Stable practice and game injury rates and head injuries highlight the fall 2003 NCAA Injury Surveillance System (ISS) report. The system, in its 20th year, monitors injuries in 15 sports, including five in the fall: football, men's and women's soccer, women's volleyball and field hockey.

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 or coaching techniques, based on ISS data.

The fall sports study indicates practice and game injury rates either similar to or lower than the average in four of the five sports monitored.

In football, practice (4.1) and game (33.0) injury rates per 1,000 athlete-exposures were similar to the 20-year averages for the sport. The game concussion rate of 3.28 (one concussion every five games for a team of 60 participants) reflects a consistent increasing trend in the sport over the past several years. Football game injury rates equate to two injuries per game for a team of 60 participants. The knee, upper leg and ankle were the most prevalent body parts injured in practice, accounting for 44 percent of all reported injuries, while 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.

Forty-two percent of all game injuries required restricted or missed participation for seven days or more, while 10 percent of game injuries required surgery of some type. Eleven-on-11 scrimmaging was the highest-risk practice activity, with an injury risk 2.5 times higher than other contact non-scrimmage activities.

Men's and women's soccer

Men's soccer showed practice (4.2) and game (17.4) injury rates that were slightly lower than the 18-year average for the sport. Assuming 15 game participants, the game rate equates to one injury every four games in the sport. The upper leg, ankle and knees were the most common body parts injured in practice, accounting for 54 percent of reported injuries. The same three were the top injuries in games, accounting for 51 percent of the injuries. Strains and sprains were the top types of injuries in both practices and games. Concussions accounted for 7 percent of game injuries, mostly from player contact.

Six percent of men's soccer game injuries resulted in surgery. In games, player contact accounted for 61 percent of all injuries, while 13 percent of game injuries were associated with attempting or receiving a slide tackle.

In women's soccer, practice (4.7) and game (14.0) injury rates also were slightly lower than the 18-year average for the sport. Assuming 15 game participants, the game rate equates to one injury every five games in the sport. The upper leg, knee and ankle were the top three body parts injured during practices, accounting for 62 percent of the reported injuries, while the knee, ankle, and head/face accounted for 62 percent of the reported injuries in game competition. Eleven percent of all reported game injuries were concussions, mostly from player contact. Strains and sprains were the top types of injuries in both practices and games.

Ten percent of women's soccer game injuries resulted in surgery. Consistent with patterns that have been monitored since 1989, women soccer players had a 1.6 times higher risk of anterior cruciate ligament injury in games than men soccer participants. Fifty-eight percent of game injuries resulted from player contact; while 6 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 injury rates that are similar to practice. The 2003 data show similar practice (3.2) and game (3.9) rates that are somewhat lower than the 21-year averages for the sport. Assuming a team of eight players, the game injury rate equates to one injury every 32 games in the sport. The ankle, knee and upper leg were the most common body parts injured in practice, accounting for 42 percent of reported injuries, while the ankle, knee and shoulder accounted for 57 percent of the reported injuries in game competition. Sprains and strains were the top two types of injuries.

Forty-eight percent of game injuries resulted in time loss of seven days or more, while 14 percent resulted in surgery. Non-contact was the mechanism of injury in 54 percent of practice and 26 percent of game injuries. Player contact accounted for 30 percent of game injuries.

In field hockey, practice (4.2) injury rates and game (8.0) injury rates were similar to the 18-year averages for the sport. Assuming 15 game participants, the game rate equates to one injury every eight games in the sport. The upper leg, lower leg and head/face were the top three body parts injured in practice, accounting for 48 percent of all practice injuries, while the head, hand and knee were the top game injuries, accounting for 51 percent of the game-related injuries. Concussions accounted for 11 percent of all game injuries, most from ball or stick contact. Twenty-nine per cent of all game injuries could be defined as above the neck (including face, nose, eyes, etc.) Strains, sprains and contusions were the top three types of injuries.

Seven percent of game injuries resulted in surgery. Contact with the ball (mostly elevated) or stick accounted for 29 percent of all practice and 59 percent of all game injuries.

How the ISS works

Exposure and injury data were submitted weekly by athletic trainers from institutions selected to represent a cross section of NCAA membership. The cross section was based on the three divisions of the NCAA and the four geographical regions of the country. The selected institutions 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 institutions in a particular sport. Rather, it collects a sampling that is representative of a cross section of the NCAA.

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.

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.

The injury rate is the 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 athlete exposures (6 divided by 563) x 1,000.

Additional information on the report is available from the health and safety staff at the NCAA national office. More information also is available on the NCAA Injury Surveillance System Web Site at www.ncaa.
org/iss.html.