There has been a significant increase in the number of youths participating in organized and recreational sports. Children and adolescents are also beginning to participate in more competitive sports at a younger age. This increase in higher-intensity sports has led an increase in the number of injuries and death in this population.1,2 According to the National Federation of State High School Associations, there were 7,807,047 participants in high school sports during the 2014/2015 season; the number of participants grew by nearly 60,000 in 1 year, with 7,868,900 in the 2015/2016 academic year.3 The increases in participation and injury rates have been attributed to a number of factors, including, but not limited to, the federal government’s passing of Title IX legislation allowing for greater equality for female athletic participation; an increased level of interest for certain youth sports such as soccer; increased media coverage of sports such as gymnastics, skating, tennis, and swimming; and a greater-than-ever emphasis on competition driven by year-round desires to improve skill and conditioning levels for hopes of obtaining collegiate-level scholarships to offset the cost of a college education.4 A study examining the emergence of female high school flag football found that flag football had an injury rate per 1000 exposures of 1.13 for practices and 5.58 for competitions; this was found to be the second highest injury rate for female sports after soccer.5 According to Safe Kids Worldwide, more than 1.24 million children were seen in the emergency room for sports-related injuries in 2013.6 Furthermore, children 13 to 15 years accounted for the greatest number of emergency room visits, making up 37% of all sports-related visits among children age 19 and younger.6.
