Has Sustained Time Away From Sports Due to the COVID-19 Pandemic Led to Increased Sport-Related Soft Tissue Injuries?

Abstract

Background: A decrease in sport-related injuries was observed in 2020, which has been attributed to COVID-19 and recommendations to suspend organized sports. In adult populations, increased injury rates have been noted in athletes returning to play after an extended period of reduced play, attributable to deconditioning. There is growing literature surrounding concern over increased injury risk after return to sport after the COVID-19 shutdowns.

Hypothesis: Like adults, pediatric patients experience an increase in sport-related injuries after periods of "deconditioning," such as during the COVID-19 shutdown.

Study design: Descriptive epidemiology study.

Level of evidence: Level 4.

Methods: The Consumer Product Safety Commission's National Electronic Injury Surveillance System database was queried to identify 13- to 18-year-old patients who sustained a sprain/strain type injury in 2019 or 2021 to an extremity, and involved sporting equipment for basketball, baseball/softball, soccer, and football. The control group was established as patients who sustained injury in 2019, and the post-COVID-19 group was established as those in 2021. Quantity of injuries sustained in these 2 groups were compared and analyzed by subgroup.

Results: There was a significant difference in the total number of sport-related sprains/strains in 2019 versus 2021 (P = 0.01), with more injuries in 2019 (n = 151,067) than in 2021 (n = 104,041). There were more injuries in boys than in girls. Proportion of injuries by sports were similar in both time periods. There was a significant decrease in basketball-related injuries by 21% (P ≤ 0.01, relative risk ratio [rrr] = 0.7979) and a significant increase in football-related injuries by 14% (P = 0.01, rrr = 1.1404) and in soccer injuries by 14.2% (P = 0.03, rrr = 1.1422).

Conclusion: There is significant heterogeneity in injury rates by sports, with no conclusive increase in injuries, contrary to expectations.

Clinical relevance: This study suggests that the relationship between deconditioning and injury may be less clear in the child-athlete, and gives recommendations for return to sport after extended breaks.

Strength-of-recommendation taxonomy (sort): Level 2c.