The Epidemiology of Severe Injuries Sustained by National Collegiate Athletic Association Student-Athletes, 2009–2010 Through 2014–2015

TLDR

Few studies have quantified the incidence of severe injuries among NCAA student‑athletes. The study aimed to describe the epidemiology of severe injuries across 25 NCAA sports during 2009‑2015. Using data from the NCAA Injury Surveillance Program, severe injuries were defined as those occurring during sanctioned competition or practice, requiring medical attention, and causing ≥21 days lost or premature season end, and the study performed a descriptive epidemiology analysis. Across 3,183 severe injuries, the overall rate was 0.66 per 1,000 athlete‑exposures, with wrestling (1.73), women’s gymnastics (1.40), and football (0.97) having the highest rates; competition injuries were 4.25 times more common than practice injuries, most occurred in the regular season, and the most affected body parts were knees, lower legs, and head/face/neck, with sprains, strains, and fractures being the leading diagnoses, while player contact was the most frequent mechanism, underscoring sport‑specific patterns that can guide prevention strategies.

Abstract

Few researchers have described the incidence of the most severe injuries sustained by student-athletes at the collegiate level.To describe the epidemiology of severe injuries within 25 National Collegiate Athletic Association (NCAA) sports in the 2009-2010 through 2014-2015 academic years.Descriptive epidemiology study.Aggregate injury and exposure data from 25 NCAA sports.Collegiate student-athletes in the 2009-2010 through 2014-2015 academic years.Injury data from the NCAA Injury Surveillance Program were analyzed. A severe injury (1) occurred during a sanctioned competition or practice, (2) required medical attention by an athletic trainer or physician, and (3) resulted in at least 21 days lost from sport activity or a premature end to the sport season. Injury counts, proportions, rates per 1000 athlete-exposures (AEs), rate ratios (RRs), and injury proportion ratios were reported with 95% confidence intervals (CIs).A total of 3183 severe injuries were reported, for an injury rate of 0.66/1000 AEs. Wrestling had the highest severe injury rate (1.73/1000 AEs), followed by women's gymnastics (1.40/1000 AEs) and football (0.97/1000 AEs). Overall, the severe injury rate was higher in competition than in practice (RR = 4.25, 95% CI = 3.97, 4.56). Most severe injuries were reported during the regular season (69.3%, n = 2206); however, severe injury rates did not differ between the preseason and regular season (RR = 0.98, 95% CI = 0.91, 1.06). Common severely injured body parts were the knee (32.9%, n = 1047), lower leg/ankle/foot (22.5%, n = 715), and head/face/neck (11.2%, n = 358). Common severe injury diagnoses were sprains (32.9%, n = 1048), strains (16.9%, n = 538), and fractures (14.4%, n = 458). Common severe injury mechanisms were player contact (39.3%, n = 1251), noncontact (25.1%, n = 800), and surface contact (12.0%, n = 383).Severe injuries occurred across many sports and by numerous mechanisms. By identifying these sport-specific patterns, clinicians' efforts can be tailored toward improving injury-prevention strategies and health outcomes.