Descriptive epidemiology of collegiate men's soccer injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2002-2003

Abstract

Objective: To review 15 years of National Collegiate Athletic Association (NCAA) injury surveillance data for men's soccer and to identify potential areas for injury prevention initiatives.

Background: The NCAA sanctioned its first men's soccer championship in 1959. Since then, the sport has grown to include more than 18 000 annual participants across 3 NCAA divisions. During the 15 years from 1988-1989 to 2002-2003, the NCAA Injury Surveillance System accumulated game and practice injury data for men's soccer across all 3 NCAA divisions.

Main results: The injury rate was 4 times higher in games compared with practices (18.75 versus 4.34 injuries per 1000 athlete-exposures, rate ratio = 4.3, 95% confidence interval = 4.2, 4.5), and preseason practices had a higher injury rate than in-season practices (7.98 versus 2.43 injuries per 1000 athlete-exposures, rate ratio = 3.3, 95% confidence interval = 3.1, 3.5). In both games and practices, more than two thirds of men's soccer injuries occurred to the lower extremities, followed by the head and neck in games and the trunk and back in practices. Although player-to-player contact was the primary cause of injury during games, most practice injuries occurred without direct contact to the injured body part. Ankle ligament sprains represented the most common injury during practices and games, whereas knee internal derangements were the most common type of severe injury (defined as 10+ days of time loss).

Recommendations: Sprains, contusions, and strains of the lower extremities were the most common injuries in men's collegiate soccer, with player-to-player contact the primary injury mechanism during games. Preventive efforts should focus on the player-to-player contact that often leads to these injuries and greater enforcement of the rules that are in place to limit their frequency and severity. Emphasis also should be placed on addressing the high rate of first-time and recurrent ankle ligament sprains.

Figure 1. Injury rates and 95% confidence intervals per 1000 athlete-exposures by games, practices, and academic year, men's soccer, 1988–1989 through 2002–2003 (n = 6693 game injuries and 6281 practice injuries). Game time trend, P = .37. Average annual change in game injury rate = −0.7% (95% confidence interval = −0.8, 2.3). Practice time trend, P = .84. Average annual change in practice injury rate = −0.1% (95% confidence interval = −1.1, 1.4)

Figure 2. Game and practice injury mechanisms, all injuries, men's soccer, 1988–1989 through 2002–2003 (n = 6693 game injuries and n = 6281 practice injuries). “Other contact” refers to contact with items such as balls or goals or with the ground. Injury mechanism was unavailable for 1% of game injuries and 4% of practice injuries

Figure 3. Game concussion injury mechanisms, men's soccer, 1988–1989 through 2002–2003 (n = 387)

Figure 4. Game anterior cruciate ligament injury mechanisms, men's soccer, 1988–1989 through 2002–2003 (n = 104)