures and other injuries. Girls who stop menstruating while competing intensely may have insufficient estrogen levels, also increasing fracture risk.
Seasonal Injuries: Both boys and girls are most likely to be injured during the fall season, Rice finds, and least likely in the spring. That is probably because of inactivity during the summer, he says, with athletes out of shape when they begin autumn training.
Reducing Risk: "Overuse" injuries--the result of repeated mini-trauma to weak body parts--are to blame for many high school athletic injuries, says Dr. Angela D. Smith, vice president of ACSM and an orthopedic surgeon at Mt. Sinai Medical Center in Cleveland. She chaired the ACSM committee that drafted a "Current Comment" paper on prevention of sports injuries issued in August.
Such injuries can be cut by 50%, say Smith and others. In Smith's study of figure skaters, presented at the ACSM meeting, those who did strength training, underwent a physical exam and stretched regularly reduced overuse injuries by half.
Athletes should also follow the 10% rule, says Smith, which advises against more than a 10% increase in training time, distance or repetition of activity.
For instance, a runner who covers 10 kilometers one week should increase only to 11 the next, without increasing intensity.
If intensity is increased, distance should not.
It is especially wise to monitor training during growth spurts because some studies find that children have an increased risk of injury then, Smith says.
Obtaining a doctor's approval for sports participation is generally required for school-organized athletics, but should be considered for other sports activities as well, experts say.
First Aid-Sprains and Strains: Taking care of injuries correctly can minimize the damage.
For sprains and strains, two of the most common sports injuries, Rice tells athletes to remember his name:
Rest the injured area.
Ice it for 20 minutes per hour.
Compress the area with a bandage.
Tooth-Saving Measures: The growing use of mouth guards in high school sports has reduced--but not eliminated--dental injuries. Quick action can increase the odds of saving teeth, says Barry Skaggs, a Los Angeles oral surgeon and UCLA clinical professor.
"If a tooth is displaced, try to push it back gently into position," he advised. If it is entirely out, "Rinse it with water and put it in the cheek area if the child is old enough not to swallow it. A parent can also put the tooth in his or her mouth to safeguard it."
Next best is to put the tooth into a glass of milk, Skaggs says. The aim is to keep the tooth intact so re-implantation is successful.
Ideally, a tooth should be reimplanted within two hours, Skaggs says. But if a tooth is stored properly, it might still be re-implantable after four or five hours, he says.
High school sports most likely to cause tooth problems, in Skaggs' experience, are baseball and basketball.
Reassuring Stats: Still, nervous parents can look at the bright side. "Overall, 79% of kids will get through a sports season without injury," Rice finds. Of those who do get hurt, 77% are off less than a week.
One of the safest sports? Co-ed golf, in which only 1.3% of different athletes were injured in Rice's ongoing study.
Here are the top 10 high-school sports in terms of injury risk:
1. Girls' cross country
4. Girls' soccer
5. Boys' cross country
6. Girls' gymnastics
7. Boys' soccer
8. Girls' basketball
9. Girls' track
10. Boys' basketball
Source: Dr. Stephen Rice, University of Washington, Seattle. Based on evaluations of 60,000 Seattle-area high-school athletes participating in more than 2.5 million practice and game days, 1979-92.