Epidemiology of Concussions in National Collegiate Athletic Association (NCAA) Sports: 2014/15-2018/19

Background: Updated epidemiology studies examining sports-related concussions (SRCs) are critical in evaluating recent efforts aimed at reducing the incidence of SRCs in National Collegiate Athletic Association (NCAA) sports. Purpose: To describe the epidemiology of SRCs in 23 NCAA sports during the 2014/15-2018/19 academic years. Study Design: Descriptive epidemiology study. Methods: SRC and exposure data collected in the NCAA Injury Surveillance Program were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics by sport, event type (practices, competitions), injury mechanism (player contact, surface contact, equipment/apparatus contact), and injury history (new, recurrent). Injury rate ratios (IRRs) were used to examine differential injury rates, and injury proportion ratios (IPRs) were used to examine differential distributions. Results: A total of 3497 SRCs from 8,474,400 athlete-exposures (AEs) were reported during the study period (4.13 per 10,000 AEs); the competition-related SRC rate was higher than was the practice-related SRC rate (IRR, 4.12; 95% CI, 3.86-4.41). The highest SRC rates were observed in men’s ice hockey (7.35 per 10,000 AEs) and women’s soccer (7.15 per 10,000 AEs); rates in women’s soccer and volleyball increased during 2015/16-2018/19. Player contact was the most prevalently reported mechanism in men’s sports (77.0%), whereas equipment/apparatus contact was the most prevalently reported mechanism in women’s sports (39.2%). Sex-related differences were observed in soccer, basketball, softball/baseball, and swimming and diving. Most SRCs reported in men’s sports (84.3%) and women’s sports (81.1%) were reported as new injuries. Conclusion: Given the increasing SRC rates observed in women’s soccer and volleyball during the latter years of the study, these results indicate the need to direct further attention toward trajectories of SRC incidence in these sports. The prevalence of equipment/apparatus contact SRCs in women’s sports also suggests that SRC mechanisms in women’s sports warrant further investigation. As most SRCs during the study period were reported as new injuries, the prevalence of recurrent SRCs in men’s and women’s ice hockey is also noteworthy.

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Comparison of Concussion Rates Between NCAA Division I and Division III Men’s and Women’s Ice Hockey Players

The American Journal of Sports Medicine ◽

10.1177/0363546517710005 ◽

2017 ◽

Vol 45 (11) ◽

pp. 2622-2629 ◽

Cited By ~ 10

Author(s):

John M. Rosene ◽

Bryan Raksnis ◽

Brie Silva ◽

Tyler Woefel ◽

Paul S. Visich ◽

...

Keyword(s):

Ncaa Division I ◽

National Collegiate Athletic Association ◽

Injury Rate ◽

Ice Hockey ◽

Division I ◽

Surveillance Program ◽

Division Iii ◽

Convenience Sample ◽

Hockey Players ◽

Rate Ratios

Background: Examinations related to divisional differences in the incidence of sports-related concussions (SRC) in collegiate ice hockey are limited. Purpose: To compare the epidemiologic patterns of concussion in National Collegiate Athletic Association (NCAA) ice hockey by sex and division. Study Design: Descriptive epidemiology study. Methods: A convenience sample of men’s and women’s ice hockey teams in Divisions I and III provided SRC data via the NCAA Injury Surveillance Program during the 2009-2010 to 2014-2015 academic years. Concussion counts, rates, and distributions were examined by factors including injury activity and position. Injury rate ratios (IRRs) and injury proportion ratios (IPRs) with 95% confidence intervals (CIs) were used to compare concussion rates and distributions, respectively. Results: Overall, 415 concussions were reported for men’s and women’s ice hockey combined. The highest concussion rate was found in Division I men (0.83 per 1000 athlete-exposures [AEs]), followed by Division III women (0.78/1000 AEs), Division I women (0.65/1000 AEs), and Division III men (0.64/1000 AEs). However, the only significant IRR was that the concussion rate was higher in Division I men than Division III men (IRR = 1.29; 95% CI, 1.02-1.65). The proportion of concussions from checking was higher in men than women (28.5% vs 9.4%; IPR = 3.02; 95% CI, 1.63-5.59); however, this proportion was higher in Division I women than Division III women (18.4% vs 1.8%; IPR = 10.47; 95% CI, 1.37-79.75). The proportion of concussions sustained by goalkeepers was higher in women than men (14.2% vs 2.9%; IPR = 4.86; 95% CI, 2.19-10.77), with findings consistent within each division. Conclusion: Concussion rates did not vary by sex but differed by division among men. Checking-related concussions were less common in women than men overall but more common in Division I women than Division III women. Findings highlight the need to better understand the reasons underlying divisional differences within men’s and women’s ice hockey and the need to develop concussion prevention strategies specific to each athlete population.

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Epidemiology of Injuries in National Collegiate Athletic Association Men's Ice Hockey: 2014–2015 Through 2018–2019

Journal of Athletic Training ◽

10.4085/1062-6050-611-20 ◽

2021 ◽

Vol 56 (7) ◽

pp. 703-710

Author(s):

Adrian J. Boltz ◽

Aliza K. Nedimyer ◽

Avinash Chandran ◽

Hannah J. Robison ◽

Christy L. Collins ◽

...

Keyword(s):

National Collegiate Athletic Association ◽

Injury Rate ◽

Injury Surveillance ◽

Ice Hockey ◽

Surveillance Program ◽

Surveillance Systems ◽

Collateral Ligament ◽

Injury Rates ◽

Rate Ratios ◽

Temporal Qualities

Context The National Collegiate Athletic Association has supported men's ice hockey, a distinct sport that mandates high-velocity gamesmanship, since 1974. Background Injury surveillance systems are designed to identify evolving injury trends and their temporal qualities. Continual monitoring of collegiate men's ice hockey athletes remains essential. Methods Exposure and injury data collected in the National Collegiate Athletic Association 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 (IRR) were used to examine differential injury rates. Results The overall injury rate was 7.65 per 1000 athlete-exposures. Injuries from competition occurred at a rate nearly 7 times that from practice injuries (IRR = 6.54, 95% CI = 6.08, 7.04). The most common specific injury diagnoses were concussions (9.6%), acromioclavicular sprains (7.3%), and medial collateral ligament tears (3.7%). Summary Injury rates by event type and season segment were higher than previously reported. Contusions accounted for nearly a quarter of all injuries, and acromioclavicular sprain rates increased notably across the study period.

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The Epidemiology of Deltoid Ligament Sprains in 25 National Collegiate Athletic Association Sports, 2009–2010 Through 2014–2015 Academic Years

Journal of Athletic Training ◽

10.4085/1062.6050-52.2.01 ◽

2017 ◽

Vol 52 (4) ◽

pp. 350-359 ◽

Cited By ~ 8

Author(s):

Thomas J. Kopec ◽

Elizabeth E. Hibberd ◽

Karen G. Roos ◽

Aristarque Djoko ◽

Thomas P. Dompier ◽

...

Keyword(s):

Student Athletes ◽

National Collegiate Athletic Association ◽

Injury Rate ◽

Injury Surveillance ◽

Deltoid Ligament ◽

Surveillance Program ◽

Injury Rates ◽

Ligament Sprain ◽

Rate Ratios ◽

Women's Soccer

Context: Deltoid ligament sprains among collegiate student-athletes have not been extensively investigated. Research regarding the mechanisms, participation-restriction time, and recurrence of deltoid ligament sprains in collegiate student-athletes is lacking. Objective: To describe the epidemiology of deltoid ligament sprains in 25 National Collegiate Athletic Association championship sports. Design: Descriptive epidemiology study. Setting: National Collegiate Athletic Association Injury Surveillance Program. Main Outcome Measure(s): We analyzed deltoid ligament sprains recorded in the Injury Surveillance Program for the 2009–2010 through 2014–2015 academic years. Deltoid ligament sprain injury rates, rate ratios, and injury proportion ratios with 95% confidence intervals (CIs) were reported. Results: During the study period, 380 deltoid ligament sprains were reported, resulting in a combined injury rate of 0.79/10 000 athlete-exposures (AEs; 95% CI = 0.71, 0.87). Most deltoid ligament sprains occurred in practices (54.2%, n = 206). However, the competition injury rate was higher than the practice injury rate (rate ratio = 3.74; 95% CI = 3.06, 4.57). The highest deltoid ligament sprain rates were in women's gymnastics (2.30/10 000 AEs; 95% CI = 1.05, 3.55), men's soccer (1.73/10 000 AEs; 95% CI = 1.14, 2.32), women's soccer (1.61/10 000 AEs; 95% CI = 1.13, 2.09), and men's football (1.40/10 000 AEs; 95% CI = 1.18, 1.62). Nearly half of all deltoid ligament sprains (49.7%, n = 189) were due to player contact, and 39.5% (n = 150) were non–time-loss injuries (ie, participation restricted for less than 24 hours). Only 8.2% (n = 31) of deltoid ligament sprains were recurrent. Conclusions: The highest deltoid ligament sprain rates were in women's gymnastics, men's and women's soccer, and men's football. However, the rate for women's gymnastics was imprecise (ie, the CI was wide), highlighting the need for further surveillance of deltoid ligament sprains in the sport. Most deltoid ligament sprains were due to player contact. Future researchers should assess interventions that may prevent deltoid ligament sprains.

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Epidemiology of Injuries in National Collegiate Athletic Association Women's Ice Hockey: 2014–2015 Through 2018–2019

Journal of Athletic Training ◽

10.4085/1062-6050-546-20 ◽

2021 ◽

Vol 56 (7) ◽

pp. 695-702

Author(s):

Avinash Chandran ◽

Aliza K. Nedimyer ◽

Adrian J. Boltz ◽

Hannah J. Robison ◽

Christy L. Collins ◽

...

Keyword(s):

National Collegiate Athletic Association ◽

Knee Injuries ◽

Injury Rate ◽

Ice Hockey ◽

Surveillance Program ◽

Injury Incidence ◽

Body Parts ◽

Shoulder Injuries ◽

Injury Rates ◽

Rate Ratios

Context The National Collegiate Athletic Association (NCAA) has sponsored women's ice hockey championships since 2001, and sponsorship has grown over time. Background Routine examinations of injuries sustained by athletes are important for identifying and understanding patterns that can be used to inform sport safety practices. 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 5.89 per 1000 athlete-exposures; preseason injury incidence rose sharply during 2016–2017 through 2018–2019. Head/face injuries (15.2%), knee injuries (13.2%), and shoulder injuries (12.9%) were the most commonly injured body parts, and injuries were most often classified as contusions (18.9%), strains (18.7%), and sprains (15.5%). Concussion (11.9%) was the most commonly reported specific injury, and concussion rates notably increased during 2017–2018 through 2018–2019. Summary Study findings were generally consistent with the existing epidemiological evidence. Injury incidence in preseason and the etiology of strains warrant further attention in this population.

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Epidemiology of Hip and Groin Injuries in Collegiate Athletes in the United States

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118771676 ◽

2018 ◽

Vol 6 (5) ◽

pp. 232596711877167 ◽

Cited By ~ 17

Author(s):

Yehuda E. Kerbel ◽

Christopher M. Smith ◽

John P. Prodromo ◽

Michael I. Nzeogu ◽

Mary K. Mulcahey

Keyword(s):

National Collegiate Athletic Association ◽

Injury Rate ◽

Collegiate Athletes ◽

The United States ◽

Ice Hockey ◽

Surveillance Program ◽

Prevention Measures ◽

Collegiate Sports ◽

Treatment And Prevention ◽

Rate Ratios

Background: Hip and groin pain is a common complaint among athletes. Few studies have examined the epidemiology of hip and groin injuries in collegiate athletes across multiple sports. Purpose: To describe the rates, mechanisms, sex-based differences, and severity of hip/groin injuries across 25 collegiate sports. Study Design: Descriptive epidemiology study. Methods: Data from the 2009-2010 through 2013-2014 academic years were obtained from the National Collegiate Athletic Association Injury Surveillance Program (NCAA ISP). The rate of hip/groin injuries, mechanism of injury, time lost from competition, and need for surgery were calculated. Differences between sex-comparable sports were quantified using rate ratios (RRs) and injury proportion ratios (IPRs). Results: In total, 1984 hip/groin injuries were reported, giving an overall injury rate of 53.06 per 100,000 athlete-exposures (AEs). An adductor/groin tear was the most common injury, comprising 24.5% of all injuries. The sports with the highest rates of injuries per 100,000 AEs were men’s soccer (110.84), men’s ice hockey (104.90), and women’s ice hockey (76.88). In sex-comparable sports, men had a higher rate of injuries per 100,000 AEs compared with women (59.53 vs 42.27, respectively; RR, 1.41 [95% CI, 1.28-1.55]). The most common injury mechanisms were noncontact (48.4% of all injuries) and overuse/gradual (20.4%). In sex-comparable sports, men had a greater proportion of injuries due to player contact than women (17.0% vs 3.6%, respectively; IPR, 4.80 [95% CI, 3.10-7.42]), while women had a greater proportion of injuries due to overuse/gradual than men (29.1% vs 16.7%, respectively; IPR, 1.74 [95% CI, 1.46-2.06]). Overall, 39.3% of hip/groin injuries resulted in time lost from competition. Only 1.3% of injuries required surgery. Conclusion: Hip/groin injuries are most common in sports that involve kicking or skating and sudden changes in direction and speed. Most hip/groin injuries in collegiate athletes are noncontact and do not result in time lost from competition, and few require surgery. This information can help guide treatment and prevention measures to limit such injuries in male and female collegiate athletes.

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Injury Surveillance of Head, Neck, and Facial Injuries in Collegiate Ice Hockey Players, 2009–2010 Through 2013–2014 Academic Years

Journal of Athletic Training ◽

10.4085/1062-6050-52.4.03 ◽

2017 ◽

Vol 52 (8) ◽

pp. 776-784 ◽

Cited By ~ 7

Author(s):

Molly MacMhathan Simmons ◽

David I. Swedler ◽

Zachary Y. Kerr

Keyword(s):

High Speed ◽

National Collegiate Athletic Association ◽

Injury Rate ◽

Injury Surveillance ◽

Ice Hockey ◽

Surveillance Program ◽

Injury Rates ◽

Full Contact ◽

Hockey Players ◽

Rate Ratios

Context: Ice hockey is a high-speed, full-contact sport with a high risk of head/face/neck (HFN) injuries. However, men's and women's ice hockey differ; checking is allowed only among men. Objectives: To describe the epidemiology of HFN injuries in collegiate men's and women's ice hockey during the 2009−2010 through 2013−2014 academic years. Design: Descriptive epidemiology study. Setting: Ice hockey data from the National Collegiate Athletic Association (NCAA) Injury Surveillance Program during the 2009−2010 through 2013−2014 academic years. Patients or Other Participants: Fifty-seven men's and 26 women's collegiate ice hockey programs from all NCAA divisions provided 106 and 51 team-seasons of data, respectively. Main Outcome Measure(s): Injury rates per 1000 athlete-exposures and rate ratios with 95% confidence intervals (CIs). Results: The NCAA Injury Surveillance Program reported 496 and 131 HFN injuries in men's and women's ice hockey, respectively. The HFN injury rate was higher in men than in women (1.75 versus 1.16/1000 athlete-exposures; incidence rate ratio = 1.51; 95% CI = 1.25, 1.84). The proportion of HFN injuries from checking was higher in men than in women for competitions (38.5% versus 13.6%; injury proportion ratio = 2.82; 95% CI = 1.64, 4.85) and practices (21.9% versus 2.3%; injury proportion ratio = 9.41; 95% CI = 1.31, 67.69). The most common HFN injury diagnosis was concussion; most concussions occurred in men's competitions from player contact while checking (25.9%). Player contact during general play comprised the largest proportion of concussions in men's practices (25.9%), women's competitions (25.0%), and women's practices (24.0%). While 166 lacerations were reported in men, none were reported in women. In men, most lacerations occurred from player contact during checking in competitions (41.8%) and player contact during general play in practices (15.0%). Conclusions: A larger proportion of HFN injuries in ice hockey occurred during checking in men versus women. Concussion was the most common HFN injury and was most often due to player contact. Lacerations were reported only among men and were mostly due to checking. Injury-prevention programs should aim to reduce checking-related injuries.

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Epidemiology of Injuries in National Collegiate Athletic Association Women's Soccer: 2014–2015 Through 2018–2019

Journal of Athletic Training ◽

10.4085/1062-6050-372-20 ◽

2021 ◽

Vol 56 (7) ◽

pp. 651-658

Author(s):

Avinash Chandran ◽

Sarah N. Morris ◽

Adrian J. Boltz ◽

Hannah J. Robison ◽

Christy L. Collins

Keyword(s):

National Collegiate Athletic Association ◽

Injury Rate ◽

Temporal Patterns ◽

Early Years ◽

Lateral Ligament ◽

Surveillance Program ◽

Ankle Sprains ◽

Injury Rates ◽

Rate Ratios ◽

Women's Soccer

Context The National Collegiate Athletic Association held the first women's soccer championship in 1982; sponsorship and participation have greatly increased since. Background Routine examinations of athlete injuries are important for identifying emerging temporal patterns. Methods Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014–2015 through 2018–2019 seasons 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 8.33 per 1000 athlete-exposures. Lateral ligament complex tears (ankle sprains) (8.6%), concussions (8.3%), and quadriceps tears (5.0%) were the most commonly reported injuries. Rates of lateral ligament complex tears followed an increasing trajectory during the study period, whereas quadriceps tear rates fluctuated during the early years, and concussion rates decreased then increased. Summary The findings of this study were mostly consistent with existing evidence; notable temporal patterns were observed with regard to lateral ligament complex tears and concussions.

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Epidemiology of Quadriceps Strains in National Collegiate Athletic Association Athletes, 2009–2010 Through 2014–2015

Journal of Athletic Training ◽

10.4085/1062-6050-52.2.17 ◽

2017 ◽

Vol 52 (5) ◽

pp. 474-481 ◽

Cited By ~ 11

Author(s):

Timothy G. Eckard ◽

Zachary Y. Kerr ◽

Darin A. Padua ◽

Aristarque Djoko ◽

Thomas P. Dompier

Keyword(s):

Student Athletes ◽

National Collegiate Athletic Association ◽

Injury Rate ◽

Surveillance Program ◽

Strain Rates ◽

Convenience Sample ◽

Injury Rates ◽

Injury Mechanisms ◽

Ncaa Athletics ◽

Rate Ratios

Context: Few researchers have examined the rates and patterns of quadriceps strains in student-athletes in the National Collegiate Athletic Association (NCAA).Objective: To describe the epidemiology of quadriceps strains in 25 NCAA sports during the 2009–2010 through 2014–2015 academic years.Design: Descriptive epidemiology study.Setting: Convenience sample of NCAA programs from 25 sports during the 2009–2010 through 2014–2015 academic years.Patients or Other Particpants: Collegiate student-athletes participating in men's and women's NCAA athletics during the 2009–2010 through 2014–2015 academic years.Main Outcome Measure(s): Aggregate quadriceps strain injury and exposure data from the NCAA Injury Surveillance Program during the 2009–2010 through 2014–2015 academic years were analyzed. Quadriceps strain injury rates and injury rate ratios (IRRs) were reported with 95% confidence intervals (CIs).Results: Overall, 517 quadriceps strains were reported, resulting in an injury rate of 1.07/10 000 athlete-exposures (AEs). The sports with the highest overall quadriceps strain rates were women's soccer (5.61/10 000 AEs), men's soccer (2.52/10 000 AEs), women's indoor track (2.24/10 000 AEs), and women's softball (2.15/10 000 AEs). Across sex-comparable sports, women had a higher rate of quadriceps strains than men overall (1.97 versus 0.65/10 000 AEs; IRR = 3.03; 95% CI = 2.45, 3.76). The majority of quadriceps strains were sustained during practice (77.8%). However, the quadriceps strain rate was higher during competition than during practice (1.29 versus 1.02/10 000 AEs; IRR = 1.27; 95% CI = 1.03, 1.56). Most quadriceps strains occurred in the preseason (57.8%), and rates were higher during the preseason compared with the regular season (2.29 versus 0.63/10 000 AEs; IRR = 3.60; 95% CI = 3.02, 4.30). Common injury mechanisms were noncontact (63.2%) and overuse (21.9%). Most quadriceps strains restricted participation by less than 1 week (79.3%).Conclusions: Across 25 sports, higher quadriceps strain rates were found in women versus men, in competitions versus practices, and in the preseason versus the regular season. Most quadriceps strains were minor in severity, although further surveillance is needed to better examine the risk factors associated with incidence and severity.

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Epidemiology of Injuries in National Collegiate Athletic Association Women's Tennis: 2014–2015 Through 2018–2019

Journal of Athletic Training ◽

10.4085/1062-6050-529-20 ◽

2021 ◽

Vol 56 (7) ◽

pp. 766-772

Author(s):

Hannah J. Robison ◽

Adrian J. Boltz ◽

Sarah N. Morris ◽

Christy L. Collins ◽

Avinash Chandran

Keyword(s):

Injury Prevention ◽

National Collegiate Athletic Association ◽

Injury Rate ◽

Surveillance Program ◽

Body Parts ◽

Prevention Strategies ◽

Time Loss ◽

Injury Rates ◽

Inflammatory Conditions ◽

Rate Ratios

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.

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Epidemiology of Injuries in National Collegiate Athletic Association Men's Football: 2014–2015 Through 2018–2019

Journal of Athletic Training ◽

10.4085/1062-6050-447-20 ◽

2021 ◽

Vol 56 (7) ◽

pp. 643-650

Author(s):

Avinash Chandran ◽

Sarah N. Morris ◽

Jacob R. Powell ◽

Adrian J. Boltz ◽

Hannah J. Robison ◽

...

Keyword(s):

National Collegiate Athletic Association ◽

Injury Rate ◽

The United States ◽

Lateral Ligament ◽

Surveillance Program ◽

Injury Incidence ◽

Collegiate Sports ◽

Injury Rates ◽

Rate Ratios ◽

Rules Changes

Context Football is among the most popular collegiate sports in the United States, and participation in National Collegiate Athletic Association (NCAA) football has risen in recent years. Background Continued monitoring of football injuries is important for capturing the evolving burden of injuries in NCAA football. The purpose of this study was to describe the epidemiology of football-related injuries among men's NCAA football players during the 2014–2015 through 2018–2019 academic years. Methods Exposure and injury data collected in the NCAA Injury Surveillance Program 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 9.31 per 1000 athlete-exposures. Most injuries occurred during general play (17.5%), blocking (15.8%), and tackling (14.0%). Concussions (7.5%), lateral ligament complex tears (6.9%), and hamstring tears (4.7%) were the most commonly reported injuries. Conclusions Results of this study were generally consistent with previous findings, though changes over time in rates of commonly reported injuries warrant attention. Continued monitoring of injury incidence is needed to appraise the effectiveness of recently implemented rules changes.

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