As teens start back-to-school sports, a study shows an alarming number of athletes play injured as a result of dirty hits.


Safe Kids Worldwide conducted research exploring the culture of youth sports.


The survey featured input from 1,000 student-athletes, 1,000 parents of student-athletes, and 1,000 coaches.


The report shows one in four young athletes reported it is normal to commit hard fouls and play rough to "send a message" during a game.


This apparently leads to a large number of injuries, with 33 percent of athletes reporting they have been hurt as a result of dirty play from an opponent.


Forty-two percent of players reported they have hidden or downplayed an injury in order to keep playing.


And, fifty percent of coaches surveyed say they've been pressured by parents to keep injured kids in the game.


Safe Kids Worldwide recommends setting ground rules at the beginning of the season to agree on a team's approach to preventing injuries.


Experts recommend encouraging athletes to speak up when they're injured and removing injured athletes from play.