Descriptive epidemiology of collegiate women'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 women's soccer and identify potential areas for injury prevention initiatives.

Background: The number of NCAA schools sponsoring women's soccer has grown tremendously, from 271 in 1988- 1989 to 879 schools in 2002-2003. During that time, the NCAA Injury Surveillance System has collected game and practice injury data for women's soccer across all 3 NCAA divisions.

Main results: The rate of injury was more than 3 times higher in games than in practices (16.44 versus 5.23 injuries per 1000 athlete-exposures, rate ratio = 3.2, 95% confidence interval = 3.1, 3.4, P < .01), and preseason practices had an injury rate that was more than 3 times greater than the rate for in-season practices (9.52 versus 2.91 injuries per 1000 athlete-exposures, rate ratio = 3.3, 95% confidence interval = 3.1, 3.5, P < .01). Approximately 70% of all game and practice injuries affected the lower extremities. Ankle ligament sprains (18.3%), knee internal derangements (15.9%), concussions (8.6%), and leg contusions (8.3%) accounted for a substantial portion of game injuries. Upper leg muscle-tendon strains (21.3%), ankle ligament sprains (15.3%), knee internal derangements (7.7%), and pelvis and hip muscle strains (7.6%) represented most of the practice injuries. Injuries were categorized as attributable to player contact, "other contact" (eg, contact with the ball, ground, or other object), or no contact. Player-to-player contact accounted for more than half of all game injuries (approximately 54%) but less than 20% of all practice injuries. The majority of practice injuries involved noncontact injury mechanisms. Knee internal derangements, ankle ligament sprains, and concussions were the leading game injuries that resulted in 10 or more days of time lost as a result of injury.

Recommendations: Ankle ligament sprains, knee internal derangements, and concussions are common injuries in women's soccer. Research efforts have focused on knee injuries and concussions in soccer, and further epidemiologic data are needed to determine if preventive strategies will help to alter the incidence of these injuries. Furthermore, the specific nature of the player contact leading to concussions and lower extremity injuries should be investigated. Preventive efforts should continue to focus on reducing knee injuries, ankle injuries, and concussions in women collegiate soccer players.

Figure 1. Injury rates and 95% confidence intervals per 1000 athlete-exposures by games, practices, and academic year, women's soccer, 1988–1989 through 2002–2003 (n = 5373 game and 5836 practice injuries). Game time trend P = .59. Average annual change in game injury rate = 0.4% (95% confidence interval = −1.1, 1.9). Practice time trend P = .28. Average annual change in practice injury rate = −0.9% (95% confidence interval = −2.5, 0.7)

Figure 2. Game and practice injury mechanisms, all injuries, women's soccer, 1988–1989 through 2002–2003 (n = 5373 game injuries and n = 5836 practice injuries). “Other contact” refers to contact with items such as balls, goals, or the ground. Injury mechanism was unavailable for 2% of game injuries and 5% of practice injuries

Figure 3. Game concussion injury mechanisms, women's soccer, 1988–1989 through 2002–2003 (n = 463)

Figure 4. Game and practice anterior cruciate ligament injury mechanisms, women's soccer, 1988–1989 through 2002–2003 (n = 298)