Western Cape High School Injury Tracking Survey
| dc.contributor.advisor | Swart, Jeroen | |
| dc.contributor.advisor | Held, Michael | |
| dc.contributor.author | Hoeks, Lynelle | |
| dc.date.accessioned | 2026-06-22T07:56:18Z | |
| dc.date.available | 2026-06-22T07:56:18Z | |
| dc.date.issued | 2026 | |
| dc.date.updated | 2026-06-22T07:54:29Z | |
| dc.description.abstract | Background: Regular physical activity through organised school sports has far-reaching health benefits for adolescents. However, participation in sports may result in injury. Sports injuries are the main cause of injury in this population group and are a significant contributing factor to both the low adolescent sports participation numbers and the high attrition rate during these years. To reduce injury incidence rates, these first need to be quantified accurately through large injury surveillance systems that are standardised for comparative and scientific sharing purposes, are of high quality and allow for ease of access to the sports science research field. Internationally there is a distinct lack of these databases for adolescent, non-elite sport and the South African landscape of injury surveillance mirrors this situation. South African adolescent sports injury incidence rates overall, and across sporting codes, are poorly reported and understood, which may put our youth at risk and at a distinct disadvantage regarding the development and implementation of injury prevention programmes. Aim: To collect high-quality injury data across various sporting codes and socio-economic profiles to determine sports injury incidence rates for adolescents attending Western Cape high schools. In addition, the objective was to provide additional information on the injuries sustained and potential risk factors involved. This study aimed to support the development of an ongoing longitudinal sports injury surveillance database in South Africa that will provide epidemiological information and injury incidence rates which can be used to motivate for and support targeted injury prevention programmes and drive policy development to reduce injury rates. 8 Study Design: Prospective descriptive cohort. Methodology: Private and government schools in the Western Cape region, South Africa, were approached to participate in the study. Three schools enrolled in the study. Exposure-based injury data from participating teams in the sporting codes rugby, football and cricket were reported between 2019–2023 for male and female adolescent learners. Coaches, teachers or dedicated medical staff recorded the injuries and exposure time information to provide injury incidence rates overall, in practice and in competition. A sports injury in this study was defined as any physical dysfunction or soft tissue damage that occurred during organised school sport — acute or repetitive in nature — and included injuries that did not cause time loss from participation in activity. Injury details were recorded to identify potential risk factors such as phase of play, mode and mechanism of injury and playing position, as well as information on injury type, site and severity in time loss. These definitions and data parameters were based on recommendations from the IOC consensus statement for recording and reporting sports injuries (Bahr et al.). Results: An overall injury incidence rate of 4.31 / 1 000 athlete-exposure hours was established, with competition injury incidence being significantly higher than practice rates: 28.78 / 1 000 and 1.18 / 1 000 respectively. Contact and collision sports had higher injury incidences, with rugby match injury rates being similar to those found in professional leagues at 85.98 / 1 000 athlete-exposure hours. Injury patterns showed statistically significantly increased risk during competition (p < 0.001), and through acute mode ( p < 0.001) and direct contact mechanisms (p < 0.001). The lower limb was the most injured region with 42.31% of overall injuries recorded and the shoulder the most at-risk joint overall, at 25.64% of all injuries. Joints and ligaments were the most susceptible structures, contributing to 29.75% of all injuries. Injuries that resulted in time loss from sports predominated, 70.51%, and these were mostly moderate in severity with 8–28 days off. 9 Results were heavily influenced by rugby data which contributed to the majority of the documented injuries (68 of the 78 total recorded) and the lack of variety in participating sporting codes, which may influence the high incidence rates in this study. Rugby-specific findings saw strong associations between player position and injury patterns. Forwards sustained more upper limb (p < 0.05), shoulder (p < 0.05), knee (p < 0.001) and ankle (p < 0.05) injuries and this position was strongly associated with injuries to joint and ligamentous structures (p = 0.014). Back line players were more susceptible to muscular injuries (p < 0.001) and injuries of the calf (p < 0.001) area. Conclusion: This study investigated the incidence, patterns, and risk factors of sports injuries among nonelite adolescent athletes in three Western Cape high schools. The overall injury rate was 4.31 / 1 000 athlete-exposure hours, with higher rates observed during matches compared to practices. Rugby exhibited the highest match-related injury rate (85.99 / 1 000 athlete exposure hours), comparable to professional levels, while football and cricket also displayed notable injury rates. Time-loss injuries, particularly in the moderate category (requiring 8–28 days of recovery), were common across all sports, with joint and ligament injuries in the lower limbs being the most prevalent. The findings highlight the need for larger longitudinal injury surveillance systems to establish reliable injury incidence rates and provide in depth epidemiological information on adolescent sports injury. This information is vital to establish and guide sports policy related to targeted injury prevention strategies and sport-specific conditioning programmes to reduce injury rates and severity, and promote sustained sports participation among adolescents. Clinical Relevance: Sports science research and provincial / national government should invest resources into establishing and managing an Injury Surveillance database for longitudinal studies investigating adolescent sports injuries across all sporting codes and socio-economic groups in South Africa to provide insights which may inform practices to reduce injury rates and mitigate risk factors and ultimately uplift the universal health of this vulnerable population group. | |
| dc.identifier.apacitation | Hoeks, L. (2026). <i>Western Cape High School Injury Tracking Survey</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Human Biology. Retrieved from http://hdl.handle.net/11427/43338 | en_ZA |
| dc.identifier.chicagocitation | Hoeks, Lynelle. <i>"Western Cape High School Injury Tracking Survey."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Human Biology, 2026. http://hdl.handle.net/11427/43338 | en_ZA |
| dc.identifier.citation | Hoeks, L. 2026. Western Cape High School Injury Tracking Survey. . University of Cape Town ,Faculty of Health Sciences ,Department of Human Biology. http://hdl.handle.net/11427/43338 | en_ZA |
| dc.identifier.ris | TY - Thesis / Dissertation AU - Hoeks, Lynelle AB - Background: Regular physical activity through organised school sports has far-reaching health benefits for adolescents. However, participation in sports may result in injury. Sports injuries are the main cause of injury in this population group and are a significant contributing factor to both the low adolescent sports participation numbers and the high attrition rate during these years. To reduce injury incidence rates, these first need to be quantified accurately through large injury surveillance systems that are standardised for comparative and scientific sharing purposes, are of high quality and allow for ease of access to the sports science research field. Internationally there is a distinct lack of these databases for adolescent, non-elite sport and the South African landscape of injury surveillance mirrors this situation. South African adolescent sports injury incidence rates overall, and across sporting codes, are poorly reported and understood, which may put our youth at risk and at a distinct disadvantage regarding the development and implementation of injury prevention programmes. Aim: To collect high-quality injury data across various sporting codes and socio-economic profiles to determine sports injury incidence rates for adolescents attending Western Cape high schools. In addition, the objective was to provide additional information on the injuries sustained and potential risk factors involved. This study aimed to support the development of an ongoing longitudinal sports injury surveillance database in South Africa that will provide epidemiological information and injury incidence rates which can be used to motivate for and support targeted injury prevention programmes and drive policy development to reduce injury rates. 8 Study Design: Prospective descriptive cohort. Methodology: Private and government schools in the Western Cape region, South Africa, were approached to participate in the study. Three schools enrolled in the study. Exposure-based injury data from participating teams in the sporting codes rugby, football and cricket were reported between 2019–2023 for male and female adolescent learners. Coaches, teachers or dedicated medical staff recorded the injuries and exposure time information to provide injury incidence rates overall, in practice and in competition. A sports injury in this study was defined as any physical dysfunction or soft tissue damage that occurred during organised school sport — acute or repetitive in nature — and included injuries that did not cause time loss from participation in activity. Injury details were recorded to identify potential risk factors such as phase of play, mode and mechanism of injury and playing position, as well as information on injury type, site and severity in time loss. These definitions and data parameters were based on recommendations from the IOC consensus statement for recording and reporting sports injuries (Bahr et al.). Results: An overall injury incidence rate of 4.31 / 1 000 athlete-exposure hours was established, with competition injury incidence being significantly higher than practice rates: 28.78 / 1 000 and 1.18 / 1 000 respectively. Contact and collision sports had higher injury incidences, with rugby match injury rates being similar to those found in professional leagues at 85.98 / 1 000 athlete-exposure hours. Injury patterns showed statistically significantly increased risk during competition (p < 0.001), and through acute mode ( p < 0.001) and direct contact mechanisms (p < 0.001). The lower limb was the most injured region with 42.31% of overall injuries recorded and the shoulder the most at-risk joint overall, at 25.64% of all injuries. Joints and ligaments were the most susceptible structures, contributing to 29.75% of all injuries. Injuries that resulted in time loss from sports predominated, 70.51%, and these were mostly moderate in severity with 8–28 days off. 9 Results were heavily influenced by rugby data which contributed to the majority of the documented injuries (68 of the 78 total recorded) and the lack of variety in participating sporting codes, which may influence the high incidence rates in this study. Rugby-specific findings saw strong associations between player position and injury patterns. Forwards sustained more upper limb (p < 0.05), shoulder (p < 0.05), knee (p < 0.001) and ankle (p < 0.05) injuries and this position was strongly associated with injuries to joint and ligamentous structures (p = 0.014). Back line players were more susceptible to muscular injuries (p < 0.001) and injuries of the calf (p < 0.001) area. Conclusion: This study investigated the incidence, patterns, and risk factors of sports injuries among nonelite adolescent athletes in three Western Cape high schools. The overall injury rate was 4.31 / 1 000 athlete-exposure hours, with higher rates observed during matches compared to practices. Rugby exhibited the highest match-related injury rate (85.99 / 1 000 athlete exposure hours), comparable to professional levels, while football and cricket also displayed notable injury rates. Time-loss injuries, particularly in the moderate category (requiring 8–28 days of recovery), were common across all sports, with joint and ligament injuries in the lower limbs being the most prevalent. The findings highlight the need for larger longitudinal injury surveillance systems to establish reliable injury incidence rates and provide in depth epidemiological information on adolescent sports injury. This information is vital to establish and guide sports policy related to targeted injury prevention strategies and sport-specific conditioning programmes to reduce injury rates and severity, and promote sustained sports participation among adolescents. Clinical Relevance: Sports science research and provincial / national government should invest resources into establishing and managing an Injury Surveillance database for longitudinal studies investigating adolescent sports injuries across all sporting codes and socio-economic groups in South Africa to provide insights which may inform practices to reduce injury rates and mitigate risk factors and ultimately uplift the universal health of this vulnerable population group. DA - 2026 DB - OpenUCT DP - University of Cape Town KW - school sports KW - sports injury LK - https://open.uct.ac.za PB - University of Cape Town PY - 2026 T1 - Western Cape High School Injury Tracking Survey TI - Western Cape High School Injury Tracking Survey UR - http://hdl.handle.net/11427/43338 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/43338 | |
| dc.identifier.vancouvercitation | Hoeks L. Western Cape High School Injury Tracking Survey. []. University of Cape Town ,Faculty of Health Sciences ,Department of Human Biology, 2026 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/43338 | en_ZA |
| dc.language.iso | en | |
| dc.language.rfc3066 | Eng | |
| dc.publisher.department | Department of Human Biology | |
| dc.publisher.faculty | Faculty of Health Sciences | |
| dc.publisher.institution | University of Cape Town | |
| dc.subject | school sports | |
| dc.subject | sports injury | |
| dc.title | Western Cape High School Injury Tracking Survey | |
| dc.type | Thesis / Dissertation | |
| dc.type.qualificationlevel | Masters | |
| dc.type.qualificationlevel | MPhil |