Football causes the most injuries of any youth and high school sport in the United States, with an injury rate of 3.96 per 1,000 athlete exposures. That’s roughly 50% higher than the next closest sport, girls’ soccer, which comes in at 2.65. But the full picture depends on whether you’re counting total injuries, specific injury types, or adjusting for how many people play each sport.
Football Leads by a Wide Margin
A national surveillance study tracking 100 representative high schools from 2015 to 2019 found that boys’ football had the highest injury rate across nine major sports. At 3.96 injuries per 1,000 athlete exposures (one athlete participating in one practice or game), football outpaced girls’ soccer (2.65) and boys’ wrestling (2.36). Boys’ sports overall had higher injury rates than girls’ sports.
Football’s dominance in injury statistics comes from a combination of factors: the sport is full-contact by design, involves high-speed collisions between large athletes, and has enormous participation numbers. Those participation numbers matter. When you look at raw emergency department visits rather than per-athlete rates, football still tops the list, but sports like basketball close the gap simply because so many kids play them.
Concussions Tell a Similar Story
The CDC ranks boys’ tackle football as the youth sport with the highest concussion rate per 1,000 athletic exposures. Tackling alone accounts for 63% of concussions in high school football. The full top-ten list for concussion rates runs: boys’ tackle football, girls’ soccer, boys’ lacrosse, boys’ ice hockey, boys’ wrestling, girls’ lacrosse, girls’ field hockey, girls’ basketball, boys’ soccer, and girls’ softball.
For head injuries specifically, football drives the most emergency department visits among children under 18. Between 2010 and 2016, football accounted for an estimated 53,657 annual ER visits for traumatic brain injuries in young athletes. Basketball was next at 29,675, followed by bicycling at 25,955 and soccer at 23,847.
Collision sports as a category carry the highest concussion risk. A large meta-analysis covering 21 sports found that collision sports like football, rugby, and ice hockey had significantly higher concussion rates than limited-contact or non-contact sports. Competition also ramps up the danger: concussion rates are markedly higher during games than in practice across nearly every sport studied.
Girls’ Soccer and Basketball Carry Hidden Risks
Girls’ soccer consistently ranks second behind football for both overall injury rates and concussion rates. That surprises many people, since soccer isn’t typically thought of as a collision sport. But heading the ball, player-to-player contact during challenges, and falls create a steady stream of injuries. Among girls who play high school basketball, 51% of concussions result from colliding with another athlete.
Female athletes also face a disproportionate risk of knee ligament tears, particularly to the ACL. Female soccer players tear their ACL at roughly 2.7 to 5.5 times the rate of male soccer players. A six-season study found ACL injury rates of 1.06% per season in female players compared to 0.38% in males. The reasons are partly biomechanical: differences in hip alignment, landing mechanics, and muscle activation patterns all contribute.
Cheerleading and Cycling Are Underestimated
Cheerleading doesn’t always make traditional sports injury lists because it isn’t classified as a sport in every state. But nearly all concussions among high school cheerleaders are linked to stunts like tosses and lifts, and most of these happen during practice rather than performances. Many cheerleaders who suffered concussions during stunts didn’t have a spotter present.
Cycling is another outlier. A survey of nearly 1,000 competitive cyclists found that 23.8% had experienced at least one concussion. That’s a strikingly high number for a non-contact sport, and it places cycling among the activities with the highest concussion percentages overall. Because cycling injuries tend to involve hitting pavement or obstacles at speed, the severity of individual crashes can rival or exceed what happens on a football field.
Overuse vs. Acute Injuries Change the Rankings
Not all sports injuries come from a single dramatic moment. About 29% of injuries among competitive college athletes are classified as overuse, meaning they develop gradually from repetitive stress rather than a specific hit or fall. The remaining 71% are acute injuries from sudden contact, twisting, or impact.
Football has the highest ratio of acute to overuse injuries, with a relative risk of 8.35 for acute injuries compared to baseline. That makes sense for a collision sport. On the other end, sports like rowing have a much lower acute injury burden because their injuries are almost entirely overuse: stress fractures, tendinitis, and chronic back pain from repetitive motion. Sports like swimming and baseball fall somewhere in between, with shoulder and elbow problems developing slowly over months or years of throwing and stroking.
This distinction matters because overuse injuries are often preventable through workload management and rest, while acute injuries in contact sports are harder to eliminate without fundamentally changing how the game is played.
What Drives the Numbers
When comparing sports, it helps to separate three different questions: which sport injures the most people total, which sport has the highest injury rate per participant, and which sport produces the most severe injuries. Football wins on all three counts in the United States, but the runners-up shift depending on the measure. Basketball generates enormous raw injury numbers because of its massive participation base, even though its per-athlete rate is moderate. Rugby and ice hockey have high per-athlete rates but smaller player pools. Individual activities like cycling and skiing produce fewer injuries overall but can be devastating when crashes occur.
Age also plays a role. Younger athletes are still developing coordination and strength, which increases injury risk in any sport. But collision sports compound that vulnerability because growing bones, developing brains, and immature neck muscles are less equipped to absorb repeated impacts. This is why youth football injury prevention programs have increasingly focused on limiting full-contact practices and teaching safer tackling techniques.