Sunday, December 16, 2012

High Pre-Season Injury Rates in NCAA Soccer

Unfortunately, injuries are a common part of soccer. From a nagging ankle sprain to a ruptured ACL, soccer players suffer injuries that can impact the overall performance of the individual and the team. At the collegiate level, the physical, psychological and emotional demands of training, travel and academic expectations combine to raise the risk of injury. Is there a pattern when injuries most often occur? It seems that pre-season is a time when players are particularly vulnerable to injury. But is this actually the case? A study recently published in the Clinical Journal of Sports Medicine suggests that that this may, in fact be the case. The investigators further suggest coaches and trainers focus on this part of the season with an eye toward reducing injury risk.

The investigators used the NCAA Injury Surveillance System. This system collects weekly logs of each team training and competing and the number of injuries suffered. For this study, the time period between the 1988-1989 and 2003-2004 academic years were used. Practice seasons were classified as pre-season (any practice prior to the first competition), in-season (practices during regular season competition) and post-season (practices during post-season play, after the final regular season competition). For this study, the investigators examined 15 different sports from nearly 250 Division I, II and III universities.

A few definitions are needed when interpreting this study. First, an injury was defined as a medical condition that occurred during practice and required the player to miss at least one training session or completion. An athlete-exposure (AE) was defined as a training session that exposed an athlete to injury regardless of its duration. For example, 25 players training 6 times per week was computed as 150 AEs.

The data set analyzes was impressive. Over the course of 16 years, more than 98,000 injuries were logged during nearly 24.5 million AEs.

The highest practice injury rates, regardless of sport, occurred during the pre-season period. Also, fall sports (such as soccer) had higher pre-season injury rates that did winter or spring sports.

As for individual sports, women’s soccer had the highest pre-season injury rate at 9.5 injures per 1000 AEs. Women’s soccer was followed by men’s wresting (8.3), men’s soccer (8.0) and women’s gymnastics (8.0). By comparison, the pre-season football injury rate was 7.2 injuries per 1000 AEs. On the positive side, one the competitive season started, the injury rate in women’s and men’s soccer dropped by nearly 70%.

Interestingly, post-season injury rates were slightly lower than in-season. One might expect that the grind of the regular season and multiple matches played each week would begin to take its toll on the players. However, this was not the case

As for the level of play, Division I women had a lower pre-season injury rate than those playing Division III. For men, injury rates were fairly consistent across the three divisions.

Why do soccer players have higher pre-season injury rates than other sports? Unfortunately, survey research studies such as this one do not offer many hard and fast explanations for the results. Nevertheless, there are a few possible reasons. First, pre-season is a time where players are competing for starting positions and trying to demonstrate their mental toughness. It is also a time when new training routines and playing styles may be being implemented. It is possible that the psychological stress of pre-season my raise the risk of injury. Second, the physical demands of pre-season can be quite high and some players may not be adequately prepared. For fall sports, the off-season training period leading up to pre-season workouts occurs during the summer months and is often unsupervised. Thus, their fitness level may not meet the coach’s expectations. For incoming freshmen, unfamiliar with collegiate soccer, this can be a major problem. On the other hand, off-season training takes place in the fall and is often under the direction of the strength and conditioning staff. Thus, fall athletes such as soccer players may not be in tip-top shape at the beginning of fall practice. Third, it likely that as the season progresses with multiple matches being played each week along with travel, coaches reduce the duration and intensity of training. More time is spent on aspects of practice that reduce the risk of injury. A common attitude expressed by many coaches late in the season is the importance of keeping players healthy.

The bottom line is that pre-season is a time where players are at risk of sustaining an injury. Given this coaches and trainers should pay close attention to strategies that will reduce injury risk. Perhaps some combination of insuring athletes are physically and mentally ready for intense training, reducing the duration of training sessions, encouraging adequate rest and proper nutrition and limiting the intensity of play with each session.


Agel J, Schisel J (2012) Practice injury rates in collegiate sports, Clinical Journal of Sports Medicine, DOI: 10.1097/JSM.0b013e3182717983