Descriptive Epidemiology of Concussions Sustained by National Collegiate Athletic Association Student-Athletes, 2009/10-2013/14 Academic Years

Background: Limited data exist on the epidemiology of concussions in collegiate student-athletes. This study uses the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) to describe the epidemiology of concussion in collegiate sports.

Methods: We analyzed concussion data from samples of schools from 25 sports during the 2009/10-2013/14 academic years. We assessed incidence rates, injury mechanisms, symptomatology, and length of participation restriction.

Results: During the 2009/10-2013/14 academic years, a total of 1,670 concussions were reported, for an injury rate of 5.56/10000AEs (practice rate=3.26/10000AEs; competition rate=14.59/10000AEs). The highest concussion rates were reported in Men’s Wrestling (10.92/10000AEs), Men’s Football (6.71/10000AEs), and Women’s Soccer (6.31/10000AEs).  Most concussions were due to Player Contact (68.0%), followed by Surface Contact (12.6%), and Ball Contact (9.4%). Women had higher concussion rates than men in Soccer (P<0.001), Basketball (P<0.001), Lacrosse (P<0.001), and Softball/Baseball (P=0.01).  An average 5.29 (SD=2.94) concussion symptoms were reported, with the most common being headache (92.2%) and dizziness (68.9%). Additionally, 8.9% of concussions resulted in participation restriction over four weeks. The proportion of concussions requiring at least a week of participation restriction increased from 42.7% in 2009/10 to 70.2% in 2013/14 (Linear trend P<0.001). 

Conclusions: Concussion rates in collegiate athletes were highest during competition and among high contact/collision sports. Rates were generally higher among women than men.  Time trends in return to play time may indicate changing concussion management practices in which team medical staff are holding out players longer to ensure symptom resolution. Injury surveillance data can inform targeted interventions for concussion outcomes.