Strains and sprains are the most common injuries among Hawke's Bay school students, with school injuries on the rise nationwide.
Figures released by ACC under the Official Information Act show Hawke's Bay students made 3005 claims for injuries at school in the last calendar year, up from 2981 in 2012.
Fractures, lacerations or stings, and soft tissue injuries such as sprains were the top three injury categories, with local injury claim costs tallying $650,000.
A national teachers union warns that unsafe physical environments are putting students at risk of further injuries at school.
Nationally there were more than 77,453 student injuries in the past year, an increase on 71,753 in 2012, costing taxpayers almost $16.5 million.
More boys were injured than girls, 46,055 compared to 31,398.
An ACC spokeswoman said the figures were not specific to school hours, school terms or to school pupils, and likely to include people using school grounds for weekend sport or other school facilities for unrelated activities.
Just-released Education Ministry figures show 755,204 students from Year 1 to 13 are heading back to school across the country, with 28,833 of those in Hawke's Bay.
Te Mata School principal Michael Bain, in Havelock North, said he used to see a lot of broken arms among students, when too many climbed on playground equipment at once.
But rates had dropped to three or four a year since the school invested in more playgrounds several years ago.
There were always one or two broken arms at the start of the year as junior students who had moved up to senior classes tried out the senior playground equipment, he said.
Normally by the end of the first week students were all "a bit knackered" and needed a few icepacks.
Mr Bain said boys were probably more likely to injure themselves than girls during rugby or soccer.
Most student injuries were "sticking plaster or bee sting" injuries.
"That's just largely tired kids falling over."
Most injuries occurred at lunchtime.
He was surprised by the rising ACC statistics, as schools tried hard to keep children safe.
His own school had just spent $75,000 on safety matting and carried out monthly playground maintenance checks.
Post Primary Teachers Association (PPTA) president Angela Roberts said the national injury figures created more questions than answers.
"Schools are struggling to provide a physically safe environment. Large classes, leaky, mouldy or poorly maintained buildings are placing increasing pressure on school resources and could certainly lead to more injuries.
"Whether or not these injuries are accident or behaviour-related is something figures like these don't reveal so there are a lot of interesting questions to be asked."
Ministry of Education head of education infrastructure services Kim Shannon refuted Ms Roberts' comments and said the ministry was unaware of any child having been injured in relation to weathertightness issues in New Zealand schools.
"All New Zealand schools have safe, healthy environments.
"Of our stock of 29,000 school buildings, as at July 2013 there were approximately 1000 buildings we have identified as needing repair to address weathertightness issues. That is approximately 3 per cent of our total building stock."
In New Zealand, injuries are the major cause of hospitalisation and death for school-aged children, and ACC has specific programmes for high school students to learn about reducing accidents.
According to the ACC figures, the biggest causes of injury to pupils were strains and sprains, resulting in 46,074 claims at $8,137,175.