The National Athletic Trainers Association (NATA) and National Collegiate Athletic Association (NCAA) have collaborated for 25 years to create the largest ongoing collegiate sports injury database in the world. In a special spring issue of the Journal of Athletic Training, the quarterly scientific publication of NATA, the studys lead authors and journal editors summarized 16 years (1988-1989 through 2003-2004) of critical injury surveillance information across 15 collegiate sports. This comprehensive information, collected by certified athletic trainers, has and will continue to shape key health and sports safety issues and further injury prevention research designed to improve athletic programs and the quality of the student athlete care.
Highlighted below are sport-specific results from the data and key recommendations from the report (www.nata.org/jat/readers/archives/42.2/i1062-6050-42-2-toc.pdf) to reduce the risk of injury. Consistent findings were that competition injury rates were higher than practice injury rates across all sports, and that preseason practice injury rates were higher that regular season practice injury rates. Overall collegiate sports participation has increased 80 percent among women and 20 percent among men during this time. Nationally, more than 380,000 student-athletes participate in NCAA sports that offer national championships. Participation rates below reflect varsity team increases or decreases during the 16-year period. Note: Data collection for womens ice hockey began in 2000-2001.
Disclaimer: The recommendations associated with the report summaries are those of the invited authors and do no necessarily represent the views of the National Athletic Trainers Association, National Collegiate Athletic Association or the Centers for Disease Control and Prevention.
Mens Baseball
Main results: Approximately 45 percent of all game and practice injuries occurred to the upper extremities. Top game injuries included upper leg strains: ankle sprains and should strains. Top practice injuries: shoulder strains and ankle sprains. The primary game injury mechanism was other contact (the ground, batted balls) or no contact (pitching). The primary practice mechanism was no contact. The positions at most risk of injury are base runner, pitcher and batter. Recommendations: Proper preseason conditioning is important to reduce injuries. Further study of batted-ball injuries is warranted and use of break-away bases to prevent sliding injuries should be supported.
Participation: Increased 39 percent.
Main results: Approximately 60 percent of all game and practice injuries occurred to the lower extremities. The top game injuries included ankle sprains and knee injuries. The top practice injuries: ankle sprains and knee injuries. The primary game injury mechanism was player contact. The primary practice mechanism was player contact.
Recommendations: Taping, bracing and neuromuscular training may help to prevent common injuries from the sport, though basketball-specific research on these interventions are lacking. The increase in head and facial injuries may indicate that officials need to investigate the current rules regarding player contact and potential new rules to decrease crowding in the lane. Participation: Increased 30 percent.
Womens Basketball
Main results: Approximately 60 percent of all game and practice injuries occurred to the lower extremities. The top game injuries were ankle sprains, knee injuries and concussions. The top practice injuries: ankle sprains and knee injuries. The primary game injury mechanism was player contact. The primary practice mechanism was no contact.
Recommendations: Evidence-based taping/bracing and neuromuscular conditioning programs may help reduce the incidence of lower extremity injuries in basketball. Future research should investigate mechanisms and risk factors for concussions in womens basketball.
Participation: Increased 34 percent.
Womens Field Hockey
Main results: There was a significant decreasing game injury trend over the 16-year sampling period. Approximately 40 percent game and 60 percent practice injuries occurred to the lower extremities. The top game injuries were ankle sprains, knee injuries and concussions. The top practice injuries: upper leg strains, ankle sprains and hip strains. The primary game injury mechanism was other contact (ball, stick). The primary practice mechanism was no contact. Recommendations: Equipment (requiring helmets and padded gloves) and rule changes (to decrease congestion near goals) as well as evidence-based injury prevention interventions (taping, bracing, neuromuscular training) may be viable preventive measures for reducing injury rates.
Participation: Increased 12 percent.
Womens Gymnastics
Main results: There was a significant decreasing game injury trend over the 16-year sampling period. Approximately 70 percent of all game and 50 percent of all practice injuries occurred to the lower extremities. The top game injuries were knee injuries, ankle sprains and lower back strains. The top practice injuries: ankle sprains and knee injuries. The primary game injury mechanism was other contact (contact with the floor upon landing). The primary practice mechanism was other contact (contact with the floor upon landing). The competition events with the highest risk of injury were floor exercise and vault.
Recommendations: Gymnasts with a history of ankle sprains should wear either ankle braces or use prophylactic tape to decrease risk of re-injury. Preventive efforts may incorporate neuromuscular training and core stability programs in the off-season and preseason to enhance landing and skill mechanics. Equipment manufacturers should re-evaluate the design of landing mats and other equipment to allow for better absorption of forces.
Participation: Decreased 23 percent.
Mens Football
Main results: There was a significant decreasing spring practice injury trend over the 16-year period. Approximately 50 percent of all game and fall and spring practice injuries occurred to the lower extremities. The top game injuries were knee injuries, ankle sprains and concussions. The top fall practice injuries: knee injuries, ankle sprains and upper leg strains. Top spring practice injuries; knee injuries, ankle sprains and upper leg strains. The primary game injury mechanism was player contact; the primary fall practice mechanism was player contact; the primary spring practice mechanism was player contact.
Recommendations: Lower extremity injury prevention initiatives (neuromuscular balance training, bracing/taping, etc.), official attention to rule enforcement, and research into improvement of protective equipment are potential areas that may contribute to injury reduction. Participation: Increased by 18 percent.
Mens Ice Hockey
Main results: There was a significant increasing game injury trend over the 16-year sampling period. Approximately one-third of all game and practice injuries occurred to the lower extremities and another one-third in games to the upper extremities. Top game injuries included knee injuries and concussions. Top practice injuries: hip strains and knee injuries. The primary game injury mechanism was player contact. The primary practice injury was other contact (with boards or glass).
Recommendations: Investigating the utility of limiting player-to-player contact in the neutral zone and at the top of the offensive and defensive zones, research into improvement of protective equipment (helmets, shoulder pads, etc.) and groin muscle-specific conditioning programs are areas to target for injury prevention. Clinicians and researchers should identify risk factors and interventions for muscle strains at the pelvis and hip region.
Participation: Increased six percent.
Womens Ice Hockey
Main Results: Approximately one-third of all game and practice injuries occurred to the lower extremities and another one-third in games to the upper extremity. Top game injuries included concussions and knee injuries. Top practice injuries: concussions and hip strains. The primary game mechanism was player contact. The primary practice mechanism was no contact. Recommendations: Though womens ice hockey does not allow for formal body checking, approximately 50 percent of all game injuries were reported resulted from contact with another player. Future researchers need to evaluate the effectiveness of the no-checking rule. Attention should be paid to mechanism-of-injury issues, and to encourage more schools to report. The authors anticipate that the hypothesized inconsistencies in skill level across and within the womens teams will also be reduced as more consistently skilled players develop.
Participation over four years: Increased 10 percent.
Mens Lacrosse
Main results: Approximately 50 percent of all game and practice injuries occurred to the lower extremities. Top game injuries included ankle sprains, knee injuries and concussions. Top practice injuries: ankle sprains and upper leg strains. The primary game mechanism was player contact. The primary practice mechanism was no contact.
Recommendations: Research into the mechanism of head injuries and the implications of design changes to protective helmets, as well as further investigation into best designs for shoulder and chest protection is needed.
Participation: Increased by 41 percent.
Womens Lacrosse
Main results: There was a significant increasing game injury trend over the 16-year sampling period. Approximately 60 percent of all game and practice injuries occurred to the lower extremities. Top game injuries included ankle sprains, knee injuries and concussions. Top practice injuries: ankle sprains and upper leg strains. The primary game injury mechanisms were no contact or other contact (sticks and balls). The primary practice mechanism was no contact. Recommendations: To reduce lower extremity injuries, future research should evaluate proprioceptive, plyometric and balance training interventions designed for female lacrosse players. Other areas of interest include determining whether protective eyewear policy changes reduced injury to the eye, orbit and nasal area and identifying any unintended consequences of the mandate, such as increased risk of injuries to other areas of the face or more aggressive play. Participation: Increased 119 percent.
Mens Soccer Injuries
Main results: Over two-thirds of all game and practice injuries occurred to the lower extremities. Top game injuries were ankle sprains and knee injuries; top practice injuries were ankle sprains and upper leg strains. The primary game injury mechanism was player contact (16 percent from slide tackles). The primary practice mechanism was no contact.
Recommendations: Preventive efforts should focus on player-to-player contact that often leads to lower extremity injuries and greater enforcement of rules that are in place to limit their frequency and severity. Emphasis should also be put on addressing high rate of first time and recurrent ankle sprains with neuromuscular exercise and taping and bracing.
Participation: Increased 35 percent.
Womens Soccer Injuries
Main results: Over two-thirds of all game and practice injuries occurred to the lower extremities. Top game injuries were ankle sprains, knee injuries and concussions. Top practices injuries: upper leg strains and ankle sprains. The primary game injury mechanism was player contact (13 percent from slide tackles). The primary practice mechanism from no contact. Recommendations: The specific nature of the player contact leading to concussions and lower-extremity injuries should be investigated. Preventive efforts should continue to focus on reducing knee and ankle injuries with neuromuscular exercise and/or taping/bracing and concussions. Participation: Increased 226 percent.
Womens Softball Injuries
Main results: Approximately 40 percent of all game and practice injuries occurred to the lower extremities. The top game injuries were ankle sprains, knee injuries and concussions. The top practice injuries: ankle sprains and upper leg strains. The primary game injury mechanism was other contact (ground, batted balls). The primary practice mechanism was no contact. The positions at most risk of injury are base runner, batter and pitcher.
Recommendations: Preventive efforts should focus on sliding technique regardless of skill level, potential equipment changes (i.e. breakaway bases), neuromuscular training programs, position-specific throwing programs, and mechanisms of low back injury. Further research is needed on these efforts as well as the area of windmill-pitching biomechanics.
Participation: Increased 65 percent.
Womens Volleyball Injuries
Main results: Approximately 55 percent of all game and practice injuries occurred to the lower extremities. The top game injuries were ankle sprains, knee injuries and shoulder strains. Top practice injuries: ankle sprains, upper leg strains and lower back strains. The primary game injury mechanism was equally distributed between no contact, player contact and other contact. The primary practice mechanism was no contact.
Recommendations: Ankle and knee injuries appear to be the most common injuries in womens volleyball. Future preventive efforts should focus on preventing first-time ankle sprains and acute traumatic knee injuries as well as reducing the risk of ankle sprain recurrence.
Participation: Increased 36 percent.
Mens Wrestling Injuries
Main results: Approximately 40 percent of all game and practice injuries occurred to the lower extremities. The top game injuries were knee injuries, ankle sprains and shoulder strains. The top practice injuries: skin infections and knee injuries. The primary game mechanism was player contact. The primary practice mechanism was player contact.
Recommendations: Expansion of the ISS to include indirect causes of injury, such as weight loss practices, would strengthen the analysis of data. Efforts by referees to be vigilant for potentially dangerous holds and by athletic trainers to improve wrestler and mat hygiene should be continued.
Participation: Decreased 23 percent.
Methodology
Results of the surveillance information were based on a sampling of NCAA Division I, II and III schools representing approximately 15 percent of schools sponsoring the above sports. Data collection for womens ice hockey began in 2000-2001. In 2004 the ISS converted to a Web-based interface program, which reflects the continued commitment to this project while providing a real-time electronic athletic-training facility record for each institution that simultaneously contributes to the aggregate national database.
For more information, please visit www.nata.org/collegiateinjurystats07.
About the National Athletic Trainers Association (NATA)
Athletic trainers are unique health care providers who specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. The National Athletic Trainers' Association represents and supports 30,000 members of the athletic training profession through education and research. NATA advocates for equal access to athletic trainers for athletes and patients of all ages, and supports H.R. 1846. For more information, visit www.nata.org.
About the National Collegiate Athletic Association (NCAA)
The NCAA is a membership-led nonprofit association of colleges and universities committed to supporting academic and athletic opportunities for more than 380,000 student-athletes at more than 1,000 member colleges and universities. Each year, more than 49,000 student-athletes compete in NCAA Championships in Division I, II and III sports. For more information, go to www.ncaa.org.
