Prevention of sports injuries in children at school: a systematic review of policies.

Background: Participation in sports as a child improves physical and psychological health. Schools need to promote sport while protecting against injury. It is not clear whether increasing evidence on injury prevention generated from professional sport is influencing school sports practices. This study reviewed policies promoting sport safety in schools to determine whether exposure to injury risk is recognised and whether evidence based prevention and management are included.

Methods: A search strategy to identify policies for children aged 4-18 years was applied to electronic databases and grey literature sources. Safeguarding policies were excluded. Included policies were critically appraised and synthesised using modified framework analysis.

Results: Twenty-six policies were analysed. Most (57.7%) were from the USA. Ten (38.5%) focused solely on concussion. Synthesis identified primary, secondary and tertiary injury prevention measures relating to people (staff, students and parents), systems, school physical environment and national-level factors.

Conclusions: Robust, evidence-based policies for reducing injury risk in school sports are limited. Guidelines with the largest evidence base were focused on concussion, with other school sport guidelines showing limited inclusion of evidence. Where included, evidence focused on injury management rather than prevention and frequently applied evidence from adult to children. Guidance was not specific to the child's age, gender or developmental stage.