Descriptive epidemiology of common National Collegiate Athletic Association (NCAA) Football injuries during the 2009/10-2013/14 academic years

background: Although football-related research is mainly concussion-related, it is important to consider other common injuries within the sport.  This study utilizes the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) to examine football data.

methods: Football data during the 2009/10-2013/14 academic years were analyzed.  Forty-eight football programs provided a total of 123 seasons of data.  Injury rates, injury rate ratios (RR), and injury proportions were reported with 95% confidence intervals (CI).  Mann-Whitney U tests compared median days of time loss between injuries.

results: The NCAA-ISP captured 8680 football injuries (rate=9.7/1,000 athlete-exposures; 95%CI: 9.5, 9.9). The competition rate was larger than the practice rate (RR=6.9; 95%CI: 6.6, 7.2).  The preseason rate was larger than the regular season/postseason rate (RR=1.1; 95%CI: 1.1, 1.2).  Although concussions comprised 7.0% of injuries, more common injuries included ankle sprains (11.5%), hip/thigh/upper leg strains (9.6%), and knee sprains (7.2%).  Rates were largest in competitions and the preseason among these injuries. The median days of time loss was higher among concussions (7.0) than ankle sprains (2.0), hip/thigh/upper leg strains (1.0), and knee sprains (5.0; all P-values<0.001).  Common injury mechanisms included player contact for concussion (90.6%), ankle sprains (61.1%), and knee sprains (76.7%), and non-contact for hip/thigh/upper leg strains (78.2%).

conclusions:  Compared to concussions, knee sprains, ankle sprains, and hip/thigh/upper leg strains comprised larger proportions of football injuries.  Concussions may be more devastating as they resulted in longer time loss.  Findings suggest that interventions to reduce the injury incidence in football should reflect the variety of injuries sustained.