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


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.


CONCLUSIONS
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.
Dick
Randall
R
National Collegiate Athletic Association, Indianapolis, IN, USA.
Putukian
Margot
M
Agel
Julie
J
Evans
Todd A
TA
Marshall
Stephen W
SW
D001265:Athletic Injuries / Q000453:epidemiology*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D011159:Population Surveillance / Q000379:methods*; D012189:Retrospective Studies; D012574:Schools / Q000706:statistics & numerical data*; D012916:Soccer / Q000293:injuries*; D014481:United States / Q000453:epidemiology
Am J Sports Med. 1999 Nov-Dec;27(6):699-706
10569353
Am J Sports Med. 2006 Feb;34(2):299-311
16423913
Am J Sports Med. 2000;28(5 Suppl):S51-7
11032108
Am J Sports Med. 2000;28(5 Suppl):S69-74
11032110
Med Sci Sports Exerc. 2001 Mar;33(3):359-67
11252059
Scand J Med Sci Sports. 2001 Oct;11(5):299-304
11696215
Br J Sports Med. 2002 Oct;36(5):354-9
12351333
Am J Sports Med. 2006 Jul;34(7):1103-11
16476915
Br J Sports Med. 2006 Feb;40(2):158-62; discussion 158-62
16432004
Am J Sports Med. 2006 Mar;34(3):490-8
16382007
Am J Sports Med. 2006 Jun;34(6):928-38
16436535
Br J Sports Med. 2006 Sep;40(9):767-72
16855067
J Athl Train. 2007 Apr-Jun;42(2):173-82
21714302
Am J Sports Med. 2006 Sep;34(9):1512-32
16905673
Br J Sports Med. 2003 Feb;37(1):13-29
12547739
Clin J Sport Med. 2003 Mar;13(2):71-8
12629423
Br J Sports Med. 2003 Jun;37(3):233-8
12782548
Am J Sports Med. 2004 Jan-Feb;32(1 Suppl):17S-22S
14754855
Am J Sports Med. 2004 Jan-Feb;32(1 Suppl):43S-53S
14754859
Am J Sports Med. 2004 Jan-Feb;32(1 Suppl):62S-8S
14754861
Int J Sports Med. 2004 Jul;25(5):326-31
15241710
Br J Sports Med. 2004 Oct;38(5):561-7
15388539
Am J Sports Med. 1983 Mar-Apr;11(2):63-7
6846683
Am J Sports Med. 1994 May-Jun;22(3):364-71
8037278
Am J Sports Med. 1994 Sep-Oct;22(5):601-6
7810782
Am J Sports Med. 1996 May-Jun;24(3):317-22
8734882
Knee Surg Sports Traumatol Arthrosc. 1996;4(1):19-21
8963746
Am J Sports Med. 1998 Mar-Apr;26(2):238-41
9548117
Br J Sports Med. 2004 Dec;38(6):690-6
15562161
Am J Sports Med. 2005 Apr;33(4):492-501
15722287
Br J Sports Med. 2005 Jun;39(6):319-23
15911599
Am J Sports Med. 2005 Jul;33(7):1003-10
15888716
Br J Sports Med. 2005 Aug;39 Suppl 1:i3-9
16046353
Br J Sports Med. 2005 Aug;39 Suppl 1:i70-7
16046359
Am J Sports Med. 2005 Dec;33(12):1882-91
16157843
Int J Sports Med. 2006 Jan;27(1):75-9
16388446
Clin J Sport Med. 2000 Apr;10(2):104-9
10798791