A trend that began in 1996 seems to be continuing as the fall 1999 NCAA Injury Surveillance System (ISS) reported an increase in football game concussions.

The system, in its 17th year, monitors injuries in 15 sports, including five in the fall: football, women's soccer, men's soccer, women's volleyball and field hockey.

Game injury (44.9 injuries per 1,000 athlete-exposures) and concussion (4.2) rates were significantly higher than the 14-year averages for football. The concussion rates in both practice and games are consistent with an increasing trend that started four years ago. Football game-injury rates equate to 2.2 injuries per game for a team of 50 game participants. The practice injury rate of 4.7 also was higher than the average for the sport.

The knee, ankle and upper leg were the most prevalent body parts injured in football practices, accounting for 43 percent of all reported injuries. The knee, ankle and shoulder accounted for 49 percent of all reported game injuries. Sprains, strains and contusions were the top three types of injuries.

More than 40 percent of all game injuries required restricted or missed participation for seven days or more, while 8 percent of injuries required surgery of some type. The highest risk practice activity was 11-on-11 scrimmaging, with an injury risk almost three times higher than other contact nonscrimmage activities.

Men's and women's soccer

The ISS reported that practice (4.2) and game (20.8) injury rates in men's soccer were consistent with the 14-year average for the sport. Assuming 15 game participants, the game rate equates to one injury every 3.2 games in the sport. Ankle, upper leg and knees were the most common body parts injured in practice, accounting for 52 percent of reported injuries; the same three were the top injuries in games. Strains, sprains and contusions were the top three types of injuries in both practices and games.

Thirty-four percent of game injuries resulted in time loss of seven days or more, while 6 percent resulted in surgery. In games, player contact accounted for 64 percent of all injuries and 7 percent of injuries were reported as concussions. Attempting or receiving a slide tackle was associated with 31 percent of game injuries.

Women's soccer showed practice (5.1) injury rates that were slightly lower than the 14-year average for the sport and game (18.5) rates that were higher. Assuming 15 game participants, the game rate equates to one injury every 3.6 games in the sport. Upper leg, ankle and knee injuries were the top three body parts injured during practices, accounting for 56 percent of the reported injuries while the knee, ankle and head accounted for 53 percent of the reported injuries in game competition. Eleven percent of all reported game injuries were concussions. Sprains and strains were the top types of injuries in both practices and games.

Thirty-seven percent of women's soccer game injuries restricted participation for seven days or more, while 11 percent resulted in surgery. Both figures are the highest reported since the survey began, indicating an increased level of injury severity in the sport. Consistent with patterns that have been monitored since 1989, women soccer players have a risk four times higher overall (six times higher in games) of anterior cruciate ligament injury than male soccer participants. Fifty-six percent of game injuries resulted from player contact; 19 percent were associated with a slide tackle.

Women's volleyball, field hockey

Women's volleyball is one of the few sports monitored that has game practice rates similar to practice rates. The 1999-00 data show practice (4.2) and game (4.3) rates that are slightly lower than the 17-year average for the sport. Assuming eight game participants, the game rate equates to one injury every 29 matches in the sport. Ankle, shoulder and knee were the most common body parts injured in practice, accounting for 42 percent of reported injuries, while the ankle, knee and foot accounted for 61 percent of the reported injuries in game competition. Sprains and strains were the top two types of injuries.

Thirty-two percent of game injuries resulted in time loss of seven days or more, while 7 percent resulted in surgery. Noncontact was the mechanism of injury in 44 percent of practice and 30 percent of game injuries.

In field hockey, practice (3.4) and game (5.9) injury rates were lower than the 14-year averages for the sport. Assuming 15 game participants, the game rate equates to one injury every 11 games in the sport.

The upper leg and knee injuries continued to be the top two body parts injured in practice, while the knee, head and ankle accounted for 38 percent of the game-related injuries. While 12 percent of game injuries were defined specifically as head injuries, 28 percent of all game injuries could be defined as above the neck (including face, nose, eyes, etc). Strains, sprains and fractures were the top three types of injuries and accounted for 63 percent of reported injuries in practice, while contusions, sprains and fractures accounted for 53 percent of the reported injuries that occurred in games.

Thirty percent of game injuries resulted in time loss of seven days or more, while 9 percent resulted in surgery. Contact with the ball or stick accounted for 17 percent of all practice and 52 percent of all game injuries.

Baseline of data

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 and reliable data on injury trends in intercollegiate athletics. Injury data are collected yearly from a representative sample of member institutions and the resulting data summaries are reviewed by the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports. The committee's goal continues to be to reduce injury rates through suggested changes in rules, protective equipment

Injury Surveillance System Highlights

The accompanying table highlights selected information from the fall 1999 Injury Surveillance System. When appropriate, injury rates and game-practice percentages are compared to an average value calculated from all years in which ISS data have been collected in a specific sport.

Game injury rate

(per 1,000 A-E) 44.9 (35.9) 4.3 (4.9) 20.8 (20.4) 18.5 (17.7) 5.9 (8.8)

% of injuries occurring in:

Top three body parts injured:

Top three types of injuries: