ISS Qualifying Report. Fall Sports Steve Marshall, PhD Jill Corlette, MS ATC

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1 ISS Qualifying Report Fall Sports Steve Marshall, PhD Jill Corlette, MS ATC

2 NCAA INJURY SURVEILLANCE PROGRAM FALL SPORTS QUALIFYING REPORT ACADEMIC YEARS MEN S FOOTBALL MEN S SOCCER WOMEN S SOCCER WOMEN S FIELD HOCKEY WOMEN S VOLLEYBALL Citation: Authored by the Datalys Center. All Rights Reserved 2009 Page 2

3 Marshall SW, Corlette J. Fall Sports Qualifying Report: Academic Years. Datalys Center for Sports Research and Prevention: Indianapolis, IN. December, 2009 Authored by the Datalys Center. All Rights Reserved 2009 Page 3

4 Table of Contents 1. Executive Summary 4 2. Incidence 6 3. Men s Football 8 4. Men s Soccer Women s Soccer Women s Field Hockey Women s Volleyball Methodology & Technical Notes 8.1 ISS Overview & History 8.2 Composition of ISS Sample 8.3 Sample Weights & Adjustment for Under-reporting 8.4 Definition 8.5 Data Management 8.6 Data Cleaning - Exposures 8.7 Data Cleaning Statistical Analysis Acknowledgements 76 Authored by the Datalys Center. All Rights Reserved 2009 Page 4

5 1. Executive Summary This document reports on the data for Fall sports collected during the period when the NCAA directly operated a web-based system - the 2004/05 to 2008/09 academic years. The sports covered by this report are: Men s Football, Men s Soccer, Women s Soccer, Women s Field Hockey, and Women s Volleyball (Spring football is not included in this report). The sport with the highest rate of completion injury was Football, followed by Men s and Women s Soccer. Football also accounted for the greatest absolute number of injuries. Concussion was the 4 th most frequent injury in Men s Soccer but the 2 nd most frequent injury in Women s Soccer. The mission of the NCAA Surveillance System is to collect accurate and reliable data on injury incidence in NCAA championship sports, and analyze, interpret, & disseminate these data to facilitate evidence-based decision-making. Throughout its entire history, the system has depended on a volunteer convenience sample of reporting schools. The composition of the sample has varied from year-to-year, as teams and schools move in and out of the reporting group. Additionally, due to time pressures and other considerations, some injuries go unreported to the system. In response, this report introduced two methodological innovations: post-stratification sample weights (to adjust for year-to-year variation in the composition of the reporting sample) adjustment for under-reporting See Chapter 8 for full details on these statistical procedures, which follow wellestablished statistical methods for large-scale surveillance systems. Note that statistics on Men s Water Polo could not be produced because there were so few schools reporting this sport during this period that a statistically valid report could not be generated. Statistics on Cross-country are also not included. There were sufficient schools reporting Cross-country data to generate a report, however, due to the individual (versus team) Authored by the Datalys Center. All Rights Reserved 2009 Page 5

6 nature of this sport, we have elected to clean those data in combination with other individual sports. Data on Cross-country will appear in a subsequent ISS Qualifying Report. All injury and exposure counts were weighted to represent national estimates during the 5-year period covered by the report. Note that these are NOT annual estimates they are cumulative estimates that cover the whole 5 years. In general, tables are ordered so that the most common injuries are listed first. When a table lists injuries by competition, practice, and both (overall), the overall ranking is used to determine the ordering of the rows. Authored by the Datalys Center. All Rights Reserved 2009 Page 6

7 2. Incidence The sports covered by this report are: Men s Football, Men s Soccer, Women s Soccer, Women s Field Hockey, and Women s Volleyball. Figure 2.1 shows competition and practice injury rates for each of these sports. The sport with the highest rate of injury was Football, followed by Men s and Women s Soccer, Field Hockey, & Volleyball. Although football has a high injury rate in competition, the practice injury rates in football, men s and women s soccer, and field hockey are similar. Football also accounted for the greatest absolute number of injuries. There were as many football injuries as the other four sports combined. We estimate that there were over one-quarter of a million football injuries over the 5 academic years (not including Spring football). Figure 2.1 Rates by Sport (error bars indicate 95% confidence intervals) Authored by the Datalys Center. All Rights Reserved 2009 Page 7

8 Table 2.1 Rates by Sport, including -to- Rate Ratio Sport Event Reported (National Estimate) Athlete Exposures (National Estimate) Rate (per 1000 Athlete Exposures) 1 -to- Rate Ratio 1 Football 9, ,593 2,153, [43.9,52.3] 14, ,349 23,215, [6.4,7.6] 23, ,943 25,369, [9.7,11.4] 6.8 [5.8, 8.2] Men s Soccer 2,621 35,786 1,513, [21.0,26.3] 2,793 37,862 5,340, [6.4,7.8] 5,414 73,648 6,853, [9.8,11.7] 3.3 [2.7, 4.1] Women s Soccer 2,904 38,795 1,788, [20.1,23.2] 3,083 40,790 5,513, [6.8,8.0] 5,987 79,585 7,302, [10.1,11.7] 2.9 [2.5, 3.4] Women s Field Hockey 491 5, , [12.1,17.4] 760 8,919 1,193, [5.9,9.0] 1,251 14,487 1,570, [7.8,10.6] 2.0 [1.3, 2.9] Women s Volleyball ,045 1,395, [7.7,9.5] 1,976 30,086 3,959, [7.0,8.2] 2,753 42,131 5,354, [7.3,8.4] 1.1 [0.9, 1.4] 1 numbers in square brackets [] indicate 95% confidence intervals Table 2.1 presents injury rates including competition-to-practice rate ratio. This rate rtio indicates the increase in the injury rate due to participation in a competition, rather than a practice. Football had the highest competition-to-practice rate ratio, with a nearly 7-times greater rate of injury in competition relative to practice. Volleyball, at the other end of the spectrum, had essentially the same rate of injury in competitions and practices (rate ratio of 1.1). Authored by the Datalys Center. All Rights Reserved 2009 Page 8

9 3. Men s Football Table 3.1 Rates by Division - Fall Football 2004/05 to 2008/09 (National Estimate) Athlete Exposures (National Estimate) Rate (per 1000 Athlete- Exposures) 1 Division Event Type Reported All Divisions 9, ,593 2,153, [43.9,52.3] 14, ,349 23,215, [6.4,7.6] 23, ,943 25,369, [9.7,11.4] Division I 5,435 51, , [50.6,65.4] 7,891 74,227 10,082, [6.3,8.4] 13, ,500 10,966, [10.0,12.9] Division II 1,122 20, , [30.4,49.3] 1,746 32,008 5,571, [4.4,7.0] 2,868 52,256 6,079, [6.8,10.4] Division III 2,739 32, , [37.4,46.8] 4,805 57,114 7,562, [6.9,8.3] 7,544 89,186 8,323, [9.6,11.8] 1 numbers in square brackets [] indicate 95% confidence intervals Table 3.1 presents injury rates by Division for Fall Football, 2004/05 to 2008/09. injury rates are higher in Division 1. Authored by the Datalys Center. All Rights Reserved 2009 Page 9

10 Table 3.2 Type of - Fall Football 2004/05 to 2008/09 Type of Sprain - ligament 36, % 6 40, % 4 77, % 5 Strain - muscle / tendon 13, % 4 40, % 4 53, % 4 Contusion (hematoma) 20, % 3 20, % 1 41, % 2 Concussion 6, % 6 9, % 6 16, % 6 Subluxation 2, % 5 6, % 5 8, % 5 Fracture / Avulsion 5, % 14 5, % 9 10, % 12 Nerve injury 3, % 4 3, % 2 6, % 3 Cartilage injury 2, % 5 4, % 7 7, % 6 Miscellaneous 1, % 4 4, % 2 6, % 3 Tendinosis % 3 4, % 1 5, % 1 Spasm / cramp 1, % 2 3, % 1 4, % 1 Dislocation 2, % 4 3, % 2 5, % 3 Other 6, % 2 18, % 2 24, % 2 National estimate based on 23,738 reported injuries. 103, % 163, % 266, % Table 3.2 presents injury type for Fall Football, 2004/05 to 2008/09. Soft-tissue injuries such as sprains and strains account for the majority of injuries, but hard-tissue injury (fracture) has the highest median days lost. Concussions accounted for approximately 6 injuries.

11 Table 3.3 Body Site of - Fall Football 2004/05 to 2008/09 Body Site of Knee 18, % 5 24, % 4 42, % 5 Shoulder / clavicle 14, % 5 20, % 3 34, % 4 Ankle 15, % 7 18, % 4 33, % 5 Thigh 7, % 4 19, % 5 27, % 4 Hand / finger 7, % 1 10, % 1 18, % 1 Head / face 7, % 6 10, % 6 17, % 6 Hip / groin 3, % 4 12, % 3 15, % 3 Foot / toe 4, % 4 7, % 3 12, % 3 Lower leg / achilles tendon 5, % 4 6, % 3 11, % 3 Lower back / sacrum / pelvis 3, % 4 7, % 3 10, % 3 Neck / cervical spine 4, % 4 5, % 2 9, % 3 Environmental / Fluids 1, % 0 4, % 1 6, % 1 Chest / upper back / ribs 3, % 4 3, % 2 6, % 3 Elbow 2, % 3 2, % 1 5, % 2 Wrist 1, % 2 2, % 1 4, % 2 Other 3, % 3 7, % 2 10, % 2 103, % 163, % 266, % National estimate based on 23,738 reported injuries. Table 3.3 presents injury body site for Fall Football, 2004/05 to 2008/09. Upper and lower extremities account for the majority of injuries. Ankle injuries and head injuries (predominately concussions) had the highest median days lost. Authored by the Datalys Center. All Rights Reserved 2009 Page 11

12 Table 3.4 Twelve Most Common Specific - Fall Football 2004/05 to 2008/09 Specific Lateral ankle ligament complex (ATF, CF, PTF) partial tear 8, % 5 11, % 4 20, % 4 Concussion 6, % 6 9, % 6 16, % 6 Hamstring partial tear 3, % 5 12, % 7 15, % 7 Medial collateral ligament (MCL) partial tear 6, % 7 5, % 9 11, % 8 Acromioclavicular (AC) sprain (partial - I or II) 5, % 6 4, % 5 10, % 6 Quadriceps contusion 3, % 3 2, % 2 6, % 3 Adductor (groin) partial tear 1, % 5 5, % 4 6, % 4 Knee contusion 3, % 3 3, % 1 6, % 2 Ant. tibiofibular syndesmosis (high ankle) partial sprain 3, % 12 2, % 11 6, % 12 Brachial Plexus Syndrome (Stinger) 2, % 4 2, % 2 5, % 3 Iliopsoas / Sartorius (partial tear) % 3 3, % 3 4, % 3 Lower leg contusion 2, % 3 1, % 2 3, % 2 Other 56, % 4 96, % 2 153, % 3 National estimate based on 23,738 reported injuries. 103, % 163, % 266, % Table 3.4 shows specific injuries (body site by injury type) for Fall Football, 2004/05 to 2008/09. Over 40 injuries were due to the top 12 specific injuries. The top three specific injuries (lateral ankle ligament tears, concussions, and hamstring tears) accounted for nearly 20 all injuries.

13 Table 3.5 Time -- Fall Football 2004/05 to 2008/09 Division Event Type Mean Standard Deviation Total All Divisions 103, , , ,099, , ,923,568 Division I 51, ,359 74, , , ,538 Division II 20, ,019 32, ,572 52, ,591 Division III 32, ,520 57, ,920 89, ,440 National estimate based on 23,738 reported injuries. Table 3.5 presents data on time lost from the sport for Fall Football, 2004/05 to 2008/09. This table indicates that athletes in D1 return to the game more quickly than D2 and D3 athletes, however, this may be a methodologic artifact introduced by higher reporting of zero-time-lost injuries in D1.

14 Table 3.6 Event Details - Fall Football 2004/05 to 2008/09 Season Segment Pre-Season % 100, % 100, % In Season 100, % 60, % 160, % Post-Season 2, % 3, % 5, % 103, % 163, % 266, % Activity General play 20, % 50, % 71, % Running play (offense) 21, % 24, % 45, % Running play (defense) 21, % 19, % 40, % Passing play (offense) 15, % 22, % 37, % Passing play (defense) 10, % 13, % 23, % Blocking drill % 9, % 9, % Conditioning % 8, % 8, % Kick off coverage 4, % 1, % 6, % Tackling drill % 5, % 5, % Kick off return 3, % 1, % 4, % Punt Coverage 2, % 1, % 3, % Other % 2, % 2, % Punt return 1, % % 2, % Kicking % 1, % 1, % PAT/FG attempt % % % PAT/FG defense % % % 103, % 163, % 266, % Mechanism Acute non-contact 14, % 47, % 61, % Tackling 21, % 19, % 41, % Being tackled 20, % 15, % 35, % Blocking 14, % 21, % 35, % Being blocked 12, % 12, % 24, % Contact with playing surface 8, % 11, % 19, % Stepped on/fall on/kicked 8, % 10, % 18, % Overuse/gradual onset 1, % 10, % 12, % Authored by the Datalys Center. All Rights Reserved 2009 Page 14

15 Table 3.6 Event Details - Fall Football 2004/05 to 2008/09 (continues) Illness 1, % 9, % 11, % Mechanism Contact with apparatus % 3, % 4, % (continued) Contact with out-of-bounds object % % % Other % 1, % 2, % 103, % 163, % 266, % National estimate based on 23,738 reported injuries. Table 3.6 presents the distribution of injuries by season, activity, and injury mechanism for Fall Football, 2004/05 to 2008/09. Data is shown for competition and practice separately and also for competition and practice combined (overall). Tackling, Being tackled, Blocking, & Being blocked account for over 50 injuries. Authored by the Datalys Center. All Rights Reserved 2009 Page 15

16 Table 3.7 Event Details for - Fall Football 2004/05 to 2008/09 Type Away 53, % Home 49, % 103, % Game Time First Quarter 13, % Second Quarter 25, % Third Quarter 24, % Fourth Quarter 20, % Overtime % Warm-up 1, % Other % Unknown 17, % 103, % Location Between the 20 yard lines 60, % Red Zone (20 yard line to goal line) 13, % End Zone 1, % Unknown 26, % Other 1, % 102, % Game Position Linebacker 14, % RB/Slotback 11, % Flanker/WR 11, % Def Tackle/NG 8, % Special Teams 8, % Def End 7, % Cornerback 7, % Safety 7, % Quarterback 5, % Off Tackle 5, % Authored by the Datalys Center. All Rights Reserved 2009 Page 16

17 Table 3.7 Event Details for - Fall Football 2004/05 to 2008/09 (continues) Off Guard 5, % Game Position Off (tight) End 3, % (continued) Center 2, % Kicker/Punter % Long Snapper % Holder % Other % 102, % National estimate based on 9,296 reported injuries. Table 3.7 presents the distribution of injuries by various game factors: home/away, location on field at time of injury, and position played, for Fall Football games, 2004/05 to 2008/09. This table is limited to injuries in competitions only. Second and third quarter are over-represented relative to first and fourth quarter. Authored by the Datalys Center. All Rights Reserved 2009 Page 17

18 Table 3.8 Mechanism of for Game - Fall Football 2004/05 to 2008/09 Task Mechanism % General play Contact with playing surface 1, % Contact with apparatus % Acute non-contact 3, % Overuse/gradual onset 1, % Illness 1, % Tackling 4, % Being tackled 1, % Blocking 2, % Being blocked 1, % Stepped on/fall on/kicked 1, % Other % 18, % Passing play (defense) Contact with playing surface % Contact with apparatus % Acute non-contact 1, % Overuse/gradual onset % Illness % Tackling 3, % Being tackled % Blocking % Being blocked 1, % Stepped on/fall on/kicked % Other % 8, % Passing play (offense) Contact with playing surface 1, % Contact with apparatus % Acute non-contact 1, % Overuse/gradual onset % Illness % Authored by the Datalys Center. All Rights Reserved 2009 Page 18

19 Table 3.8 Mechanism of for Game - Fall Football 2004/05 to 2008/09 Task Mechanism % (continues) Tackling % Passing play (offense) Being tackled 6, % (continued) Blocking 1, % Being blocked % Stepped on/fall on/kicked % Other % Contact with out-of-bounds object % 13, % Running play (defense) Contact with playing surface 1, % Contact with apparatus % Acute non-contact 1, % Overuse/gradual onset % Illness % Tackling 8, % Being tackled % Blocking % Being blocked 4, % Stepped on/fall on/kicked 1, % Other % 18, % Running play (offense) Contact with playing surface 1, % Contact with apparatus % Acute non-contact 1, % Overuse/gradual onset % Illness % Tackling % Being tackled 7, % Blocking 5, % Being blocked % Stepped on/fall on/kicked 1, % Authored by the Datalys Center. All Rights Reserved 2009 Page 19

20 Table 3.8 Mechanism of for Game - Fall Football 2004/05 to 2008/09 Task Mechanism % (continues) Other % Running play (offense) Contact with out-of-bounds object % (continued) 19, % Other Contact with playing surface % Contact with apparatus % Acute non-contact 1, % Overuse/gradual onset % Illness % Tackling 2, % Being tackled 1, % Blocking 1, % Being blocked 2, % Stepped on/fall on/kicked % Other % 12, % National estimate based on 8,246 reported injuries Table 3.8 presents the distribution of injuries for a cross-tabulation of activity by mechanism of injury, for Fall Football games, 2004/05 to 2008/09. This table is limited to injuries in competitions only. Authored by the Datalys Center. All Rights Reserved 2009 Page 20

21 Table 3.9 Event Details for - Fall Football 2004/05 to 2008/09 Event Event Details Segment Team drills 96, % Individual drills 28, % Unknown 19, % Conditioning 6, % Post practice 2, % Warm-up 2, % Other 1, % 158, % Type Regular 145, % Scrimmage 10, % Walk-through 2, % 158, % National estimate based on 14,015 reported injuries Table 3.9 presents the distribution of injuries for event details, for Fall Football practices, 2004/05 to 2008/09. This table is limited to injuries in practices only. Authored by the Datalys Center. All Rights Reserved 2009 Page 21

22 Table 3.10 Mechanism for Game Concussions - Fall Football 2004/05 to 2008/09 Task Mechanism % General play Contact with playing surface % Tackling % Being tackled % Blocking % Being blocked % Stepped on/fall on/kicked % Other % % Kick off coverage Contact with playing surface % Tackling % Being tackled % Blocking % Being blocked % % Passing play (offense) Contact with playing surface % Tackling % Being tackled % Blocking % Being blocked % Other % Contact with out-of-bounds object % 1, % Running play (defense) Contact with playing surface % Tackling % Being tackled % Blocking % Being blocked % Stepped on/fall on/kicked % Authored by the Datalys Center. All Rights Reserved 2009 Page 22

23 Table 3.10 Mechanism for Game Concussions - Fall Football 2004/05 to 2008/09 Task Mechanism % (continues) 1, % (continued) Running play (offense) Contact with playing surface % Tackling % Being tackled % Blocking % Being blocked % Stepped on/fall on/kicked % 1, % Other Contact with playing surface % Tackling % Being tackled % Blocking % Being blocked % Stepped on/fall on/kicked % Other % 1, % National estimate based on 572 reported injuries Table 3.10 is similar to Table 3.8, but it is limited to concussions only. It presents the distribution of injuries for a cross-tabulation of activity by mechanism of injury, for concussions in Fall Football games, 2004/05 to 2008/09. This table is limited to concussion injuries in competitions only. Authored by the Datalys Center. All Rights Reserved 2009 Page 23

24 4. Men s Soccer Table 4.1 Rates by Division - Men's Soccer 2004/05 to 2008/09 (National Estimate) Athlete Exposures (National Estimate) Rate (per 1000 Athlete- Exposures) 1 Division Event Type Reported All Divisions 2,621 35,786 1,513, [21.0,26.3] 2,793 37,862 5,340, [6.4,7.8] 5,414 73,648 6,853, [9.8,11.7] Division I 1,186 11, , [24.8,33.2] 1,245 12,128 1,612, [6.5,8.5] 2,431 23,666 2,010, [10.3,13.3] Division II 362 8, , [15.4,33.0] 336 8,356 1,271, [4.5,8.6] ,201 1,637, [7.6,13.4] Division III 1,073 15, , [18.4,22.7] 1,212 17,378 2,455, [6.1,8.1] 2,285 32,781 3,206, [9.2,11.3] 1 numbers in square brackets [] indicate 95% confidence intervals Table 4.1 presents injury rates by Division for Men s Soccer, 2004/05 to 2008/09. injury rates are higher in Division 1. Authored by the Datalys Center. All Rights Reserved 2009 Page 24

25 Table 4.2 Type of - Men's Soccer 2004/05 to 2008/09 Type of Strain - muscle / tendon 7, % 5 11, % 4 18, % 4 Sprain - ligament 9, % 5 8, % 5 18, % 5 Contusion (hematoma) 9, % 3 5, % 2 14, % 3 Concussion 2, % 6 1, % 3 3, % 5 Miscellaneous % 2 1, % 3 2, % 3 Fracture / Avulsion 2, % % 12 2, % 9 Laceration 1, % % 1 1, % 1 Tendinosis % 3 1, % 2 1, % 2 Spasm / cramp % % 2 1, % 2 Cartilage injury % % 6 1, % 6 Overuse % % % 2 Subluxation % % % 4 Other 1, % 5 4, % 2 6, % 2 35, % 37, % 73, % National estimate based on 5,414 reported injuries. Table 4.2 presents injury type for Men s Soccer, 2004/05 to 2008/09. Soft-tissue injuries such as sprains and strains account for the majority of injuries, but hard-tissue injury (fracture) has the highest median days lost. Concussions accounted for 3 practice injuries but over 6% of competition injuries. Authored by the Datalys Center. All Rights Reserved 2009 Page 25

26 Table 4.3 Body Site of - Men's Soccer 2004/05 to 2008/09 Body Site of Ankle 6, % 4 6, % 5 13, % 4 Thigh 5, % 5 6, % 4 11, % 4 Knee 4, % 5 4, % 3 9, % 4 Hip / groin 2, % 4 4, % 3 7, % 4 Lower leg / achilles tendon 3, % 3 3, % 3 6, % 3 Foot / toe 2, % 4 3, % 3 6, % 3 Head / face 3, % 4 1, % 3 5, % 4 Shoulder / clavicle 1, % % 4 2, % 5 Lower back / sacrum / pelvis % 3 1, % 2 2, % 2 Hand / finger % % 1 1, % 1 Chest / upper back / ribs % % 2 1, % 3 Environmental / Fluids % % % 1 Nose % % % 5 Wrist % % % 2 Mouth % % % 1 Other 1, % 3 1, % 2 2, % 2 35, % 37, % 73, % National estimate based on 5,414 reported injuries. Table 4.3 presents injury body site for Men s Soccer, 2004/05 to 2008/09. Upper and lower extremities account for the majority of injuries. Authored by the Datalys Center. All Rights Reserved 2009 Page 26

27 Table 4.4 Twelve Most Common Specific - Men's Soccer 2004/05 to 2008/09 Specific Lateral ankle ligament complex (ATF, CF, PTF) partial tear 3, % 4 4, % 5 8, % 5 Hamstring partial tear 2, % 8 2, % 5 5, % 6 Adductor (groin) partial tear 1, % 5 2, % 3 3, % 4 Concussion 2, % 6 1, % 3 3, % 5 Quadriceps partial tear % 7 2, % 5 3, % 5 Quadriceps contusion 1, % % 3 2, % 3 Lower leg contusion 1, % % 2 2, % 2 Foot / toe contusion 1, % 4 1, % 2 2, % 3 Medial collateral ligament (MCL) partial tear 1, % 8 1, % 9 2, % 8 Knee contusion 1, % % 2 1, % 2 Iliopsoas / Sartorius (partial tear) % 5 1, % 4 1, % 4 Ankle contusion % % 2 1, % 3 Other 16, % 4 18, % 2 35, % 3 National estimate based on 5,414 reported injuries. 35, % 37, % 73, % Table 4.4 shows specific injuries (body site by injury type) for Men s Soccer, 2004/05 to 2008/09. Nearly one-half of injuries were due to the top 12 specific injuries. The top three specific injuries (lateral ankle ligament tears, adductor tears, and hamstring tears) all involved the lower extremity. Concussions were the fourth most common specific injury.

28 Table 4.5 Time -- Men's Soccer 2004/05 to 2008/09 Division Event Type Mean Standard Deviation Total All Divisions 35, ,251 37, ,664 73, ,916 Division I 11, ,439 12, ,348 23, ,786 Division II 8, ,385 8, ,535 17, ,920 Division III 15, ,427 17, ,782 32, ,209 National estimate based on 5,414 reported injuries. Table 4.5 presents data on time lost from the sport for Men s Soccer, 2004/05 to 2008/09. Cumulatively over the 5-year period, injuries resulted in one-half million days lost from the sport of collegiate men s soccer. Table 4.6 (next page) presents the distribution of injuries by season, activity, and injury mechanism for Fall Football, 2004/05 to 2008/09. Data is shown for competition and practice separately and also for competition and practice combined (overall). Direct contact between players, as mechanism of injury, accounted for twice as many injuries in games as in practices.

29 Table 4.6 Event Details - Men's Soccer 2004/05 to 2008/09 Season Pre-Season 1, % 21, % 23, % In Season 31, % 15, % 47, % Post-Season 2, % % 3, % 35, % 37, % 73, % Activity General play 11, % 16, % 27, % Defending 5, % 3, % 8, % Ball handling / dribbling 3, % 2, % 6, % Goaltending 1, % 2, % 4, % Loose ball 2, % 1, % 4, % Heading ball 2, % 1, % 4, % Shooting (foot) 1, % 2, % 3, % Passing (foot) 1, % 1, % 3, % Conditioning % 3, % 3, % Receiving a slide tackle 1, % % 1, % Receiving Pass % % 1, % Attempting a slide tackle 1, % % 1, % Blocking shot % % 1, % Other % % % 35, % 37, % 73, % Mechanism Direct player contact 15, % 7, % 22, % Acute non-contact 8, % 14, % 22, % Contact with playing surface 3, % 3, % 6, % Overuse/gradual onset 1, % 4, % 6, % Contact with apparatus 1, % 2, % 4, % Illness % 1, % 2, % Indirect player contact 1, % % 1, % Unknown % % % Contact with out-of-bounds object % % % Contact with ball % % Other 3, % 2, % 6, % 35, % 37, % 73, % Authored by the Datalys Center. All Rights Reserved 2009 Page 29

30 National estimate based on 5,414 reported injuries. Table 4.7 Event Details for - Men's Soccer 2004/05 to 2008/09 Type Away 19, % Home 16, % 35, % Game Time First half 12, % Second half 16, % Overtime % Overtime Penalty kicks % Warm-up % Unknown 4, % Other % 35, % Location Top of goal box extended to center line 8, % Top of goal box extended to center line 7, % Goal box (defense) 3, % Goal box (offense) 2, % Side of goal box (defense) 2, % Side of goal box (offense) 1, % Unknown 9, % Other % 35, % Game Position Midfield 12, % Defense 10, % Forward 9, % Goalkeeper 2, % Other % 35, % National estimate based on 2,621 reported injuries. Authored by the Datalys Center. All Rights Reserved 2009 Page 30

31 Table 4.8 Mechanism of for Game - Men's Soccer 2004/05 to 2008/09 Task Mechanism % Ball handling / dribbling Direct player contact 1, % Acute non-contact % Other % Contact with playing surface % Indirect player contact % Contact with apparatus % Contact with out-of-bounds object % Overuse/gradual onset % Unknown % 3,245 Defending Illness % Direct player contact 2, % Acute non-contact % Contact with playing surface % Other % Contact with apparatus % Indirect player contact % Overuse/gradual onset % Unknown % 4,769 General play Contact with out-of-bounds object % Acute non-contact 3, % Direct player contact 3, % Overuse/gradual onset 1, % Contact with playing surface % Other % Indirect player contact % Contact with apparatus % Illness % Unknown % 10,047 Other Illness % (continues) Contact with ball % Authored by the Datalys Center. All Rights Reserved 2009 Page 31

32 Table 4.8 Mechanism of for Game - Men's Soccer 2004/05 to 2008/09 Task Mechanism % Other Direct player contact 6, % (continued) Other 2, % Acute non-contact 2, % Contact with playing surface 1, % Contact with apparatus % Indirect player contact % Unknown % Overuse/gradual onset % 13,446 National estimate based on 2,301 reported injuries Table 4.9 Event Details for - Men's Soccer 2004/05 to 2008/09 Event Event Details Segment Team drills 23, % Unknown 6, % Conditioning 3, % Individual drills 2, % Warm-up 1, % Other % 36, % Type Regular 33, % Scrimmage 2, % Walk-through % 36, % National estimate based on 2,699 reported injuries. Table 3.10 (next page) presents is a cross-tabulation of activity by mechanism for concussions in men s soccer games. Nearly one-third of concussions in soccer games were due to direct player contact while heading the ball. Table 4.10 Mechanism for Game Concussions - Men's Soccer 2004/05 to 2008/09 Authored by the Datalys Center. All Rights Reserved 2009 Page 32

33 Task Mechanism % Defending Direct player contact % Contact with apparatus % Contact with playing surface % Other % 264 General play Direct player contact % Contact with playing surface % Contact with apparatus % Indirect player contact % Other % 285 Goaltending Direct player contact % Other % Contact with apparatus % 192 Heading ball Indirect player contact % Direct player contact % Other % Contact with playing surface % Contact with apparatus % Unknown % 900 Other Direct player contact % Other % Contact with apparatus % Contact with playing surface % Indirect player contact % Unknown % 438 National estimate based on 155 reported injuries Authored by the Datalys Center. All Rights Reserved 2009 Page 33

34 5. Women s Soccer Table 5.1 Rates by Division - Women's Soccer 2004/05 to 2008/09 (National Estimate) Athlete Exposures (National Estimate) Rate (per 1000 Athlete- Exposures) 1 Division Event Type Reported All Divisions 2,904 38,795 1,788, [20.1,23.2] 3,083 40,790 5,513, [6.8,8.0] 5,987 79,585 7,302, [10.1,11.7] Division I 1,447 15, , [22.6,28.2] 1,475 15,108 1,973, [6.8,8.5] 2,922 30,502 2,579, [10.6,13.0] Division II 340 8, , [16.4,23.8] 374 9,726 1,481, [4.9,8.2] ,557 1,920, [7.8,11.5] Division III 1,117 14, , [17.6,21.5] 1,234 15,956 2,058, [6.8,8.7] 2,351 30,526 2,802, [9.9,11.9] 1 numbers in square brackets [] indicate 95% confidence intervals Table 3.1 presents injury rates by Division for Women s Soccer, 2004/05 to 2008/09. injury rates tended to be higher in Division 1. Authored by the Datalys Center. All Rights Reserved 2009 Page 34

35 Table 5.2 Type of - Women's Soccer 2004/05 to 2008/09 Type of Sprain - ligament 12, % 5 8, % 5 20, % 5 Strain - muscle / tendon 4, % 4 11, % 4 16, % 4 Contusion (hematoma) 9, % 2 3, % 2 13, % 2 Concussion 4, % 6 1, % 7 5, % 6 Miscellaneous 1, % 3 2, % 2 3, % 3 Tendinosis % 2 1, % 1 2, % 1 Fracture / Avulsion 1, % % 14 2, % 10 Cartilage injury 1, % 6 1, % 4 2, % 5 Spasm / cramp % 2 1, % 2 1, % 2 Inflammation (general) % % % 3 Overuse % % % 2 Subluxation % % 4 1, % 4 Other 3, % 4 5, % 2 8, % 3 38, % 40, % 79, % National estimate based on 5,987 reported injuries. Table 5.2 presents injury type for Women s Soccer, 2004/05 to 2008/09. In Table 5.1, we estimated approximately 3,000 concussions in Men s Soccer over the 5-year period. Women s Soccer accumulated nearly twice as many (nearly 6,000). Authored by the Datalys Center. All Rights Reserved 2009 Page 35

36 Table 5.3 Body Site of - Women's Soccer 2004/05 to 2008/09 Body Site of Ankle 7, % 5 6, % 4 13, % 4 Knee 8, % 5 7, % 4 15, % 5 Thigh 3, % 4 7, % 4 11, % 4 Lower leg / achilles tendon 3, % 2 4, % 2 7, % 2 Head / face 5, % 5 1, % 5 7, % 5 Hip / groin 1, % 4 3, % 4 5, % 4 Foot / toe 2, % 3 3, % 3 5, % 3 Lower back / sacrum / pelvis % 3 1, % 1 2, % 2 Shoulder / clavicle 1, % % 2 2, % 2 Hand / finger % % 1 1, % 1 Chest / upper back / ribs % % 2 1, % 2 Environmental / Fluids % % % 2 Neck / cervical spine % % % 3 Nose % % % 1 Elbow % % % 2 Other 1, % 3 1, % 2 3, % 2 38, % 40, % 79, % National estimate based on 5,987 reported injuries. Table 5.3 presents injury body site for Women s Soccer, 2004/05 to 2008/09. As with Men s Soccer, the lower extremity accounts for the majority of injuries. Authored by the Datalys Center. All Rights Reserved 2009 Page 36

37 Table 5.4 Twelve Most Common Specific - Women's Soccer 2004/05 to 2008/09 Specific Lateral ankle ligament complex (ATF, CF, PTF) partial tear 4, % 5 4, % 4 8, % 4 Concussion 4, % 6 1, % 7 5, % 6 Quadriceps partial tear % 5 4, % 5 5, % 5 Hamstring partial tear 1, % 5 2, % 4 3, % 5 Lower leg contusion 1, % % 1 2, % 2 Adductor (groin) partial tear % 4 1, % 4 2, % 4 Medial collateral ligament (MCL) partial tear 1, % % 8 2, % 8 Knee contusion 1, % % 2 1, % 2 Quadriceps contusion 1, % % 2 1, % 2 Foot / toe contusion % % 2 1, % 2 Iliopsoas / Sartorius (partial tear) % 4 1, % 5 1, % 4 Ant. tibiofibular syndesmosis (high ankle) partial sprain % % 8 1, % 8 Other 18, % 3 21, % 2 40, % 3 National estimate based on 5,987 reported injuries. 38, % 40, % 79, % Table 5.4 shows specific injuries (body site by injury type) for Women s Soccer, 2004/05 to 2008/09. Nearly 50 injuries were due to the top 12 specific injuries. Concussions were the 4 th most frequent injury in Men s Soccer, but the 2 nd most frequent injury in Women s Soccer.

38 Table 5.5 Time -- Women's Soccer 2004/05 to 2008/09 Division Event Type Mean Standard Deviation Total All Divisions 38, ,135 40, ,276 79, ,411 Division I 15, ,435 15, ,875 30, ,310 Division II 8, ,614 9, ,712 18, ,326 Division III 14, ,086 15, ,688 30, ,774 National estimate based on 5,987 reported injuries. Table 5.5 presents data on time lost from the sport for Women s Soccer, 2004/05 to 2008/09. The total number of days lost was higher in Women s Soccer than in Men s Soccer. This partly reflects the fact that more member-institutions that sponsor Women s Soccer (n=926) than Men s Soccer (n=751). However, it also reflects a higher mean days lost in Women s Soccer (13.2) than in Men s Soccer (7.8).

39 Table 5.6 Event Details - Women's Soccer 2004/05 to 2008/09 Event Details Season Pre-Season 1, % 25, % 27, % In Season 35, % 14, % 49, % Post-Season 1, % % 2, % 38, % 40, % 79, % Activity General play 12, % 16, % 28, % Defending 6, % 2, % 9, % Ball handling / dribbling 3, % 2, % 6, % Goaltending 2, % 3, % 5, % Conditioning % 5, % 5, % Heading ball 3, % 1, % 4, % Shooting (foot) 1, % 2, % 4, % Loose ball 2, % % 3, % Passing (foot) 1, % 1, % 3, % Receiving Pass % 1, % 1, % Blocking shot % % 1, % Attempting a slide tackle % % 1, % Receiving a slide tackle 1, % % 1, % Other % 1, % 1, % 38, % 40, % 79, % Mechanism Acute non-contact 6, % 14, % 21, % Direct player contact 15, % 5, % 20, % Contact with playing surface 6, % 4, % 11, % Overuse/gradual onset 1, % 7, % 8, % Contact with apparatus 2, % 4, % 7, % Illness % 1, % 2, % Indirect player contact 1, % % 1, % Unknown % % % Contact with out-of-bounds object 9 0.0% % Other 3, % 1, % 5, % 38, % 40, % 79, % National estimate based on 5,987 reported injuries. Authored by the Datalys Center. All Rights Reserved 2009 Page 39

40 Table 5.7 Event Details for - Women's Soccer 2004/05 to 2008/09 Event Event Details Type Away 20, % Home 18, % 38, % Game Time First half 13, % Second half 19, % Overtime % Overtime Penalty kicks % Warm-up 1, % Unknown 4, % Other % 38, % Location Top of goal box extended to center line 9, % Top of goal box extended to center line 8, % Goal box (defense) 3, % Side of goal box (defense) 2, % Goal box (offense) 2, % Side of goal box (offense) 1, % Unknown 8, % Other 1, % 38, % Game Position Midfield 12, % Defense 11, % Forward 10, % Goalkeeper 2, % Other % 37, % National estimate based on 2,904 reported injuries. Authored by the Datalys Center. All Rights Reserved 2009 Page 40

41 Table 5.8 Mechanism of for Game - Women's Soccer 2004/05 to 2008/09 Task Mechanism % Ball handling / dribbling Direct player contact 1, % Contact with playing surface % Other % Acute non-contact % Contact with apparatus % Indirect player contact % Overuse/gradual onset % Unknown % Illness % 3,104 Defending Direct player contact 2, % Contact with playing surface 1, % Other % Acute non-contact % Contact with apparatus % Indirect player contact % Overuse/gradual onset % 5,779 General play Contact with out-of-bounds object % Direct player contact 3, % Acute non-contact 3, % Contact with playing surface 1, % Overuse/gradual onset 1, % Other % Illness % Indirect player contact % Contact with apparatus % Unknown % 10,781 (continues) Authored by the Datalys Center. All Rights Reserved 2009 Page 41

42 Table 5.8 Mechanism of for Game - Women's Soccer 2004/05 to 2008/09 Task Mechanism % Heading ball Direct player contact 1, % (continued) Contact with playing surface % Other % Contact with apparatus % Acute non-contact % Indirect player contact % Unknown % 3,100 Other Unknown % Other 1, % Indirect player contact % Direct player contact 4, % Contact with playing surface 1, % Contact with apparatus 1, % Acute non-contact 1, % Overuse/gradual onset % 10,061 National estimate based on 2,466 reported injuries Table 5.8 presents the distribution of injuries for a cross-tabulation of activity by mechanism of injury, for Women s Soccer games, 2004/05 to 2008/09. This table is limited to injuries in competitions only. Authored by the Datalys Center. All Rights Reserved 2009 Page 42

43 Table 5.9 Event Details for - Women's Soccer 2004/05 to 2008/09 Event Event Details Segment Team drills 17, % Running 3, % Unknown 7, % Conditioning 5, % Individual drills 3, % Other 1, % Warm-up 1, % 40, % Type Regular 36, % Scrimmage 2, % Walk-through % 40, % National estimate based on 3,030 reported injuries. Table 5.9 presents the distribution of injuries for event details, for Women s Soccer practices, 2004/05 to 2008/09. This table is limited to injuries in practices only. Table 5.10 (next page) presents the cross-tabulation of activity by mechanism of injury, for concussions in Women s Soccer, 2004/05 to 2008/09. As with Men s Soccer, a large proportion of concussions relate to player contact while attempting to head the ball. Authored by the Datalys Center. All Rights Reserved 2009 Page 43

44 Table 5.10 Mechanism for Game Concussions - Women's Soccer 2004/05 to 2008/09 Task Mechanism % Defending Direct player contact % Contact with playing surface % Contact with apparatus % Other % Indirect player contact % 629 General play Direct player contact % Contact with apparatus % Contact with playing surface % Other % Indirect player contact % Illness % 553 Goaltending Direct player contact % Contact with apparatus % Other % Contact with playing surface % Indirect player contact % 391 Heading ball Other % Direct player contact % Contact with apparatus % Contact with playing surface % Indirect player contact % 1,480 Other Direct player contact % Contact with playing surface % Contact with apparatus % Other % Indirect player contact % Authored by the Datalys Center. All Rights Reserved 2009 Page 44

45 Task National estimate based on 262 reported injuries Mechanism 693 % 6. Women s Field Hockey Table 6.1 Rates by Division - Women's Field Hockey 2004/05 to 2008/09 Division Event Type Reported (National Estimate) Athlete Exposures (National Estimate) Rate (per 1000 Athlete- Exposures) 1 All Divisions 491 5, , [12.1,17.4] 760 8,919 1,193, [5.9,9.0] 1,251 14,487 1,570, [7.8,10.6] Division I 255 2, , [11.1,18.4] 334 2, , [4.6,7.2] 589 4, , [6.5,9.4] Division II -- no data no data no data -- Division III 236 3, , [11.1,18.4] 426 6, , [6.1,10.9] 662 9, , [8.0,12.1] 1 numbers in square brackets [] indicate 95% confidence intervals Table 6.1 presents injury rates by Division for Field Hockey, 2004/05 to 2008/09. No data was collected in Division 2. Authored by the Datalys Center. All Rights Reserved 2009 Page 45

46 Table 6.2 Type of - Women's Field Hockey 2004/05 to 2008/09 Type of Contusion (hematoma) 1, % 1 1, % 1 3, % 1 Strain - muscle / tendon % 3 2, % 4 3, % 4 Sprain - ligament % 5 1, % 2 1, % 3 Miscellaneous % % % 2 Fracture / Avulsion % % % 5 Tendinosis % % % 2 Concussion % % % 4 Laceration % % % 1 Spasm / cramp % % % 0 Inflammation (general) % % % 9 Overuse % % % 2 Cartilage injury % % % 15 Other % 4 1, % 3 1, % 3 5, % 8, % 14, % National estimate based on 1,251 reported injuries. Authored by the Datalys Center. All Rights Reserved 2009 Page 46

47 Table 6.3 Body Site of - Women's Field Hockey 2004/05 to 2008/09 Body Site of Thigh % 3 1, % 4 1, % 4 Knee % 3 1, % 4 2, % 3 Head / face 1, % % 1 1, % 2 Hand / finger % % 1 1, % 2 Ankle % % 2 1, % 3 Lower leg / achilles tendon % % 2 1, % 2 Hip / groin % % % 7 Foot / toe % % % 2 Lower back / sacrum / pelvis % % % 2 Shoulder / clavicle % % % 2 Wrist % % % 1 Respiratory % % % 2 Nose % % % 5 Chest / upper back / ribs % % % 2 Mouth % % % 2 Other % % % 1 5, % 8, % 14, % National estimate based on 1,251 reported injuries. Authored by the Datalys Center. All Rights Reserved 2009 Page 47

48 Table 6.4 Twelve Most Common Specific - Women's Field Hockey 2004/05 to 2008/09 Specific Quadriceps partial tear % % % 3 Lateral ankle ligament complex (ATF, CF, PTF) partial tear % % % 3 Hamstring partial tear % % % 5 Concussion % % % 4 Hand / finger contusion % % % 1 Facial contusion % % % 0 Knee contusion % % % 2 Facial laceration % % % 0 Iliotibial (IT) band friction syndrome % % % 9 Adductor (groin) partial tear % % % 5 Foot / toe contusion % % % 1 Phalangeal fracture (finger) % % % 3 Other 2, % 3 5, % 2 8, % 2 National estimate based on 1,251 reported injuries. 5, % 8, % 14, %

49 Table 6.5 Time -- Women's Field Hockey 2004/05 to 2008/09 Division Event Type Mean Standard Deviation Total All Divisions 5, ,550 8, ,782 14, ,332 Division I 2, ,356 2, ,935 4, ,291 Division II --- no data --- Division III 3, ,194 6, ,848 9, ,042 National estimate based on 1,256 reported injuries.

50 Table 6.6 Event Details - Women's Field Hockey 2004/05 to 2008/09 Season Pre-Season % 5, % 5, % In Season 4, % 3, % 8, % Post-Season % % % 5, % 8, % 14, % Activity General play 2, % 3, % 6, % Conditioning % 1, % 1, % Defending 1, % % 1, % Goaltending % % 1, % Ball handling / dribbling % % % Shooting % % % Blocking shot % % % Other % % % Loose ball % % % Tackling % % % Receiving Pass % % % Passing % % % 5, % 8, % 14, % Mechanism Acute non-contact 1, % 3, % 5, % Contact with apparatus 2, % 1, % 4, % Overuse/gradual onset % 1, % 2, % Direct player contact % % % Illness % % % Contact with playing surface % % % Unknown % 9 0.1% % Indirect player contact % % % Other % % % 5, % 8, % 14, % National estimate based on 1,251 reported injuries. Authored by the Datalys Center. All Rights Reserved 2009 Page 50

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