The NCAA News - News and Features

March 23, 1998

Knee surgery down, but number of concussions up in football

Lower knee-surgery rates and higher concussion rates in football highlighted results from the NCAA fall 1997 Injury Surveillance System (ISS).

The system, in its 15th year, monitors injuries in 16 different sports, including five in the fall: football, women's soccer, men's soccer, women's volleyball and field hockey.

Football practice- and game-injury rates were similar to the 13-year averages for the sport. This year's data showed 3.8 injuries per 1,000 athlete-exposures (A-E) for practice and 34.1 injuries per 1,000 A-E for games.

The knee, ankle and shoulder were the top three body parts injured, accounting for 47 percent of all reported injuries. Sprains, strains and contusions were the top three types of injuries, accounting for 66 percent of all reported injuries. A total of 35 percent of reported injuries restricted participation for seven days or more.

Game-related surgery rates were 10 times higher than those for practice injuries, a trend that has been consistent over the past eight years. Game-related knee surgeries remained below the 13-year average for the sport for the second straight year. Rates of game-related concussions (2.4 per 1,000 A-E) were the highest recorded in the sport since 1986. Schools sponsoring football averaged more than one game-related concussion during the season.

Women's soccer showed a practice-injury rate (5.3) that was slightly below its 12-year average and a game-injury rate (18.5) that was slightly higher than its average. Upper-leg, knee and ankle injuries were the three most common and accounted for 51 percent of the reported injuries. Strains, sprains and contusions were the top three types of injuries and accounted for 68 percent of reported injuries.

Twenty-seven percent of women's soccer injuries restricted participation for seven days or more. Anterior-cruciate ligament (ACL) injuries occurred in women's soccer players at a rate (0.32) twice that of men's soccer, which is consistent with previous comparison data.

Men's soccer showed practice- (4.3) and game-injury (17.9) rates that were slightly below the 12-year averages for the sport. Ankle, upper-leg and knee injuries were the most common, accounting for 50 percent of those reported. Sprains, strains and contusions were the top three types of injuries, accounting for 75 percent of those reported.

Twenty-seven percent of reported injuries restricted participation for seven days or more.

Women's volleyball is one of the few sports monitored that has similar injury rates for practices and games. This season's data was no different -- a practice rate (3.4) that was slightly below the 14-year average and a game rate (4.9) that matched the average.

Ankle, knee and shoulder injuries were the most common, accounting for 51 percent of those reported. Sprains, strains and tendinitis were the top three types of injuries. They accounted for 71 percent of reported injuries. Twenty-two percent of reported injuries restricted participation for seven days or more.

Practice (3.2) and game (7.1) injury rates in field hockey were lower than the 12-year averages for the sport. The lower game-injury rate continued a two-year trend of decline from a value of 12.3 in 1995.

Knee, upper-leg and ankle injuries were the most common, accounting for 36 percent of those reported. Ten percent of reported injuries involved the hand and fingers. Strains, sprains and contusions were the top three types of injuries and accounted for 58 percent of reported injuries. Twenty-one percent of reported injuries restricted participation for seven days or more.

While game-injury rates were relatively low, when such injuries occurred, more than 16 percent were to the head or face.

The survey, conducted as part of the ISS, provides a baseline of injury data from a national sampling. Researchers should be cautious when comparing ISS results with injury data from other studies. No common definition of injury, measure of severity or evaluation of exposure exists in athletics-injury literature. The information in the summary must be evaluated under the definitions and methodology outlined for the ISS.

The ISS was developed in 1982 to provide current, reliable data on injury trends in intercollegiate athletics. Injury data are collected yearly from a representative sample of member schools and the resulting data summaries are reviewed by the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports. That committee's goal continues to be to reduce injury rates through suggested changes in rules, protective equipment or coaching techniques, based on ISS data.

Sampling

Exposure and injury data were submitted weekly by athletic trainers from schools selected to represent a cross-section of the NCAA membership. The cross-section was based on the NCAA's three divisions and the four geographical regions of the country. The selected schools amount to a minimum 10 percent sample of the membership sponsoring the sport; therefore, the resulting data should be representative of the total population of NCAA institutions.

The system does not identify every injury that occurs at NCAA schools in a particular sport. Rather, it collects a sampling that is representative of a cross-section of the NCAA.

Exposures

An athlete-exposure (A-E) is one athlete participating in one practice or game in which he or she is exposed to the possibility of athletics injury. For example, five practices, each involving 60 participants, and one game involving 40 participants, would result in a total of 340 A-Es for a particular week.

Injuries

A reportable injury in the ISS is defined as one that:

1. Occurred as a result of participation in an organized intercollegiate practice or game, and

2. Required medical attention by a team athletic trainer or physician, and

3. Resulted in restriction of the student-athlete's participation or performance for one or more days beyond the day of injury.

Injury rate

An injury rate is a ratio of the number of injuries in a particular category to the number of athlete-exposures in that category. This value is then multiplied by 1,000 to produce an injury rate per 1,000 athlete-exposures. For example, six reportable injuries during a period of 563 athlete-exposures would give an injury rate of 10.7 injuries per 1,000 A-Es [(six divided by 563) times 1,000].

Additional information on the report is available from the sports sciences staff at the NCAA national office.

The accompanying tables highlight selected information from the fall ISS. When appropriate, injury rates and game-practice percentages are compared to an average value calculated from all years in which ISS data has been collected in a sport.