The NCAA News - News & Features

Injury surveillance and its application to sports rules, policies and issues

While the committee realizes that participation in sports requires an acceptance of risk of injury, it is dedicated to minimizing this risk whenever possible without affecting the nature of the game. The committee uses data from the ISS and input from other sports medicine groups to justify health and safety recommendations related to sports rules, policies and issues. These recommendations generally develop jointly following discussion with the relevant sports or sports-rules committee.

Specific health and safety issues are included in this report, followed by committee recommendations for specific action or a review of current committee initiatives.

1. Spring Football. Spring football-practice injury rates are more than double those of fall football-practice injury rates. The committee finds this disparity unacceptable. Discussions with the American Football Coaches Association and NCAA Football Rules Committee have been ongoing for two years.

Recommendation: Student-athletes should not be exposed to a nontraditional-season injury risk that is higher than that experienced during the regular season. Legislation should be sponsored that would require the first two days of spring practice to be noncontact, reduce the number of contact days from 10 to five while maintaining a total of 15 practice days, and remove shoulder pads from all noncontact practices. The College/University Athletic Trainers' Committee endorses this position.

2. Injury Surveillance System Enhancements. The ISS has been in existence since 1982 and is a primary tool to stimulate committee and Association awareness of safety issues related to rules, equipment and policy.

Current initiative: Current enhancements give the ISS the potential to expand participation within existing sports and to expand injury-monitoring to all NCAA-sponsored activities. As the system evolves, the committee anticipates a future one-time request for funds to assist in hardware/software purchases associated with injury-data collection for member institutions.

3. Wrestling.

a. Skin infections. Skin infections in wrestling have accounted for 20 percent of all time-loss incidents in the sport from 1992 to 1995. In a decision made by the NCAA Wrestling Committee and endorsed by the competitive-safeguards committee, skin examinations were required before all matches for the 1995-96 season. Skin infections accounted for only eight percent of time-loss incidents in the sport this past year.

b. Weight loss. NCAA wrestling championships permitted acute weight-loss behaviors including excessive dehydration, contrary to recommendations from the American College of Sports Medicine, American Medical Association, and the NCAA's sports medicine guidelines. In April, the competitive-safeguards and wrestling committees released a joint statement that significantly addressed this issue.

Current initiative. The committee will continue to monitor closely both the skin-infection and acute weight-loss issues in conjunction with the Wrestling Committee. Changing the emphasis from making weight to competing safely is a priority.

4. Women's Lacrosse and Field Hockey. While the number of head and facial injuries in the sport of women's lacrosse and field hockey is not high, both sports are played with a ball that has the size and composition to cause significant damage in these areas. Until recently, NCAA women's lacrosse and field hockey championships had rules adopted from national organizations that prohibited the use of traditional head protection and discouraged the use of other face protection. Discussions between the competitive-safeguards committee and the relevant sports committees resulted in the establishment of an eye-wear standard for women's lacrosse and the optional use of soft helmets in both sports.

Current initiative: The committee will continue to monitor head and face injuries in women's lacrosse and field hockey. It encourages the NCAA Field Hockey Committee to investigate the possibility for developing eye-wear standards. It encourages both sports to educate participants on the protective-equipment options available to them.

5. Ice Hockey. The game-concussion injury rate in ice hockey has doubled since 1990. Discussions with the NCAA Ice Hockey Rules Committee have led to stricter penalties associated with noncompliance with the mouthpiece rule, hitting from behind and checking into the boards.

Current initiative: The committee will encourage enforcement of existing rules to address head injuries in the sport of ice hockey. Part of this effort should involve accountability for officials. In addition, a mechanism for recertification of the hockey helmet and addition of a four-point chin strap should be considered.

6. Baseball and Softball. Livelier bats and their association with injury from batted balls have been a concern in both baseball and softball in the past few years. The ISS has been modified to review injuries caused by batted balls.

Current initiative: The committee supports research to quantify the injury risk from batted balls and rules-committee efforts to develop a bat standard.

7. HIV, Bleeding and Sports. The recent interest regarding HIV in sports has stimulated athletics associations and medical organizations to develop comprehensive policies on this topic. NCAA members are also interested in keeping current on this topic.

Current initiative: Using data from a modified ISS form and information from the Centers for Disease Control and Prevention, the committee has determined that the risk of HIV transmission during participation in NCAA sports is less than one chance in one million exposures. The committee will continue to keep the membership informed on this issue through the Sports Medicine Handbook, this newsletter and other outlets.

8. Research.

a. Anterior-cruciate ligament (ACL) injuries. ISS data show a distinct and consistently higher anterior-cruciate ligament injury rate in female collegiate soccer and basketball student-athletes than in their male counterparts. A June meeting with representative medical personnel from member institutions began discussion on identification of causative factors.

Current initiative: The committee recommends follow-up of the June meeting by profiling ACL-injured athletes through this year (see related article on page 7). Variables that appear frequently in the injured athlete will be examined in a multicenter prospective study during 1997-98. In addition, a videotape library of noncontact ACL injuries will be compiled for analysis of injury mechanism. Participation by other sports medicine organizations also will be encouraged where appropriate.

b. Overuse injuries. Overuse injuries are thought to

account for a significant number of time-loss

events in collegiate athletics, yet they are difficult to

identify in the ISS or in any other inj jury-tracking

sy tem. A better understanding and recognition of

these injuries may assist in preventive efforts.

Current initiative: The committee will sponsor a focus group with a purpose of better defining overuse injuries and developing a surveillance instrument that will be compatible with the ISS. Sports to be reviewed specifically include swimming, cross country, and track and field. Relevant sports already monitored by the ISS also will be evaluated.