The Excitement — and the Risks of Returning to Play
Every August across Ohio, fields, courts, and tracks come alive again. Football players put on their pads, soccer teams return to daily drills, runners lace up for cross country, and volleyball teams begin tournaments. Fall sports are exciting for athletes, families, and communities — but this season also marks the highest risk of injury for student athletes.
Studies show that 40% of adolescent athletes experience at least one injury per year, and nearly 4 in 10 of those are re-injuries in the same body region. The majority of these injuries occur early in the season, when athletes are transitioning from the relative rest of summer into the intensity of structured practices and competition.
Why Early-Season Injuries Happen
The spike in injuries during the fall season is not a coincidence. Research highlights several key reasons:
Abrupt training increases: Many athletes go from unstructured summer activity to double practices in August. This sudden load leads to breakdowns in bone, tendon, and muscle tissue.
Insufficient conditioning: Athletes often return without adequate base fitness, increasing their risk of sprains, strains, and overuse injuries.
Previous injury history: Athletes with preseason pain or a history of injuries are 3.5 times more likely to get hurt again during the season.
Lack of proper warm-up: Teams that skip neuromuscular warm-ups are significantly more likely to see ankle and knee injuries.
Notably, over half of all high school sports injuries (51–59%) occur during practice, not competition — meaning injury prevention must be built into daily training, not just game day routines.
Common Injuries in Fall Sports
Different sports carry different injury profiles. Understanding these patterns helps parents and coaches spot risks early.
Football: Highest overall injury rate among high school sports, around 4.11 injuries per 1,000 athlete-exposures (AEs). Common injuries include concussions, knee ligament tears, and shoulder instability.
Soccer (boys and girls): Around 2.46 injuries per 1,000 AEs, with ankle sprains and ACL tears most frequent. Girls’ soccer has one of the highest ACL tear rates of any sport.
Cross Country: Lower acute injury rates (~1.5 per 1,000 AEs), but overuse injuries account for more than 60% of all injuries. Shin splints and stress fractures are especially common, particularly in girls (as high as 19.2 per 10,000 AEs in girls’ cross country).
Volleyball: Frequent ankle sprains and overuse shoulder pain. Jumping and repetitive overhead movements strain both lower extremities and shoulders.
Tennis & Field Hockey: Shoulder overuse, wrist injuries, and shin splints are common.
The lower extremity is by far the most affected region: around 50% of all high school sports injuries involve the ankle, knee, or leg.
How Long Do These Injuries Keep Athletes Out?
Ankle sprains: 1–3 weeks, but 20–30% become chronic if not properly rehabilitated.
Shin splints: 2–6 weeks, can progress to stress fractures if ignored.
ACL tears: 9–12 months, and only 65% of athletes return to their pre-injury level of play.
Concussions: Recovery varies widely; return-to-play protocols often last 1–3 weeks.
These numbers highlight why early recognition and appropriate care are so important.
5 Proven Strategies to Prevent Early-Season Injuries
1️⃣ Dynamic Warm-Ups (Not Just Static Stretching)
Neuromuscular training–based warm-up programs can decrease musculoskeletal injury risk by over 35% in youth team sports.
Dynamic stretching improves performance by about 1.3%, while static stretching (especially when held for more than 60 seconds) can reduce performance by 3–4%.
Programs like FIFA 11+ (for soccer) cut ACL injury risk by up to 50%.
➡️ Takeaway: Dynamic warm-ups with agility, balance, and stability drills are non-negotiable for injury prevention.
2️⃣ Gradually Increase Training Intensity
The American Academy of Pediatrics recommends advancing training loads by no more than 10–20% per week.
A sudden spike in workload (acute:chronic workload ratio >1.5) is strongly associated with higher injury risk, especially in running sports.
➡️ Takeaway: Coaches and parents should monitor practice hours and intensity increases carefully.
3️⃣ Prioritize Recovery (Sleep + Nutrition)
Adolescent athletes average only 6.3 hours of sleep per night, well below the recommended 8–10 hours.
Athletes sleeping <8 hours per night are 1.7 times more likely to suffer an injury.
Adequate nutrition and hydration accelerate muscle repair, improve performance, and lower injury rates.
➡️ Takeaway: Sleep and diet are as important as drills and weights in preventing injuries.
4️⃣ Don’t Push Through Pain
Athletes reporting preseason musculoskeletal pain are 3.5 times more likely to sustain a new injury during the season.
Ignoring pain often leads to chronic conditions like stress fractures, tendinitis, or ligament injuries.
➡️ Takeaway: Pain that lingers beyond a few days should always be evaluated.
5️⃣ Preseason or Early-Season Checkups
Up to 26% of student athletes report pain at the start of a season.
Functional movement testing can identify athletes at risk: poor movement scores are linked to a higher likelihood of knee and ankle injuries.
Both the American Academy of Pediatrics (AAP) and the American College of Sports Medicine (ACSM) recommend preseason evaluations as a key injury prevention strategy.
➡️ Takeaway: A preseason evaluation can mean the difference between a full season and one cut short by injury.
For Parents: Red Flags to Watch For
Parents are often the first to notice when something isn’t right. Warning signs include:
Limping or obvious compensation during walking or running.
Pain every time the athlete practices.
Swelling in a joint that persists despite ice and rest.
Complaints of “nagging pain” in the shin, knee, or ankle.
🚨 These are all reasons to seek sports medicine evaluation immediately, not just “normal soreness.”
Case Example
A 15-year-old cross country runner develops shin pain two weeks into practice. She continues running through the pain, assuming it’s “just shin splints.” By mid-season, she develops a stress fracture, missing the rest of the season.
➡️ With early recognition, gait evaluation, and training load modification, her season could have been saved.
This is a common scenario — and one CCSRM aims to prevent.
The Role of Sports Medicine Specialists at CCSRM
At Columbus Center for Sports and Regenerative Medicine, we focus on keeping athletes in the game with minimal downtime. Our approach includes:
Evidence-based rehab tailored to the specific demands of each sport.
Orthobiologics when appropriate, such as PRP (platelet-rich plasma), which may accelerate recovery in tendon and ligament injuries.
Sports physicals that go beyond paperwork — we screen for prior injuries and movement patterns that could impact the upcoming season.
Frequently Asked Questions (FAQ)
Q: Can my child play with mild pain?
👉 Mild soreness after new activity is normal. But pain that persists or worsens with play needs medical evaluation.
Q: How soon after an ankle sprain can my child return to sport?
👉 Minor sprains may recover in 1–3 weeks with proper care. But rushing back increases the risk of re-injury and chronic instability.
Q: What if my child had an injury last season?
👉 Prior injuries are the #1 predictor of future injury. A preseason checkup is especially important for these athletes.
📣 Call to Action
Don’t let preventable injuries derail your athlete’s season. At CCSRM, we provide:
✅ Quick, stress-free sports physicals ($65 flat rate).
✅ Comprehensive injury screenings and movement assessments.
✅ Advanced treatments to keep athletes safe, strong, and competitive.
📅 Schedule your appointment today and give your child the best chance at a safe and successful season.
References
Prieto-González P, Martínez-Castillo JL, Fernández-Galván LM, et al. Epidemiology of Sports-Related Injuries and Associated Risk Factors in Adolescent Athletes: An Injury Surveillance. Int J Environ Res Public Health. 2021;18(9):4857. doi:10.3390/ijerph18094857.
Team Physician Consensus Statement. Selected Issues in Injury and Illness Prevention. Med Sci Sports Exerc. 2016;48(1):159-171. doi:10.1249/MSS.0000000000000827.
Post EG, Simon JE, Robison H, Morris SN, Bell DR. Epidemiology of Overuse Injuries in US Secondary School Athletics, 2014–2019. J Athl Train. 2022;57(5):510-516. doi:10.4085/1062-6050-600-20.
Adirim TA, Cheng TL. Overview of Injuries in the Young Athlete. Sports Med. 2003;33(1):75-81. doi:10.2165/00007256-200333010-00006.
Brenner JS, Watson A. Overuse Injuries, Overtraining, and Burnout in Young Athletes. Pediatrics. 2024;153(2):e2023065129. doi:10.1542/peds.2023-065129.
Emery CA, Pasanen K. Current Trends in Sport Injury Prevention. Best Pract Res Clin Rheumatol. 2019;33(1):3-15. doi:10.1016/j.berh.2019.02.009.
Behm DG, Alizadeh S, Daneshjoo A, Konrad A. Potential Effects of Dynamic Stretching on Injury Incidence: A Narrative Review. Sports Med. 2023;53(7):1359-1373. doi:10.1007/s40279-023-01847-8.
Behm DG, Blazevich AJ, Kay AD, McHugh M. Acute Effects of Muscle Stretching: A Systematic Review. Appl Physiol Nutr Metab. 2016;41(1):1-11. doi:10.1139/apnm-2015-0235.
Team Physician Consensus Statement. Load, Overload, and Recovery in the Athlete. Med Sci Sports Exerc. 2019;51(4):821-828. doi:10.1249/MSS.0000000000001910.
DiFiori JP, Benjamin HJ, Brenner J, et al. Overuse Injuries and Burnout in Youth Sports: Position Statement. Clin J Sport Med. 2014;24(1):3-20. doi:10.1097/JSM.0000000000000060.
Team Physician Consensus Statement. Select Issues in Pain Management for Youth Athletes. Med Sci Sports Exerc. 2020;52(9):2037-2046. doi:10.1249/MSS.0000000000002333.
Herring SA, Putukian M, Kibler WB, et al. Return to Sport/Return to Play: Team Physician Consensus Statement – 2023 Update. Med Sci Sports Exerc. 2024;56(5):767-775. doi:10.1249/MSS.0000000000003371.
Ahmed F. Khan, MD, CAQSM
CCSRM - Columbus Center for
Sports and Regenerative Medicine