3. INJURY DATA AND PREVENTION. The NFHS Sports Medicine Advisory Committee and the NFHS Basketball Sport Committees use information from the National High School Sports-Related Injury Surveillance Study (High School RIO) to monitor rates and patterns of sports injuries among high school student-athletes. High School RIO is in its 6th year of collecting sports exposure and injury data.
A. Injury Data. The most recent High School RIO report captured the following trends in boys and girls basketball.
1) A large portion of injuries for both boys and girls are ankle injuries (34.7% and 33.0% respectively). However, ankle injury rates have not significantly increased over time for either gender. The ankle injuries are most often occurring during rebounding activities for both boys and girls (43.3% and 31.4% respectively).
2) Concussion rates in boys’ and girls’ basketball have not significantly changed over time. However, boys are sustaining concussions more often during rebounding activities (28.5%) and girls during defending activities (26.5%) – both primarily due to player-to-player contact.
3) The incidence, rate and proportion of Anterior Cruciate Ligament (ACL) injuries to girls have not significantly changed over time.
NOTE: The full report may be found at
NFHS | National Federation of State High School Associations under the Sports Medicine link.
B. Injury Prevention. While the rules of the game can’t always prevent the types of injuries mentioned above from occurring, coaches, players and officials all have an important role to play in keeping the risk of injury to a minimum. To assist in preventing injuries, the committee has addressed the following areas of concern:
1) Coaches and officials must be able to recognize the signs and symptoms of a concussion, and be well versed in and follow NFHS and the respective state association concussion guidelines.
2) There are several aspects of the game where injuries may be more likely to occur, but rebounding and defending were specifically noted in the data above. Officials must adjudicate all rules as written, especially regarding illegal contact in those two areas. An airborne player is especially vulnerable to sustaining a serious injury with the slightest contact. Officials and coaches must be conscientious in protecting airborne players in the area of rebounding and shooting.
3) Officials should not hesitate to rule a flagrant foul when “violent” contact occurs against an opponent, especially to the head.
4) Officials must also remain diligent in ruling excessive swinging of the elbows, even when no contact occurs (violation).