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Injury Survey Raises Concerns


Spring football had the highest practice injury rate of all collegiate sports during the 1994 season, according to a survey released by the National Collegiate Athletic Association (NCAA) in Overland Park, Kansas. Among women's collegiate sports, gymnastics had the highest injury rate, followed by soccer and basketball (1).

The latest annual update of the NCAA Injury Surveillance System (ISS) includes data from 16 sports for the 1994-95 season. In the ISS, 15% to 20% of schools sponsoring a particular sport are sampled, maintaining divisional and regional representation. According to ISS guidelines, a reportable injury is defined as one that requires medical attention and limits athletic participation for at least one practice or game. An athlete-exposure occurs each time one individual participates in a practice or game, exposing him or her to the risk of injury.

The injury data are reviewed annually by the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports. One of the aims of the ISS survey is to provide baseline injury information that enables various NCAA sports committees to make reasonable recommendations on safety, equipment, and rule changes, says Randall W. Dick, MS, the NCAA's assistant director of sports sciences and a chief ISS investigator.

One area of current concern is that the injury rate for spring football practice is more than double the injury rate seen in fall football practice. In spring football practice there were 9.4 injuries per 1,000 athlete-exposures; in fall football practice, the rate was 4.1 injuries per 1,000 athlete-exposures.

Dick says the NCAA is working with the American Football Coaches Association in Waco, Texas, to make spring practices safer. For example, in the fall the first three practices must be noncontact; however, there is no such rule regarding spring workouts, in which 10 of 15 practices can include contact. "It's left up to the coach to decide how to distribute the contact days, so, theoretically, the first 10 spring sessions can be contact," Dick says. "The goal of our current discussion is to accomplish the technique instruction desired by the coaches within a practice format that results in fewer injuries."

Further analysis of the NCAA survey reveals a relatively higher rate of anterior cruciate ligament injuries in female soccer and basketball players compared with their male counterparts. Anatomic differences (eg, narrower femoral notch, greater Q angle) are just some of the many variables that may explain the difference in injury rates, Dick says. Other variables that have been suggested are differences in shoes, physical condition, brace use, and joint strength (2). "The current challenge is to explain the sex-specific factors associated with this injury," Dick says. "Once this question is addressed, the goal will be to develop prevention measures based on such findings."


  1. Dick RW: National Collegiate Athletic Association Injury Surveillance System 1994-95. Overland Park, Kansas NCAA, 1995
  2. Arendt E, Dick R: Knee injury patterns among men and women in collegiate basketball and soccer: NCAA data and review of literature. Am J Sports Med 1995;23(6):694-701

Gerald Secor Couzens
Woodstock, New York