Version July 2025
| The STAR score provides a quantative assessment of the risk for overuse injury among youth, adolescent, and young adult athletes. Score range: 8 to 24
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| Assessment with range 1 to 3 points | Questions for patient/family | 1 point awarded | 2 points awarded | 3 points awarded |
| Overuse injury and severity | Do you have an injury currently or have you recently recovered from an injury? | No injury | Overuse injury (eg, muscle strain, tibial apophysitis) | Serious overuse injury (eg, bone stress injury/fracture) |
| Sports training ratio (ratio of formal training to free play) | How many hours per week do you practice your sport? How many hours of free play do you have each week? | 2:1 or lower | Higher than 2:1 (ie, minimal or no free play) | |
| Competition-to-training ratio (for primary sport) | How many hours per week do you play in formal games for your main sport? How many hours per week do you participate in team practices for your main sport? | 1:4 or higher | From 1:3 to 1:1 | Higher than 1:1 |
| Acute-to-chronic workload ratio (ratio of workload during current week or week before injury was sustained to average weekly training load) | How many hours did you train (practices plus games) this week (or the week before you were injured)? How many hours did you train on average each week during the most recent 4-week period when you were healthy? | 0.8 to 1.2 (ie, workload this week is consistent with typical week) | Less than 0.8 or from 1.3 to 1.5 | Higher than 1.5 (ie, workload is over 50% greater this week compared with typical week) |
| Percentage predicted adult height | >96% (ie, after adolescent growth spurt) | <85% (ie, before adolescent growth spurt) | 85 to 96% (ie, amidst adolescent growth spurt) | |
| Assessment with range 1 to 5 points | Questions for patient/family | 1 point awarded | 3 points awarded | 5 points awarded |
| Sport specialization category | (Refer to Jayanthi sport specialization table) | Low specialization | Moderate specialization | High specialization |
| Sport training load (hours per week compared with patient age) | How many hours per week do you participate in your main sport (practices plus games)? | Total hours ≤ Patient age | Total hours > Patient age | |
| Female sex | No | Yes | ||
