Most injuries - more than 60 percent - occurred during practice, not in games. Kamehameha Schools and Mililani High, which took part in the survey, reflected the national trend, based on data collected from 123 schools nationwide.
The three-year national study is the first of its kind conducted by the National Athletic Trainers Association since 1986-88. This is the first of three yearly reports.
Trainers said the reason why practice accounts for most injuries - all resulting in the loss of at least one day of practice or play - is that players spend considerably more time on the practice field than the playing field.
"Players tend to get injured when they're not giving 100 percent, and in practice, they tend to slack off more than they do in a game situation," said Mililani head coach James Millwood.
Kamehameha's certified trainer, Cindy Clivio, said one of the keys to reducing practice injuries is to reduce contact drills.
"The current thinking among progressive coaches is to do less hitting during practices," she said. "This keeps the players 'hungry' for games."
Clivio said Kamehameha has reduced its contact in practice sessions over the past few years. Millwood also only holds full-contact intrasquad scrimmages on Tuesdays.
Aiea head coach Wendell Say said he's also been requiring less contact in practice the past few years and it doesn't seem to be affecting his players' aggressiveness.
"I think they're just as aggressive," said Say. "It's not like when I was playing and we had to get 100 hits on either shoulder every day."
The survey indicated that in games, an offensive player is substantially more at risk than a defensive player.
About 55.5 percent of injuries were suffered by offensive players and 35.8 percent by defenders. Special teams players received 4.3 percent of the injuries.
Conditioning and properly fitted equipment are the most basic means to prevent injury.
"Although not scientifically proven, I believe a year-round, or preseason strength and conditioning program will help reduce the risk of injury," said Mililani's Troy Furutani, one of 15 nationally certified trainers assigned to public high schools in Hawaii.
But there are some optional safety devices that some trainers strongly advocate.
Glenn Beachy, Punahou's trainer, said that 20.3 percent of the injuries reported to him pertain to the ankle, and he now encourages his players to wear a prophylactic ankle brace that has proved very effective.
He said the reason why Punahou and other schools continue to have substantial ankle injuries is that players are not inclined to strap on the preventive brace.
"They think it's going to slow them down," he said. "But studies have found they lose only about a quarter of an inch in vertical jump and maybe a tenth of second in the 40-yard dash."
The braces cost $25 apiece.
Clivio said Kamehameha had five concussions and three of those were suffered by two quarterbacks playing at Aloha Stadium. She said the impact of the quarterback's head hitting the artificial turf, which rests upon a hard surface, caused the concussions.
Kamehameha played all but one of its 10 Interscholastic League of Honolulu games at Aloha Stadium, while Mililani played only one of its games there.
Asked if she thinks quarterbacks deserve more protection for their heads, Clivio said yes.
"As a trainer, of course I think quarterbacks should be protected," she said. "There is a Pro Cap that's used by some in the NFL. But I think players would be hesitant to wear it because it is a huge layer of foam on top of the helmet."
The hip/thigh/leg area continued to lead in nationwide frequency of injuries (17.3 percent).
Kamehameha reported 15.1 percent of its 179 injuries in that area. But the Trojans' most often injured area was the knee (24 percent). The team had three anterior cruciate ligament ruptures and one medial collateral ligament sprain.
"I think knee injuries are cyclical," said Punahou's Beachy. "We had two anterior cruciate ligament injuries which were our first in three years."
One, a non-contact, season-ending injury to Afatia Thompson, occurred at the stadium. Thompson nonetheless won the ILH rushing title and later signed a letter of intent to play for the University of Hawaii.
Next on the national hit list was the forearm/wrist/hand area, which accounted for 15 percent of injuries. The Kamehameha and Mililani figures were almost identical in this area.