A HIGHER EDUCATION ASSOCIATION
DEDICATED TO
EXCELLENCE
ATHLETICS
Evaluating Athletic and Heat Injuries
in Preseason NCAA Football
Following Policy Change Using the
NCAA Injury Surveillance System
Jill Corlette, National Collegiate Athletic Association
Robert Oppliger, American College of Sports Medicine
Randall Dick, National Collegiate Athletic Association
NCAA.org/health-safety
Objectives
+ NCAA Injury Surveillance
System overview
+ Recognize the unique risk
of heat injuries in
preseason football practice
+ Preseason football practice
policy changes
NCAA.org/health-safety
ISS Background
+ NCAA created ISS in 1982 as an injury
data collection tool for collegiate
athletics
– NCAA Competitive Safeguards and Medical
Aspects of Sports
– NCAA sport rules committees
+ Data collection by certified athletic
trainers
NCAA.org/health-safety
ISS Definitions
+ Injuries: a recordable injury is one that
1) occurred as a result of participation in
an organized intercollegiate practice or
contest; and
2) required medical attention by a certified
athletic trainer or physician; and
3) resulted in restricted participation for
one or more calendar days beyond the
day of injury
NCAA.org/health-safety
ISS Definitions
+ Athlete exposures (A-E):
defined as 1 student-athlete
participating in 1 practice or contest
in which he or she is exposed to the
possibility of athletic injury
+ Injury Rate:
the number of injuries in a particular
category divided by the number of
athletic-exposures (A-E) in that
category.
NCAA.org/health-safety
Preseason Football Injuries Data
Committees concerned about data regarding
preseason heat injuries in NCAA:
+ 95% of time loss HI occurred in preseason
+ 85% of time loss HI occurred wearing full
pads or helmets and shoulder pads
NCAA.org/health-safety
NCAA Preseason Football Policy
Change
+ 87% of time loss HI occurred on days with
multiple practices
+ 49% of ALL practice injuries over the entire
season (and all 45% of injuries with time loss of
7 days or more) occurred during the 8-10
preseason multiple practice days
+ 2003 NCAA modified the preseason fall football
practice because of concerns about high rates of
preseason injuries.
NCAA.org/health-safety
NCAA Preseason Football Policy
Change
2003 – No limit on number of practices
2004 – 5 day acclimatization period (3 hrs max.)
2003 – No equipment limitations (DI and DII)
2004 - Days 1-2 : Helmets only
Days 3-4 : Helmets and Shoulder pads
Day 5 : Full pads
NCAA.org/health-safety
NCAA Preseason Football Policy
Change
2003 – No required recovery time
2004 – 3 hours recovery between practices
2003 – No limit on practice length
2004 – Single or split practices, total 3 hours
Additional 1 allowed walkthrough for first
5 days of acclimatization without any
equipment at all
NCAA.org/health-safety
Preseason Football Injuries Data
Heat injury classification: (NATA*)
Heat cramps
Heat exhaustion
Heat syncope
Exertional heat stroke
Exertional hyponatremia
*Casa DJ, Armstrong LE, Hillman SK, Montain SJ, Reiff RV, Rich BE, Roberts WO, and Stone JA. National Athletic Trainers' Association Position
Statement: Fluid Replacement for Athletes. J Athl Train. 2000 Apr–Jun; 35(2): 212–224.
NCAA.org/health-safety
Football Sample
2006
2007
Totals
Number of schools
in ISS
56
60
116
Number of schools
with heat injuries
25
31
56
Preseason A-E
145,822
148,629
294,451
In season A-E
293,921
310,958
604,879
Represent 10% of NCAA schools sponsoring
football
For both years, the average number of
Preseason practice days were 24 (± 7) days.
NCAA.org/health-safety
Preseason Football Injuries Data
2006
N
(Avg Rate with SD)
2007
N
(Avg Rate with SD)
Heat Injuries
Days 1 -5
38
(1.46 ± 4.35)
42
(1.59 ± 4.22)
Heat Injuries
Days 6 +
56
(0.48 ± 1.03)
52
(0.37 ± 0.88)
Heat Injuries
In Season
13
(0.04 ± 0.15)
12
(0.04 ± 0.11)
All Injuries
Days 1-5
438
(13.97 ± 10.68)
409
(16.84 ± 12.51)
All Injuries
Days 6+
1106
(9.58 ± 6.57)
974
(14.32 ± 8.69)
All Injuries
In Season
2269
(7.85 ± 5.10)
2059
(12.00 ± 7.57)
NCAA.org/health-safety
Preseason Heat Injuries by
Equipment
NCAA.org/health-safety
2006
N (%)
2007
N (%)
Helmets Only
24 (25.53)
14 (14.89)
Helmets and
Shoulder Pads
19 (20.21)
23 (24.47)
Full Pads
37 (39.36)
34 (36.17)
No Pads
0 (0.00)
6 (6.38)
Unknown
14 (14.89)
17 (18.09)
Totals
94
94
Preseason Heat Injuries by Practice
Type
Heat
Exhaustion
N (%)
Hyponatremia
N (%)
Heat
Syncope
N (%)
Totals
2006
Heat
Cramps
N (%)
Regular
47 (50.00)
40 (42.55)
4 (4.26)
0
91
Walk-through
0
0
0
0
0
Scrimmage
2 (2.13)
1 (1.06)
0
0
3
Regular
32 (34.04)
57 (60.64)
1 (1.06)
1 (1.06)
91
Walk-through
0
0
0
0
0
Scrimmage
0
2 (2.13)
0
0
2
Other
0
1 (1.06)
0
0
1
2007
NCAA.org/health-safety
Comparison
Before Policy Change
(16 years)
After Policy Change
(2 years)
Preseason HI rate
0.44
per 1000 A-E
0.43
per 1000 A-E
Preseason all injuries
rate
7.24
per 1000 A-E
11.95
per 1000 A-E
NCAA.org/health-safety
Limitations
+
+
+
+
Voluntary data collection
Small number of schools reporting data
Variability in data entry
System change from paper-based
system to web-based system beginning
in 2005
NCAA.org/health-safety
Conclusion
ISS data collection important for NCAA
informed decision-making
Heat Injuries are a continued concern in
preseason football
NCAA policy on acclimatization days will
continue to be assessed in coming
years
NCAA.org/health-safety
Health and Safety Resources
Bylaws, Guidelines, Rules
Website: www.ncaa.org/health-safety
www.ncaa.org/ISS
NCAA.org/health-safety
Health and Safety Resources
Educational Handbooks
Website: www.ncaa.org/health-safety
www.ncaa.org/ISS
NCAA.org/health-safety