Body Checking Injuries in National Collegiate Athletic Association Men's Ice Hockey: Findings From the NCAA Injury Surveillance Program 2009/10 to 2019/20.

OBJECTIVE: To describe the epidemiology of body checking injuries in the National Collegiate Athletic Association (NCAA) Men's Ice Hockey. DESIGN: Secondary data analysis of historical cohort data. SETTING: A convenience sample of injuries in NCAA Men's Ice Hockey during the 2009/10 to 2019/20 academic years. PATIENTS OR PARTICIPANTS: NCAA student-athletes. INDEPENDENT VARIABLES: Event type, season, time loss, body part, diagnosis, player position, and mechanism. MAIN OUTCOME MEASURES: This study examined injuries that occurred during practice or competition, regardless of time loss, reported to the NCAA Injury Surveillance Program. Injury counts, rates, and proportions were used. The injury rate and proportion ratios with 95% confidence intervals were also constructed. Three independent logistic regression models were constructed to examine differential odds of time loss (≥1 day; TL) injury and the 2 most common injuries, between body checking injuries and all other injuries. RESULTS: Overall, 1290 body checking injuries (rate = 1.59/1000 athlete-exposures) were reported during the study period. Most were attributed to the upper extremity (42%) or head/neck (27%). The competition injury rate generally decreased after 2012/13. After adjusting for covariates, odds of (1) a TL injury was lower and (2) an acromioclavicular sprain was higher among body checking injuries as compared with injuries attributed to all other activities. Odds of concussion was not associated with body checking injuries. CONCLUSIONS: Body checking injuries were frequently attributed to the head/neck and upper extremities, and the rate of these injuries during competition appeared to be decreasing. Still, improvements in helmet and shoulder pad technology may further improve health and safety.

Epidemiology of Hamstring Tears in National Collegiate Athletic Association Athletes: Findings From the National Collegiate Athletic Association Injury Surveillance Program Between 2014/2015 and 2018/2019.

OBJECTIVE: To describe the epidemiology of hamstring tears in National Collegiate Athletic Association (NCAA) sports. DESIGN: Descriptive epidemiology study. Athletic trainers from NCAA schools reported injuries to the NCAA Injury Surveillance Program. SETTING: A convenience sample of NCAA hamstring tear injuries during the 2014/2015 through 2018/2019 academic years. PATIENTS OR PARTICIPANTS: NCAA student-athletes. INDEPENDENT VARIABLES: Sport, sex, event type, season segment, injury history, and activity at the time of injury. MAIN OUTCOME MEASURES: Injury counts, rates, and proportions were used. RESULTS: Two thousand ninety-six hamstring tears from 8 474 400 athlete-exposures (AEs) were reported (2.47 per 10 000 AEs). Rates were highest in Men's Soccer (5.97 per 10 000 AEs) and Women's Soccer (3.13 per 10 000 AEs), among all Men's and Women's sports, respectively. Competition-related rates in Men's and Women's sports were highest in 2015 to 2016 then followed a decreasing pattern across the remainder of the study period. Among sex-comparable sports, rates were higher in men's (compared with women's) Baseball/Softball, Soccer, and Track and Field. The prevalence of recurrent injuries was comparable among men's (14.8%) and women's (11.5%) sports. Time loss hamstring tears were more prevalent in Men's sports than Women's sports [injury proportion ratio = 1.33; 95% confidence interval, (1.21, 1.47)]. CONCLUSIONS: Overall, hamstring tear rates were higher across all Men's sports compared with Women's sports. Rates across event type were comparable in several sports; and so, adjustments to practice are needed considering that practice environments are more modifiable than competitions. Indeed, improving hamstring tear prevention programs to reduce the burden of this injury in NCAA athletes remains critical.

Comparison of Kinematics for Head Impacts Initiated by Helmets and Shoulder Pads Among High School American Football Athletes.

Helmets and shoulder pads are required equipment intended to protect American football athletes by attenuating collision forces during participation. Surprisingly, research differentiating kinematics from head impacts initiated by helmets from those initiated by shoulder pads among adolescent athletes has not been completed. The current study's purpose was to determine the effects of equipment on head impact kinematics. Sixty-nine male American football athletes from three high schools wore helmets equipped with Head Impact Telemetry (HIT) System instrumentation to quantify peak linear (g) and rotational (rad/s2) accelerations. Data were extracted for video-confirmed impacts during two competitions. Separate multivariable linear regressions using ordinary least squares were conducted to determine if equipment type (helmet vs. shoulder pad) was associated with log-transformed linear and rotational accelerations. In total, 1150 video-confirmed impacts involved helmet (N = 960) or shoulder pad (N = 190) initiated contact. Linear (p = 0.809) and rotational (p = 0.351) acceleration were not associated with equipment type. Head impact kinematics were similar between impacts initiated by either helmets or shoulder pads and suggests an opponent's shoulder pads and helmet can deliver comparable forces to the struck player. Equipment manufacturers may need to consider the unintended role shoulder pads may contribute to head injury risk.

Differences in Overuse Injuries in Gender-Comparable Sports: A Nationally Representative Sample of High School Athletes.

CONTEXT: Participation in high school sports has physical, physiological, and social development benefits, while increasing the risk of acute and overuse injuries. Risk of sports-related overuse injury differs between boys and girls. OBJECTIVE: To investigate differences in overuse injuries among United States high school athletes participating in the gender-comparable sports of soccer, basketball, and baseball/softball. DESIGN: Descriptive epidemiology study using a nationally representative sample from the High School Reporting Information Online (RIOTM) database. SETTING: High schools. PATIENTS OR OTHER PARTICIPANTS: Athletes with overuse injuries during the 2006-2007 through 2018-2019 academic years. MAIN OUTCOME MEASURES: National estimates and rates of overuse injuries were extrapolated from weighted observed numbers (with the independent variables: sport, gender, academic year, class year, event type, body site, diagnosis, recurrence, activity, and position). RESULTS: Among an estimated 908, 295 overuse injuries nationally, 43.9% (n=398,419) occurred in boys' soccer, basketball, and baseball, while 56.1% (n=509,876) occurred in girls' soccer, basketball, and softball. When comparing gender across sports, girls were more likely to sustain an overuse injury than boys (soccer: IRR: 1.37; 95% CI: 1.20-1.57; basketball: IRR: 1.82; 95% CI: 1.56-2.14; and baseball/softball: IRR: 1.21; 95% CI: 1.04-1.41). Most overuse injuries in soccer and basketball for both genders occurred to a lower extremity (soccer: 83.9% [175,369/209,071] for boys, 90.0% [243,879/271,092] for girls; basketball: 77.0% [59,239/76,884] for boys, 80.5% [81,826/101,709] for girls), while most overuse injuries in baseball and softball were to an upper extremity (72.5% [81,363/112,213] for boys, 53.7% [73,557/136,990] for girls). For boys' baseball, pitching (43.5% [47,007/107,984]) was the most common activity associated with an overuse injury, which differed from the most common activity of throwing (31.7% [39,921/126,104]) for girls' softball. CONCLUSIONS: Gender differences observed in this study can help guide future strategies that are more specific to gender and sport to reduce overuse injuries among high school athletes.