The NCAA’s health and safety needs are addressed through the collaborative efforts of national office staff, governance committees, sports rules committees, sports issues committees and external associations.  

The NCAA Committee on Competitive Safeguards and Medical Aspects of Sports advises the Association’s constituents and continually tracks on events and issues related to the health and safety of the student-athlete. The committee acts on issues through the use of NCAA injury-surveillance data, NCAA-sponsored sports-science research, expert opinion and clinical experience.

The following examples highlight significant changes that have mitigated the risk of injury in sports participation.

NCAA sports rules modifications

Baseball

1998 – The establishment of a wood-like standard for non-wood bats protects the integrity of the game and the safety of the student-athletes.

Ice hockey

1995 – An analysis of concussion injuries in ice hockey leads to rules changes and officiating emphasis on reducing hitting from behind and contact to the head.

Women’s lacrosse

2003 – The use of appropriate eye protection in women’s lacrosse is mandated to minimize the risk of catastrophic eye injury.

Track and field

2002 –The size of the pole vault landing pit is increased. 

Wrestling

1998 – Following the sudden deaths of three collegiate wrestlers, the NCAA Wrestling Rules Committee and the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports implement a mandatory weight-certification program that promotes safe weight-management practices. 

1998 – The NCAA requires all wrestling coaches covering practice or competition to be certified in first aid and cardiopulmonary resuscitation.

Football

1976 – Rule changes for the 1976 football season eliminate the head and face as a primary and initial contact area for blocking and tackling.

1997 – Modifications of permissible equipment and contact in spring football are implemented to reduce risk of injury. 

2003 – Divisions I, II, and III modify permissible equipment during the preseason period for student-athletes to minimize risk of heat illness.

2005 – The NCAA Football Rules Committee changes college football rules regarding spearing and head-down contact. In addition to the rule change, the NCAA focuses on the education of student-athletes, coaches, officials and administrators regarding prevention of head and neck injuries.  

2008 – The NCAA makes the horse-collar tackle illegal, revamps illegal contact of an opponent and simplifies the chop-block rule. More emphasis is placed on eliminating hits on defenseless players and blows to the head.  No player is permitted to initiate contact and target an opponent with the crown of his helmet, and no player is permitted to  initiate contact and target a defenseless opponent above the shoulders. 

2009 – A rule is added to allow for conference review and sanctions on fouls related to targeting/initiating contact to players.

NCAA legislation  

A more complete listing of NCAA legislation involving health and safety issues is summarized in Appendix A of the NCAA Sports Medicine Handbook. Examples of the most recent changes include:

2003 –Divisions I, II, and III modify permissible equipment and multiple practice sessions by mandating an acclimatization preseason period for student-athletes to minimize their risk of heat illness and general injuries in football.

2003 – Division I modifies the summer workout period to help minimize the risk of heat illness and general injuries. The legislation mandates that a sports-medicine staff member be present during conditioning sessions and that supervising strength and conditioning coaches be certified in first aid and cardiopulmonary resuscitation.

2005 – The NCAA approves legislation that requires member institutions to certify insurance coverage for medical expenses resulting from athletically related injuries sustained while participating in defined covered events.

2007 - NCAA Divisions I, II and III approve legislation that mandates medical examinations for all student-athletes. Before participation in any practice, competition or out-of-season conditioning activities, student-athletes who are beginning their initial season of eligibility are required to undergo a medical examination or evaluation administered or supervised by a physician.

2009 – Division III approves sport-safety training legislation that requires each head coach to maintain current certification in first aid, cardiopulmonary resuscitation and automatic external defibrillator use. 

NCAA Sports Medicine Handbook

The guidelines in the Sports Medicine Handbook are developed on topics relevant to intercollegiate athletics, applicable to a large population of student-athletes and not accessible in another easily obtainable source. The guidelines are reviewed or updated at least every four years. Guidelines added to the handbook since 1994:

1994 – The “Cold Stress” guideline is added to educate the membership about reducing life-threatening condition due to cold exposures in athletics.

1994 – The “Concussion or Mild Traumatic Brain Injury in the Athlete” guideline is added to help reduce recognition-management and return-to-play decisions for student-athletes with concussions, therefore helping reduce catastrophic events secondary to concussions. 

1997 – The “Lightning Safety” guideline is added and is recognized as the premium standard for preventing lighting-strike incidence in sports.

2000 – The “Institutional Alcohol, Tobacco and Other Drug-Education Programs” guideline is added to educate the NCAA membership on the minimal criteria for conducting an adequate drug-education program to prevent drug and alcohol abuse. 

2004 – The “Catastrophic Incident in Athletics” guideline is added to help institutions appropriately respond to a catastrophic medical event. 

2006 – The “Depression: Interventions for Intercollegiate Athletics” guideline is added to address suicide in the sport population and to educate the membership on its prevalence and the importance of early recognition and appropriate referral.  

Additional NCAA health and safety initiatives  

1983 – The NCAA starts a sports-injury surveillance program to collect accurate and reliable data on injury incidence in NCAA championships sports and to analyze, interpret and disseminate those data to assist evidence-based decision-making. The goal continues to be reducing injury rates through suggested changes in rules, protective equipment or coaching techniques based on the data.

1986 – The NCAA begins conducting drug testing for NCAA-banned substances at Divisions I, II, and III championships. All student-athletes participating in NCAA championships are subject to drug testing. 

1990 – NCAA Divisions I and II start year-round drug testing. Any Division I or II student-athlete may be tested for training drugs such as anabolic steroids. 

1992-2005 – A 13-year analysis of non-contact anterior cruciate ligament injuries in basketball and soccer leads to a focus on prevention efforts for female athletes, who have a higher risk than males for such injuries.

2002 – Division I out-of-season workout guidelines are forwarded to the membership in an effort to curb unsafe practices.

2004 – After the death of a Cornell University student-athlete in lacrosse, the NCAA hosts a multi-organizational summit addressing the prevalence, mechanism and prevention of commotio cordis in sports. Language is added immediately to the “Emergency Care and Coverage” guideline in the NCAA Sports Medicine Handbook that recommends planned access to early defibrillation as well as continued research and development of appropriate chest protectors for the sports of men’s lacrosse. 

2004 – Divisions II and III initiate an educational campaign to increase awareness of institutional responsibility for protecting the health of and providing a safe environment for all student-athletes participating in preseason workouts.     

2006 – The NCAA teams with the American Council on Education and United Educators to publish “Safety in Student Transportation,” a 60+-page resource guide that colleges and universities can use to minimize the risk involved with transporting students.

2006 – The NCAA partners with Varsity Brands, the parent company of the largest national cheer organizations, to undertake an important cheerleading risk-management initiative to enhance safety for college cheerleaders. As a first step, the NCAA’s Catastrophic Injury Insurance Program includes a new requirement that cheerleading activities must be supervised by a safety-certified coach or advisor to be considered a covered event.

2009 – The NCAA recommends its member institutions test student-athletes to confirm their sickle-cell trait status if that information is not already known.