Released June 2003
271 pages

INTRODUCTION

MAGNITUDE OF SPORTS INJURIES IN THE UNITED STATES
Since 1987, American Sports Data, Inc. has been tracking sports and fitness participation in the U.S. In the year 2001, 50.6 million people over the age of 6 were frequent exercisers who participated in a single activity such as running, cycling or treadmill exercise on at least 100 occasions. In addition, 39.9 million were frequent participants in a recreational sport such as basketball, tennis, softball or skateboarding, having participated at least 25 times, in most cases. Another 15.3 million were outdoors enthusiasts, participating in an active outdoor pursuit such as hiking, mountain biking, or skiing, at least 15 times during the year. Many more Americans were less frequent players and participants; a clear majority of the population (68% or 170 million people) participated at least once in any of the sports/activities monitored by ASD.

A substantial number of these sports and exercise participants suffer injuries each year. Of the 35-40 million annual injury-related emergency room visits, approximately 10% are sports-induced — an estimate confirmed in a pilot study of the present research which also indicated that less serious sports injuries (e.g. those not requiring ER treatment) — were perhaps five times as numerous.

POTENTIAL GROWTH OF THE SPORTS INJURY POPULATION
Although no reliable tracking data exist, it is widely believed that sports injuries in the U.S. are becoming more and more prevalent — across all age groups. While much has been written of late about a child obesity epidemic, the decline of Phys Ed in public schools, and the multitude of sedentary distractions that compete against the physical activity of children, there is also thought to have been a paradoxical increase in their sports injuries!

The contradiction, however, is easily reconciled. First, while there has been a drop in traditional team sports participation among children, this fall-off has come from the less intense, unpressured, casual forms of pickup play — which are in severe decline. By contrast, most organized team sports (except baseball) have maintained participation levels, and a few, such as soccer, lacrosse and fast-pitch softball — are flourishing. Unfortunately, the competitive culture of most organized youth sports is now so intense, it threatens not only the morale and character development of children, but their physical safety as well! But, due to a lack of survey documentation, such observations remain anecdotal.

For reasons that may have something to do with the vicarious needs of parents, children are introduced to sports at unprecedented ages. Increasingly, children under the age of five are participating in soccer, t-ball, martial arts and other sports — practices that may also contribute to rising youth injury rates. A little later the child may be forced to specialize; he or she may for example, be encouraged to play on three different soccer teams, enduring three-hour practices, year-round. Naturally, this is a middle-class scenario; but sports and medical professionals sense that it is emblematic of the new super-competitive youth sports culture.

Youthful sports injuries are also being fueled by the increasingly popular non-traditional sector of Extreme Sports — also dubbed "Millennial", "Alternative, or "Action Sports". An obvious argument is that extreme sports (Skateboarding, Snowboarding, Wakeboarding, Mountain Biking, etc.) are inherently risky and therefore conducive to rising injury rates; less obvious is the probability that many children are driven to the solitude and serenity of these more "dangerous" sports by fanatical coaches and parents. Whatever the reality, the net effect of this interaction on sports injuries is unclear.

Baby Boomers (aged 35-54) continue to drive sports/exercise participation, and as a corollary, are generating higher rates of sports injury. According to the U.S. Consumer Products Safety Commission, sports-related ER injuries in this group increased by 33% from 1991 - 1998, but this rise — according to CPSC — paralleled increases in activity participation. Boomers are very important to the near-term future of sports medicine; many ushered in the original fitness movement and have made exercise a lifelong commitment. From 1987 - 2001, health club membership among people aged 35-54 increased by 135%; after stripping out the effect of population growth, the incidence of membership could still claim a 60% rise.

The phenomenal growth of people over 55 in sports and fitness almost suggests an emerging branch of "geriatric sports medicine". From 1987 - 2001, health club membership skyrocketed by 266%; and even after holding population constant, the increase was an astounding 219% — clearly depicting a vast change in lifestyle and cultural values for older Americans. This trend is not limited to health clubs — it extends to home/outdoors fitness, and also includes active recreational and outdoors sports. From 1990 - 1996, the CPSC recorded an increase of 54% in all sports injuries among people 65+ years of age; it also deduced from its data that sports and fitness participation is not limited to the youngest seniors. As the 65+ cohort ages, "they may remain active into their 70's, 80's and perhaps even 90's", a report states.

SPORTS INJURY EPIDEMIOLOGY: A DEARTH OF NORMATIVE STATISTICS
Sports injury research is an intensely practical component of the sports participation knowledge base, and the mere existence of a sub-discipline called "sports injury epidemiology" (in this context, roughly the descriptive quantification of injuries deriving from sports participation) suggests a great abundance of vital and compelling data. But nothing could be further from reality: THERE HAS NEVER BEEN A MAJOR NATIONAL PUBLIC SURVEY OF SPORTS INJURIES IN THE U.S. — at least not since the 1970's!

Given the considerable number and variety of groups that stand to benefit from such a research initiative, this is indeed a curious state of affairs. Governing medical bodies, federal agencies, professional associations, educational institutions, municipalities and a host of other sports venues should be natural evangelists for such an effort. Presumably, sporting goods manufacturers — always fervent in the pursuit of safer products and protective equipment — would also be eager consumers of such information; not to mention the sports medical community, for which injury information is the very lifeblood. Then, of course, there are a multitude of lower-profile users: federal agencies, safety groups, insurers, risk consultants, personal injury lawyers, etc. who are also natural beneficiaries.

At the very least, we would expect that arbiters of sports medicine — the de facto medical policemen who oversee research, publish journals, issue safety guidelines and other proclamations to the sports and fitness industries, might — at some point or other — have commisioned a national study on the very subject of their expertise. But not a single professional organization has made this effort!