Wrestling holds worldwide popularity, and large numbers of United States high school and college males participate. However, the sport`s arduous nature results in high injury rates. Hypothesis: Wrestling injury rates and patterns will differ between high school and college practice and match exposures. Study Design: Descriptive epidemiology study. Methods: Wrestling-related injury data were collected during the 2005-2006 academic year from 74 nationally representative high schools via High School Reporting Information Online (RIO) and from 15 Division I, II, and III colleges via the National Collegiate Athletic Association Injury Surveillance System. Results: Certified athletic trainers reported 387 injuries among participating high school wrestlers during 166 279 athlete-exposures, for an injury rate of 2.33 injuries per 1000 athlete-exposures. Nationally, high school wrestlers sustained an estimated 99 676 injuries and 8741 skin infections during the 2005-2006 season. In college, 258 injuries occurred among participating wrestlers during 35 599 athlete-exposures, for an injury rate of 7.25 injuries per 1000 athlete-exposures. The injury rate per 1000 athlete-exposures was higher in college than high school (rate ratio [RR] = 3.11, 95% confidence interval [CI]: 2.66-3.64) and was higher in matches than in practice in high school (RR = 2.12, 95% CI: 1.73-2.59) and college (RR = 5.07, 95% CI: 3.96-6.50). Diagnoses in greater proportions of college wrestlers included lacerations (injury proportion ratio [IPR] = 5.98, 95% CI: 2.27-15.74) and cartilage injuries (IPR = 2.69, 95% CI: 1.26-5.74). Body parts injured in greater proportions of high school wrestlers included elbow (IPR = 3.90, 95% CI: 1.66-9.14) and hand (IPR = 2.59, 95% CI: 1.21-5.54). Almost half of all injured high school (44.9%) and college (42.6%) wrestlers resumed wrestling within <1 week. Skin infections represented 8.5% and 20.9% of all reported high school and college events, respectively, and frequently affected the head/face/neck (50.0%).
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