Objective To investigate the injury rates and patterns associated with high school track and field running events, stratified by sex and athletic exposure. Design Descriptive epidemiology study. Setting United States high schools. Patients or Other Participants High school athletes participating in track and field running events. Main Outcome Measure(s) Data were obtained from the National High School Sports-Related Injury Surveillance System, High School Reporting Information Online, from 2008 to 2019. Data were analyzed for hurdles, sprints, and middle- and long-distance running events. Injury number, types, locations, and athlete demographics were analyzed across various track and field events. Results A total of 2629 injuries occurred during 5 486 279 AEs. Injury rates standardized to AEs were higher in competition than in practice (rate ratio [RR] = 2.13, 95% CI = 1.96, 2.31). Injury rates were higher for girls in practice (RR = 1.56, 95% CI = 1.41, 1.73), while boys had higher injury rates in competition (RR = 3.03, 95% CI = 2.68, 3.41). Injuries were most commonly located in the thigh (35.1%) and leg (19.8%). The most frequent injury type was muscle strain (42.2%). Recurrent injuries comprised a larger proportion of chronic injuries than new injuries (injury proportion ratio = 1.44, 95% CI = 1.28, 1.62). Sprints had the highest number of injuries (n = 1507), followed by middle and long distance (n = 712) and hurdles (n = 391). Concussions were most common in hurdles, tendonitis in middle- and long-distance running, and avulsions in sprints. Conclusions Injury types varied by event, highlighting the need for injury-prevention strategies tailored to the specific demands of each event. This study adds to the limited body of epidemiological research on track and field running injuries among high school athletes from 2008 to 2019. Key Points Running-related injuries in track and field predominantly affect the lower extremity, with muscle strains representing the most common injury pattern, particularly involving the proximal musculature. Injury mechanisms are most often noncontact and acute, although a substantial proportion are related to overuse, highlighting the dual contribution of high-intensity loading and cumulative training stress. Injury patterns vary by event discipline, with sprint-based activities more commonly associated with proximal muscle injuries, while middle- and long-distance events demonstrate a greater burden of distal overuse conditions.
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