More than 26,000 people lodged claims for sporting injuries between July 2009 and June 2010, according to data released to the Otago Daily Times.
Soft-tissue damage, including strains and sprains, were the most common injuries, followed by fractures and dislocations, and lacerations and punctures.
Nationally, more than 340,000 people claimed ACC for sporting injuries, costing $356 million.
This is an increase on the 250,000 people who received compensation in 2005-06, when payouts totalled $216 million.
Leading Otago's top 10 sporting injuries list was rugby union, followed by skiing and snowboarding.
A spike in claims occurred during the main ski season between July and September.
Nationally, the injury list was led by a wide margin by rugby union, with 53,638 new claims and 12,580 players receiving ongoing assistance, costing $59 million.
Considering Otago's proximity to beaches, lakes and rivers, it is no surprise many residents partake in water sports and water-based activities.
Water-skiing was implicated in 262 new claims, boating in 166, surfing in 147, fishing in 115, and windsurfing in 23.
Cricket appears to be one of the least injury-prone sports in Otago. Only one or two new claims were made in the last financial year. Others low on the injury count were those involving ATVs (five), polo (seven), and hang-gliding (nine).
An ACC spokeswoman said top sports in terms of injury claims also had the highest participation rates as 145,000 people played rugby in 2009.
The organisation works with the New Zealand Rugby Union in an injury prevention programme called RugbySmart. It focuses on technique in contact, physical conditioning, encouraging the use of mouthguards and appropriate treatment and management of injuries.
It is compulsory for all coaches, including All Black coach Graham Henry, to attend RugbySmart workshops, and it has helped reduce the number of serious spinal and brain injuries in the sport from more than 10 to fewer than three a year.
Taieri rugby player Kurt Webster knows what it is like to suffer an injury on a rugby field.
The 29-year-old blindside flanker and lock ruptured his ACL knee-joint in 2009 when he was tackled in the second game of the season.
His knee was "pretty much dislocated entirely", which meant six weeks off work, nine months off exercise, and surgery.
ACC was "really good" throughout his treatment but accidents were just part of his sport and players had to "take it as it comes".
