Abstract
Background:
The interscholastic sport of Girls Flag Football (GFF) has grown significantly in recent years. Despite its rising popularity, there is limited data regarding the distribution, onset, and mechanism of injuries sustained by GFF players over the course of a season. The purpose of this study was to describe the incidence and characteristics of injuries in this emerging sport.
Hypothesis:
Injury incidence, distributions, mechanisms, and onset characteristics for injuries sustained by GFF athletes will be comparable to injuries in other girl’s contact sports, such as soccer and lacrosse.
Methods:
Injury data were prospectively collected from 16 high schools in Florida and Wisconsin during the Spring 2025 GFF season. School personnel reported the onset and mechanisms for the injuries sustained by the players. Descriptive statistics were used to analyze injury patterns, while the injury incidence rates were calculated per 1000 exposures.
Results:
Participants included 374 players (Grades 9 – 12) who participated in a total of 10,014 exposures (practice = 6,132 [61%], competition = 3,882 [39%]). 23 players (6.1%) sustained a total of 25 injuries. The injury rate during competition was higher (p<0.001) than the injury rate in practice (competition=4.89/1000 exp., practice=0.86/1000 exp., RR=6.00 [IQR: 2.32, 15.50]. Nearly all (95.3%, n=24) were acute onset injuries while 83.3%, (n=20) were the result of contact with another player (75%, n=15) or the ground (25%, n=5). Injuries occurred most often to the Hand/Wrist/Fingers (25.0% n=6), Ankle (20.8%, n=5), Knee (12.5%, n=3) and Head (12.5%, n = 3) and most often consisted of Ligament sprains (33%.3, n=8), Contusions (33.3%, n=8), Concussions (8.3%, n=2), Fractures (8.3%, n=2) and Muscle-tendon strains (8.3%, n=2). Most injuries (62.5%, n=15) occurred while playing defense and were the result of attempting to de-flag the ball carrier (60%, n=9) and defending a pass (20%, n=3). The most common injuries occurred while playing offense (n=9) and were the result of attempting to catch the ball (44.4%, n=4) and running the ball (44.4%, n=4). Ten of the injuries (41.4%) resulted in the player being removed from the practice or competition while half (50%, n=12) required a referral to an ED or MD for additional evaluation and treatment.
Conclusion:
GFF is associated with a measurable injury burden, with contact-related mechanisms and defensive play posing the greatest risk. Further research and continued collaboration among medical professionals, athletes, and coaches is needed to develop targeted injury prevention strategies and to support the safe continued growth of this sport.