Early Sport Specialization Among Former National Collegiate Athletic Association Athletes: Trends, Scholarship Attainment, Injury, and Attrition

2021 ◽  
Vol 49 (4) ◽  
pp. 1049-1058
Author(s):  
Caitlin M. Rugg ◽  
Monica J. Coughlan ◽  
Justine N. Li ◽  
Sharon L. Hame ◽  
Brian T. Feeley

Background: Many youth athletes focus on 1 sport to gain a competitive advantage, but early sport specialization may increase risk of overuse injuries and burnout. College athletes have successfully achieved advanced status; therefore, the study of their specialization patterns is a method to assess how specialization affects an athletic career. Purpose: To determine trends in sport specialization by sex, sport, and decade of participation in National Collegiate Athletic Association (NCAA) athletes and assess the effect of specialization on scholarship attainment, injury, and attrition. Study Design: Cohort study; Level of evidence, 3. Methods: An electronic survey was distributed to NCAA athletes who participated from 1960 to 2018. Survey topics included sex, sport, decade of participation, scholarship status, ≥30-day time-loss injuries sustained in college, orthopaedic surgery in college, career length, and age of single-sport specialization. Early specialization was defined as specialization in a single sport before age 15 years. Rates of early specialization were calculated for each sport, sex, individual and team sports, and decade of participation. Rates of scholarship attainment, injury, and attrition were compared between groups. Univariate associations were queried with logistic regression analysis to determine predictors of specialization, scholarship attainment, injury, and early attrition. Results: Of 1550 athletes who participated (17% response rate), 544 (35.1%) were women. Overall, 18.1% of athletes specialized before age 15 years (n = 281). Athletes in gymnastics, tennis, swimming and diving, and soccer were significantly more likely to specialize early, whereas football and baseball athletes were more likely to specialize late ( P < .05 for all groups). Early specialization was more common among women (23.4% vs 15.2%; odds ratio, 1.72; P < .01). There was a trend toward earlier specialization for recent college graduates, with graduates from the last decade more likely to be classified as early specialization than those from previous decades ( P = .036). Scholarship attainment was overall equivalent between groups. Time-loss injuries, lower extremity injuries, and orthopaedic surgery in college were not statistically different between groups. Career lengths were similar, but burnout was more common among early specialization athletes (10.5% vs 7.0%; odds ratio, 3.76; P < .01). Conclusion: Less than one-fifth of NCAA athletes surveyed specialized before age 15 years, and neither scholarship attainment nor time-loss injury rate was affected by early specialization. Early specialization is on the rise but is associated with increased burnout.

2019 ◽  
Vol 7 (4) ◽  
pp. 232596711983537 ◽  
Author(s):  
Douglas W. Bartels ◽  
Mario Hevesi ◽  
Cody Wyles ◽  
Jeffrey Macalena ◽  
Sanjeev Kakar ◽  
...  

Background: Participation in National Collegiate Athletic Association (NCAA) football is at an all-time high. This population of athletes experiences a substantial injury burden, with many injuries affecting the upper extremities. Purpose/Hypothesis: The purpose of this study was to describe the epidemiology of hand and wrist injuries in college football players from the academic years 2009–2010 to 2013–2014. We hypothesized that variables such as event type (practice vs game), mechanism of injury, and player position would have an effect on the injury incidence. Study Design: Descriptive epidemiological study. Methods: An epidemiological study utilizing the NCAA Injury Surveillance Program was performed to investigate rates and patterns of hand and wrist injuries in participating varsity football teams from 2009–2010 to 2013–2014. Results: A total of 725 hand and wrist injuries were captured in 899,225 athlete-exposures. The observed practice injury rate was 0.51 injuries per 1000 athlete-exposures, compared with a game injury rate of 3.60 ( P < .01). Player-on-player contact was the most common injury mechanism reported, with blocking being the most common activity at the time of injury. Offensive linemen were most likely to experience an injury. Of all injuries sustained, 71.4% resulted in no time loss from competition, whereas 9.8% of injuries resulted in longer than 7 days of time loss. A fracture resulted in the greatest time loss from competition (mean ± SD, 8.3 ± 24.0 days; median, 0 days [range, 0-148 days] for injuries sustained in a practice setting) (mean ± SD, 7.7 ± 15.8 days; median, 0 days [range, 0-87 days] for injuries sustained in a game setting). Conclusion: Hand and wrist injuries were found to be significantly more common in games when compared with practices. This study provides valuable prognostic data regarding expected time loss on a per-injury pattern basis. Further investigation on specific injury subtypes and expected time loss as a result of these injures would provide trainers, players, and coaches with useful information on an expected postinjury recovery and rehabilitation timeline.


2019 ◽  
Vol 54 (1) ◽  
pp. 30-41 ◽  
Author(s):  
Lauren A. Pierpoint ◽  
Andrew E. Lincoln ◽  
Nina Walker ◽  
Shane V. Caswell ◽  
Dustin W. Currie ◽  
...  

ContextThe advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of boys' and men's lacrosse injury data.ObjectiveTo describe the epidemiology of injuries sustained in high school boys' lacrosse in the 2008–2009 through 2013–2014 academic years and collegiate men's lacrosse in the 2004–2005 through 2013–2014 academic years using Web-based sports injury surveillance.DesignDescriptive epidemiology study.SettingOnline injury surveillance from lacrosse teams of high school boys (annual average = 55) and collegiate men (annual average = 14).Patients or Other ParticipantsBoys' and men's lacrosse players who participated in practices and competitions during the 2008–2009 through 2013–2014 academic years in high school or the 2004–2005 through 2013–2014 academic years in college.Main Outcome Measure(s)Athletic trainers collected time-loss (≥24 hours) injury and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated.ResultsHigh School Reporting Information Online documented 1407 time-loss injuries during 662 960 AEs. The National Collegiate Athletic Association Injury Surveillance Program documented 1882 time-loss injuries during 390 029 AEs. The total injury rate from 2008–2009 through 2013–2014 was higher in college than in high school (3.77 versus 2.12/1000 AEs; IRR = 1.78; 95% CI = 1.63, 1.94). Most injuries occurred during competitions in high school (61.4%) and practices in college (61.4%). Injury rates were higher in competitions compared with practices in high school (IRR = 3.59; 95% CI = 3.23, 4.00) and college (IRR = 3.38; 95% CI = 3.08, 3.71). Lower limb injuries, muscle strains, and ligament sprains were common at both levels. Concussion was the most frequent competition diagnosis for all high school player positions.ConclusionsRates of time-loss injury were higher in college versus high school and in competitions versus practices. Attention to preventing common lower leg injuries and concussions, especially at the high school level, is essential to decrease their incidence and severity.


2019 ◽  
Vol 54 (2) ◽  
pp. 212-225 ◽  
Author(s):  
Erin B. Wasserman ◽  
Johna K. Register-Mihalik ◽  
Eric L. Sauers ◽  
Dustin W. Currie ◽  
Lauren A. Pierpoint ◽  
...  

Context The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of girls' and women's softball injury data. Objective To describe the epidemiology of injuries sustained in high school girls' softball in the 2005–2006 through 2013–2014 academic years and collegiate women's softball in the 2004–2005 through 2013–2014 academic years using Web-based sports injury surveillance. Design Descriptive epidemiology study. Setting Online injury surveillance from softball teams in high school girls (annual average = 100) and collegiate women (annual average = 41). Patients or Other Participants Girls' or women's softball players who participated in practices and competitions during the 2005–2006 through 2013–2014 academic years in high school and the 2004–2005 through 2013–2014 academic years in college. Main Outcome Measure(s) Athletic trainers collected time-loss injury and exposure data. Injury rates per 1000 athlete-exposures (AEs) were calculated. Injury rate ratios (IRRs) with 95% confidence intervals (CIs) compared injury rates by competition level, school size or division, event type, and time in season. Results The High School Reporting Information Online system documented 1357 time-loss injuries during 1 173 722 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 1848 time-loss injuries during 579 553 AEs. The injury rate was higher in college than in high school (3.19 versus 1.16/1000 AEs; IRR = 2.76; 95% CI = 2.57, 2.96). The competition injury rate was higher than the practice injury rate in high school (IRR = 2.02; 95% CI = 1.82, 2.25) and in college (IRR = 1.39; 95% CI = 1.27, 1.52). Softball players at both levels sustained a variety of injuries, with the most common being ankle sprains and concussions. Many injuries also occurred while fielding or running bases. Conclusions Injury rates were greater in collegiate versus high school softball and in competitions versus practices. These findings highlight the need for injury-prevention interventions, including strength-training and prevention programs to reduce ankle sprains and provide protection for batters from pitches and fielders from batted balls.


2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0013
Author(s):  
Jimmy J. Chan ◽  
Kevin K. Chen ◽  
Javier Z. Guzman ◽  
Ettore Vulcano

Category: Hindfoot, Lesser Toes, Midfoot/Forefoot, Sports, Trauma Introduction/Purpose: Foot injuries represent a broad category of injuries that may have profound implications in National Collegiate Athletic Association (NCAA) athletes. Accordingly, a more thorough characterization of these injuries and what predisposes NCAA athletes to them is crucial to their prevention. This study examines the incidence and effect of foot injuries on NCAA athletes and their athletic season. Methods: Foot injuries across 16 sports among men and women during the 2004-05 to 2013-14 academic years were analyzed from the NCAA Injury Surveillance Program (NCAA-ISP). Three common orthopaedic foot injuries were sub-analyzed, including fifth metatarsal injuries (5MT), Lisfranc injuries, and turf toes. Multiple variables were reported including injury rates per 100,000 athlete-exposures (IR), operative rate, annual injury rate trends, re-injury rates, in-season status (pre/in/post-season) at time of injury, and time loss distributions were compiled and calculated. Results: A total of 3718 foot injuries were identified over 10-year period. 4.4% of all injuries were operative. Overall foot injury rate was comparable between male (IR=31.1) and female athletes (IR=32.4); however, the operative injury rate was greater in male compared to female (IR=2.0 vs. 0.6) athletes. The top three operative injuries were 5MT (45.1%), stress fractures (12.2%), and Lisfranc injuries (7.9%). 10.8% of turf toes are re-injury, and average time loss was 7.0 days. 43% of 5MT injuries were operative, and 19.2% were re-injuries. 40.6% of 5MT injuries were season-ending with an average time loss of 36.5 days. 33% of Lisfranc injuries were operative, and 7.5% were re-injuries. 45.9% of Lisfranc injuries were season-ending with an average time loss of 25.9 days. Conclusion: Foot injuries are among the most common form of injuries that occur in NCAA athletics. In addition, these injuries can sometimes lead to significant loss of playing time and may even result in the end of the athlete’s season or career. Certain NCAA sports such as men’s football and basketball may more likely predispose patients to season ending injuries and require operative fixation. Close examination of the kinds of foot injuries and their respective mechanisms may help elucidate trends useful in the development of various prevention strategies.


2017 ◽  
Vol 5 (2) ◽  
pp. 232596711668678 ◽  
Author(s):  
Andrew R. Peterson ◽  
Adam J. Kruse ◽  
Scott M. Meester ◽  
Tyler S. Olson ◽  
Benjamin N. Riedle ◽  
...  

Background: There are approximately 2.8 million youth football players between the ages of 7 and 14 years in the United States. Rates of injury in this population are poorly described. Recent studies have reported injury rates between 2.3% and 30.4% per season and between 8.5 and 43 per 1000 exposures. Hypothesis: Youth flag football has a lower injury rate than youth tackle football. The concussion rates in flag football are lower than in tackle football. Study Design: Cohort study; Level of evidence, 3. Methods: Three large youth (grades 2-7) football leagues with a total of 3794 players were enrolled. Research personnel partnered with the leagues to provide electronic attendance and injury reporting systems. Researchers had access to deidentified player data and injury information. Injury rates for both the tackle and flag leagues were calculated and compared using Poisson regression with a log link. The probability an injury was severe and an injury resulted in a concussion were modeled using logistic regression. For these 2 responses, best subset model selection was performed, and the model with the minimum Akaike information criterion value was chosen as best. Kaplan-Meier curves were examined to compare time loss due to injury for various subgroups of the population. Finally, time loss was modeled using Cox proportional hazards regression models. Results: A total of 46,416 exposures and 128 injuries were reported. The mean age at injury was 10.64 years. The hazard ratio for tackle football (compared with flag football) was 0.45 (95% CI, 0.25-0.80; P = .0065). The rate of severe injuries per exposure for tackle football was 1.1 (95% CI, 0.33-3.4; P = .93) times that of the flag league. The rate for concussions in tackle football per exposure was 0.51 (95% CI, 0.16-1.7; P = .27) times that of the flag league. Conclusion: Injury is more likely to occur in youth flag football than in youth tackle football. Severe injuries and concussions were not significantly different between leagues. Concussion was more likely to occur during games than during practice. Players in the sixth or seventh grade were more likely to suffer a concussion than were younger players.


2018 ◽  
Vol 53 (8) ◽  
pp. 738-751 ◽  
Author(s):  
Zachary Y. Kerr ◽  
Gary B. Wilkerson ◽  
Shane V. Caswell ◽  
Dustin W. Currie ◽  
Lauren A. Pierpoint ◽  
...  

Context: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of football injury data.Objective: To describe the epidemiology of injuries sustained in high school football in the 2005–2006 through 2013–2014 academic years and collegiate football in the 2004–2005 through 2013–2014 academic years using Web-based sports injury surveillance.Design: Descriptive epidemiology study.Setting: Online injury surveillance from football teams of high school boys (annual average = 100) and collegiate men (annual average = 43).Patients or Other Participants: Football players who participated in practices and competitions during the 2005–2006 through 2013–2014 academic years in high school or the 2004–2005 through 2013–2014 academic years in college.Main Outcome Measure(s): Athletic trainers collected time-loss injury (≥24 hours) and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated.Results: The High School Reporting Information Online system documented 18 189 time-loss injuries during 4 539 636 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 22 766 time-loss injuries during 3 121  476 AEs. The injury rate was higher among collegiate than high school (7.29 versus 4.01/1000 AEs; IRR = 1.82; 95% CI = 1.79, 1.86) athletes. Most injuries occurred during competitions in high school (53.2%) and practices in college (60.9%). The competition injury rate was higher than the practice injury rate among both high school (IRR = 5.62; 95% CI = 5.46, 5.78) and collegiate (IRR = 6.59; 95% CI = 6.41, 6.76) players. Most injuries at both levels affected the lower extremity and the shoulder/clavicle and were diagnosed as ligament sprains and muscle/tendon strains. However, concussion was a common injury during competitions among most positions.Conclusions: Injury rates were higher in college than in high school and higher for competitions than for practices. Concussion was a frequent injury sustained during competitions, which confirms the need to develop interventions to mitigate its incidence and severity.


2021 ◽  
Vol 56 (7) ◽  
pp. 766-772
Author(s):  
Hannah J. Robison ◽  
Adrian J. Boltz ◽  
Sarah N. Morris ◽  
Christy L. Collins ◽  
Avinash Chandran

Context The National Collegiate Athletic Association (NCAA) has sponsored women's tennis programs since 1966. Women's tennis has risen in global prominence and popularity within the NCAA. Background Continued surveillance of athletic injuries in the NCAA is critical for identifying emerging injury trends and assessing injury prevention strategies. Methods Exposure and injury data collected in the NCAA Injury Surveillance Program from 2014–2015 through 2018–2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates. Results The overall injury rate was 4.16 per 1000 athlete exposures. Injury to the shoulder, foot, and trunk were the most prevalent throughout the study period. Approximately 30% of all injury diagnoses were related to inflammatory conditions. Also, 32.1% of all injuries were time-loss injuries, and 45.0% of all injuries were non–time-loss injuries. Conclusions The findings of this study differed slightly from those of previous investigations, most notably with regard to injury rate by season segment and commonly injured body parts. Future surveillance efforts should attempt to capture the nuances of tennis competitions.


2017 ◽  
Vol 10 (1) ◽  
pp. 60-69 ◽  
Author(s):  
Christine M. Baugh ◽  
Gil S. Weintraub ◽  
Andrew J. Gregory ◽  
Aristarque Djoko ◽  
Thomas P. Dompier ◽  
...  

Background: There were 18,844 volleyball players in the National Collegiate Athletic Association (NCAA) in the 2014-2015 academic year. Little research has examined sex-based differences among these athletes. Purpose: To examine injury epidemiology in NCAA men’s and women’s volleyball athletes. Study Design: Descriptive epidemiology study. Level of Evidence: Level 3. Methods: Injury surveillance data from the 2013-2014 through 2014-2015 academic years were obtained from the NCAA Injury Surveillance Program for 6 men’s and 33 women’s collegiate volleyball teams. Injury rates per 1000 athlete-exposures (AEs) and injury rate ratios (IRRs) with 95% CIs were calculated. Time-loss (TL) injuries resulted in participation restriction for at least 24 hours, and non-time-loss (NTL) injuries resulted in participation restriction of less than 24 hours. Results: Overall, 83 and 510 injuries were reported in men and women, respectively, leading to injury rates of 4.69 and 7.07 per 1000 AEs. The injury rate was greater in women than men (IRR, 1.51; 95% CI, 1.19-1.90). TL injury rates were 1.75 and 2.62 per 1000 AEs for men and women, respectively. The ankle was the most commonly injured body part among TL injuries (men, 25.8%; women, 24.3%); the knee was the most commonly injured body part among NTL injuries (men, 25.5%; women, 16.3%). Among TL injuries, common diagnoses included sprains (men, 25.8%; women, 31.2%) and concussions (men, 19.4%; women, 14.8%). Most TL concussions were due to ball contact (men, 83.3%; women, 53.6%). Compared with men, women had a greater NTL overuse injury rate (IRR, 3.47; 95% CI, 1.61-7.46). Compared with women, men had a greater TL injury rate associated with ball contact (IRR, 2.24; 95% CI, 1.07-4.68). Conclusion: There are differences in injury patterns and rates between male and female intercollegiate volleyball players. Although a limited-contact sport, a notable number of concussions were sustained, mostly from ball contact. Clinical Relevance: Understanding injury patterns may aid clinicians in injury diagnosis, management, and prevention.


2019 ◽  
Vol 7 (4) ◽  
pp. 232596711983642 ◽  
Author(s):  
Neill Y. Li ◽  
Avi D. Goodman ◽  
Nicholas J. Lemme ◽  
Brett D. Owens

Background: The management and outcomes of elbow ulnar collateral ligament (UCL) injuries in throwing athletes have been well investigated. However, less is known regarding the management, severity, and outcomes of such injuries in contact athletes. Purpose: To compare the incidence, severity, and outcomes of elbow UCL injuries between throwing and contact athletes in collegiate sports. Study Design: Descriptive epidemiology study. Methods: Elbow UCL injuries were queried from the National Collegiate Athletic Association (NCAA) Injury Surveillance Program between the seasons of 2009-2010 and 2013-2014 in 25 varsity sports. The rates and distribution of injuries by mechanism, participation restriction time, and outcomes (eg, season-ending injury, surgery) were examined. A severe injury was defined as loss of ≥21 days from participation, a season-ending injury, or requiring a surgical intervention. The injury frequency, incidence per 10,000 athlete-exposures (AEs), and injury proportion ratio comparing throwing and contact athletes were calculated with 95% CIs. Results: Over the course of 5 seasons, 109 UCL injuries were recorded, for an overall injury rate of 0.29 per 10,000 AEs. Of these injuries, 83 (76.1%) were a result of contact and 26 (23.9%) from throwing. Men’s wrestling (1.78 per 10,000 AEs) and men’s baseball (1.12 per 10,000 AEs) sustained the highest injury rates. A larger proportion of throwing (n = 8; 36.4%) compared with contact (n = –7; 9.1%) ( P < 0.01) injuries results in >21 days of time loss. Additionally, more throwing-related UCL injuries required surgery (n = 2; 11.1%) compared with contact-related injuries (n = 1; 1.3%) ( P < 0.01). As a result, throwing athletes demonstrated a significantly higher proportion of severe injuries than contact athletes (injury proportion ratio, 4.62 [95% CI, 1.72-12.40]). Conclusion: The evaluation of athletes in 25 collegiate varsity sports across 5 seasons found over 3 times more elbow UCL injuries in contact versus throwing athletes. However, the number of severe injuries in throwing athletes was significantly higher than in contact athletes. These findings demonstrate that although elbow UCL injuries are prone to occur in both contact and throwing athletes, their prevention, management, and outcomes must be framed on a sport-by-sport basis.


2019 ◽  
Vol 54 (2) ◽  
pp. 198-211 ◽  
Author(s):  
Erin B. Wasserman ◽  
Eric L. Sauers ◽  
Johna K. Register-Mihalik ◽  
Lauren A. Pierpoint ◽  
Dustin W. Currie ◽  
...  

Context The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of boys' and men's baseball injury data. Objective To describe the epidemiology of injuries sustained in high school boys' baseball in the 2005–2006 through 2013–2014 academic years and collegiate men's baseball in the 2004–2005 through 2013–2014 academic years using Web-based sports injury surveillance. Design Descriptive epidemiology study. Setting Online injury surveillance from baseball teams in high school boys (annual average = 100) and collegiate men (annual average = 34). Patients or Other Participants Boys' or men's baseball players who participated in practices and competitions during the 2005–2006 through 2013–2014 academic years in high school or the 2004–2005 through 2013–2014 academic years in college, respectively. Main Outcome Measure(s) Athletic trainers collected time-loss injury and exposure data. Injury rates per 1000 athlete-exposures (AEs) were calculated. Injury rate ratios (IRRs) with 95% confidence intervals (CIs) compared injury rates by school size or division, time in season, event type, and competition level. Results The High School Reporting Information Online system documented 1537 time-loss injuries during 1 573 257 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 2574 time-loss injuries during 804 737 AEs. The injury rate was higher in college than in high school (3.20 versus 0.98/1000 AEs; IRR = 3.27; 95% CI = 3.07, 3.49). The competition injury rate was higher than the practice injury rate in high school (IRR = 2.27; 95% CI = 2.05, 2.51) and college (IRR = 2.32; 95% CI = 2.15, 2.51). Baseball players at the high school and collegiate levels sustained a variety of injuries across the body, with the most common injuries reported to the upper extremity. Many injuries also occurred while fielding or pitching. Conclusions Injury rates were greater in collegiate versus high school baseball and in competition versus practice. These findings highlight the need for injury-prevention interventions focused on reducing the incidence of upper extremity injuries and protecting batters from pitches and fielders from batted balls.


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