Kickball and Its Underappreciated Pediatric Injury Burden: An 18-Year Retrospective Epidemiological Study

Abstract

Background: Kickball is a popular childhood game most frequently played during gym class or recess at schools throughout the United States (US). Despite this, the national health burden of injuries associated with kickball has never been explored in the US pediatric population. Purpose: To report national estimates and demographic characteristics of pediatric patients presenting to US emergency departments between 2000 and 2017 with kickball-associated injuries. Study Design: Descriptive epidemiology study. Methods: This study retrospectively analyzed the National Electronic Injury Surveillance System (NEISS) database (2000-2017) to identify annual cases of injuries associated with playing kickball presenting to US emergency departments in the pediatric population (age ≤18 years). Results: On average, 10,644 (95% CI, 8671-12,618) pediatric kickball-associated injuries presented to US emergency departments each year. There was no significant change in the number of injuries between the years 2000 (n = 10,331; 95% CI, 7781-12,881) and 2017 (n = 9407; 95% CI, 7233-11,582) ( P = .64). Patients frequently sustained sprains, strains, or muscle tears (34.4%; 95% CI, 32.4%-36.5%) and fractures (24.8%; 95% CI, 23.1%-26.5%); these injuries most commonly affected the ankle (13.7%; 95% CI, 12.2%-15.2%) and the fingers of the hand (17.1%; 95% CI, 15.5%-18.7%). The greatest proportion of injuries occurred in male patients (60.7%; 95% CI, 58.7%-62.7%) who were 10 to 12 years of age (44.8%; 95% CI, 43.0%-46.6%), with over half of kickball-associated injuries occurring at school (54.1%; 95% CI, 50.7%-57.5%). Conclusion: Despite kickball’s ubiquity as a schoolyard game, its associated injuries remain largely underappreciated. This is particularly unjustified when considering that the annual pediatric injury burden associated with playing kickball surpasses that of other sports acknowledged as carrying a high injury risk, such as martial arts or tennis.