Playing It Rough: How Injuries Hit High School Band Members

3 min read

Nov. 8, 2023 – Is marching band a sport? Believe it or not, band members get injuries similar to those in other sports, mainly to knees and ankles, as shown in a new study. 

Potential marching band-related injuries include not only soft tissue injuries, but also serious conditions such as mild traumatic brain injury or heat-related injury, according to Air Force Capt. Jacob R. Coene, MD, of Brooke Army Medical Center in San Antonio, TX.

“Unlike other organized athletics, there is [little] data on marching band injuries,” he said. “A better understanding of the injuries experienced by marching band members can be leveraged to implement injury prevention strategies and help keep marching band members safe.”

In a poster presented at the annual meeting of the American Academy of Pediatrics, Coene and colleagues used the National Electronic Injury Surveillance System (NEISS) database to search for emergency department visits by people 10 to 25 years of age that related to “marching” or “band.” The visits were grouped by age (10 to 13 years, 14 to18 years, and 19 to 25 years), sex, and body part. 

The researchers estimated there were 20,335 marching band injuries between 2012 and 2021 in the United States, based on 579 actual cases. Half of the injuries were in the lower extremities, with the most injured areas being the ankle and knee (18% for both), followed by the torso (10%). 

Most of the injuries (84%) were in high schoolers (ages 14 to 18 years) and 71% were in females. The most frequent major diagnoses were soft tissue injuries, mild traumatic brain injuries, heat-related injuries, and fractures, with population-based estimates of 10,891, 918, 875, and 763, respectively. 

Overall, 98% of the marching band injuries didn't require any more care beyond an emergency department visit, which suggests that many of these injuries could be prevented. But 16% were considered serious, including cases of mild traumatic brain injury, fractures, and heat-related injury, said Coene. 

He was surprised by the high rate of injury in females and high school students. 

“I do not have an explanation for the increased frequency of injuries in these groups versus males and collegiate-level students, and this is an exciting area for future study,” he said. 

“I was not surprised that lower-extremity soft tissue injuries were the most frequently observed diagnoses, as these are commonly observed injuries with physical activity and especially marching,” Coene noted, “but I was surprised by mild traumatic brain injury accounting for 6% of all diagnoses, and I am curious how marching band members obtain these injuries, as well as how they could be prevented or reduced.”

Cross-training for the band members may be as valuable as keeping their instruments in tune. When asked what marching band members can do to help prevent injuries, Coene advised exercises and neuromuscular training programs similar to those used in other organized athletics. 

“Implementing these programs within marching band could lead to injury reduction, but this will require further research,” he noted. 

Given the risk of mild traumatic brain injury observed, “education on mild traumatic brain injury could help band directors and marching band members recognize these injuries and know how to respond if they occur,” he said. 

Looking ahead, “additional research is needed to identify modifiable risk factors for marching band injury and to assess intervention strategies such as exercise or neuromuscular training programs on the reduction of marching band-related injury,” Coene said. 

The researchers were not able to examine all possible risk factors, including the marching surface, footwear, and the instrument played, which was a limitation of the study, Coene noted. Are tuba players more likely to have knee injuries than flutists? Are the girls on the drum line at greater risk for sprained ankles than the boys? Stay tuned for further studies.