Examining Social and Moral Character in Collegiate Athletes

Sommerfield, LM, McAnulty, SR, McBride, JM, Zwetsloot, JJ, Austin, MD, Mehlhorn, JD, Calhoun, MC, Young, JO, Haines, TL, and Utter, AC. Validity of urine specific gravity when compared with plasma osmolality as a measure of hydration status in male and female NCAA collegiate athletes. J Strength Cond Res 30(8): 2219-2225, 2016-The purpose of this study was to evaluate the response of urine specific gravity (Usg) and urine osmolality (Uosm) when compared with plasma osmolality (Posm) from euhydration to 3% dehydration and then a 2-hour rehydration period in male and female collegiate athletes. Fifty-six National Collegiate Athletic Association (NCAA) wrestlers (mean ± SEM); height 1.75 ± 0.01 m, age 19.3 ± 0.2 years, and body mass (BM) 78.1 ± 1.8 kg and 26 NCAA women's soccer athletes; height 1.64 ± 0.01 m, age 19.8 ± 0.3 years, and BM 62.2 ± 1.2 kg were evaluated. Hydration status was obtained by measuring changes in Posm, Uosm, Usg, and BM. Male and female subjects dehydrated to achieve an average BM loss of 2.9 ± 0.09% and 1.9 ± 0.03%, respectively. Using the medical diagnostic decision model, the sensitivity of Usg was high in both the hydrated and dehydrated state for males (92%) and females (80%). However, the specificity of Usg was low in both the hydrated and dehydrated states for males (10 and 6%, respectively) and females (29 and 40%, respectively). No significant correlations were found between Usg and Posm during either the hydrated or dehydrated state for males or females. Based on these results, the use of Usg as a field measure of hydration status in male and female collegiate athletes should be used with caution. Considering that athletes deal with hydration status on a regular basis, the reported low specificity of Usg suggests that athletes could be incorrectly classified leading to the unnecessary loss of competition.

Sunscreen use and availability among female collegiate athletes

In the United States higher education, collegiate athletes mostly have a four-year eligibility within a five-year time frame to compete for and represent their institutions. During this period, collegiate athletes are expected to perform successfully in both academic and athletic roles so that they can maintain benefits, such as scholarships and eligibility. In other words, being a collegiate athlete brings about a multitude of pressures and stressors from handling this dual role, which include but are not limited to, scheduling classes, fatigue, financial pressure, and inflexibility of coaches (Cosh & Tully, 2015). According to the National Collegiate Athletic Association (NCAA) (2020), collegiate athletes are only allowed to participate in athletic-related activities for 20 hours per week, four hours a day in season, and eight hours per week during off season (NCAA, 2020). However, previous empirical research has indicated that Division I level collegiate athletes spend about 40 hours per week participating in sport-related activities (Smith & Hardin, 2018). Even though collegiate athletes invest tremendous time and effort in athletics, less than two percent of collegiate athletes become professional athletes after college (NCAA, 2018). For collegiate athletes, both athletic and academic performances require tremendous amounts of efforts due to their intense schedule. That is, it is convoluted for collegiate athletes to have identical motivation or reasons for attending college and participating in their sport. While collegiate athletes strive to balance in both academic and athletic responsibilities, they exhibit various types of motivation factors. According to Doupona Topic (2005), female collegiate athletes seem to be more academically motivated and less athletically motivated compared to male collegiate athletes. Also, Beamon and Bell (2006) found that African American collegiate athletes place less emphasis on academics than athletics, and they place less emphasis on education than Caucasian collegiate athletes. For African American collegiate athletes’ academic underperformance and negative psychosocial experiences can happen due to unwelcoming campus climate, inadequate academic support, and an overemphasis on their athletic roles (Beamon, 2008). As mentioned above, only a few collegiate athletes have a chance to move on to professional sport after their collegiate career. That is, majority of collegiate athletes go through a transitioning process moving out from sport. Numerous studies within the literature support that collegiate athletes often have a difficult time transitioning out of sport (Lally, 2007; Smith & Hardin, 2018). Motivation may be one of the solutions to overcome this abstruse moment. To foster effective and successful higher education environments in collegiate athletics, it is essential to understand what motivates collegiate athletes in their dual roles and how collegiate athletes set up create and implement their goals.

Objective To examine the association of multiple health behaviors to mental health functioning in male and female collegiate athletes. Participants: Prospective National Collegiate Athletic Association (NCAA) Division I athletes (n = 183) completed a health and wellness survey in the summer prior to joining the athletic program. Methods: Health behaviors (eating, sleeping, substance use, sexual, and aggressive behaviors) and mental health functioning (psychological distress and perceived stress) were assessed. Partial least squares (PLS) modeling was used as a multivariate approach to simultaneously examine the association of health behaviors to mental health functioning. Results: Aggressive behaviors, alcohol use, and fatigue were significantly associated with symptoms of psychological distress and stress in both males and females. Attention to nutrition, unhealthy dietary habits, and lower alcohol use was further related to psychological distress in female athletes only. Conclusions: Athletes’ eating, sleeping, substance use, and aggressive behaviors may provide insight into their mental health functioning.

Social support has been identified as an important factor in facilitating recovery from injury. However, no previous authors have prospectively assessed the change in social support patterns before and after injury. To examine the preinjury and postinjury social support patterns among male and female collegiate athletes. Prospective observational study. A Big Ten Conference university. A total of 256 National Collegiate Athletic Association Division I male and female collegiate athletes aged 18 or older from 13 sports teams. Injury incidence was identified using the Sports Injury Monitoring System. Social support was measured using the 6-item Social Support Questionnaire. Data on preinjury and postinjury social support patterns were compared. Male athletes reported more sources of social support than female athletes, whereas female athletes had greater satisfaction with the support they received. Athletes' social support patterns changed after they became injured. Injured athletes reported relying more on coaches (P = .003), athletic trainers (P < .0001), and physicians (P = .003) for social support after they became injured. Athletes also reported greater postinjury satisfaction with social support received from friends (P = .019), coaches (P = .001), athletic trainers (P < .0001), and physicians (P = .003). Our findings identify an urgent need to better define the psychosocial needs of injured athletes and also strongly suggest that athletic trainers have a critical role in meeting these needs.

Sassone, J, Muster, M, and Barrack, MT. Prevalence and predictors of higher-risk supplement use among National Collegiate Athletic Association Division I athletes. J Strength Cond Res 33(2): 443-450, 2019-This study aimed to identify the prevalence and predictors associated with the use of higher-risk dietary supplements, defined as supplements containing herbal ingredients, caffeine, or those classified for weight loss, muscle-building, or as a preworkout supplement, among 557 National Collegiate Athletic Association Division I male and female collegiate athletes. Although 252 (45.2%) athletes reported the use of a dietary supplement on ≥2 days per week over the past year, 46 (8.3%) athletes met criteria for higher-risk supplement use. Twenty (3.6%) athletes reported the use of herbal, 1 (0.2%) caffeinated, 5 (0.9%) weight loss, 28 (5.0%) preworkout, and 1 (0.2%) muscle-building supplements. Body mass index status (BMI ≥30 kg·m), sport-type (sports using the phosphocreatine energy system), and college year (≥4th year) were associated with the use of preworkout, muscle-building, or herbal supplements. A multiple regression analysis identified predictors of higher-risk supplement use including the number of dietary supplements used in the past year (odds ratio [OR] = 2.1, 95% confidence interval [CI] = 1.7-2.7, p < 0.001), the reported motivation of taking dietary supplements to gain muscle and lose body fat (OR = 3.5, 95% CI = 1.1-11.7, p = 0.04), and the motivation to increase athletic endurance (OR = 3.5, 95% CI = 4.0, 95% CI = 1.6-9.9, p < 0.005). These factors may be considered as a part of a screening process to evaluate athletes with an increased risk of higher-risk supplement use and potential consequences to health or eligibility status.

Background:There is a high incidence of hand and wrist injuries in athletes participating in collegiate sports, but there is little information published characterizing them.Purpose:To characterize hand and wrist injuries in collegiate athletes using a large national database.Study Design:Descriptive epidemiology study.Methods:This retrospective cross-sectional analysis was designed using data from the National Collegiate Athletic Association (NCAA) Injury Surveillance Program database to identify hand and wrist injuries (exclusive of any radial or ulnar fractures) in male and female collegiate athletes participating in NCAA Division I, II, and III sports from 2004 to 2015. Descriptive analyses were performed on stratified data to examine the associations between these injuries and sport, event type, and sex.Results:Men’s ice hockey (8.25 per 10,000 athlete-exposures [AEs]) and women's ice hockey (8.21 per 10,000 AEs) had the highest rate of hand and wrist injuries in all exposures. In every sport except women’s gymnastics (P = .107), injuries were more commonly sustained during competition rather than during practice. Ligamentous injury to the phalynx was the most commonly sustained injury overall (1.416 per 10,000 AEs), and a metacarpal fracture was the most commonly sustained hand or wrist fracture (0.507 per 10,000 AEs). Injuries sustained during men’s wrestling (14.08 days) and women’s gymnastics (10.39 days) incurred the most time lost from sport. Surgery for hand and wrist injuries was most commonly required for men’s football (0.413 per 10,000 AEs) and women’s field hockey (0.404 per 10,000 AEs).Conclusion:Hand and wrist injuries were common among collegiate athletes. Male athletes experienced injuries with more frequency and severity. Injuries occurred more commonly during competition. While the majority of injuries were minor and did not require surgery, certain sports conferred a much higher risk of significant injuries requiring a surgical intervention.

BackgroundOutcomes after anterior cruciate ligament reconstruction (ACLR) may not be optimal, with poor physical and psychological function potentially affecting return to sport (RTS) ability. Understanding the relationship between commonly used hop tests and the Anterior Cruciate Ligament – Return to Sport Index (ACL-RSI) may improve rehabilitation strategies and optimize patient outcomes.Hypothesis/PurposeThe purpose of this study was to examine the relationship between ACL-RSI scores and limb symmetry index (LSI) for the single hop for distance (SHD), triple hop for distance (THD), crossover hop for distance (CHD), timed 6-meter hop (T6H), and single leg vertical hop (SLVH) in a cohort of National Collegiate Athletic Association (NCAA) Division 1 collegiate athletes after ACLR. The hypothesis was that SLVH LSI would be more highly correlated with ACL-RSI score than all horizontal hop tests.Study designCross-Sectional StudyMethodsTwenty-one National Collegiate Athletic Association (NCAA) Division 1 collegiate athletes (7 males, 14 females) at 6.62 ± 1.69 months after ACLR were included in this retrospective study. Primary outcomes were ACL-RSI score and LSI for SHD, THD, CHD, T6H, and SLVH. The relationship between ACL-RSI scores and performance on hop tests (LSIs) was evaluated using correlation analysis and step-wise linear regression (p ≤ 0.05).ResultsThere were significant correlations found when comparing ACL-RSI and the LSI for SHD (rs = 0.704, p < 0.001), THD (rs = 0.617, p = 0.003), CHD (rs = 0.580, p = 0.006), and SLVH (rs = 0.582, p = 0.006). The CHD explained 66% (R2 value of 0.660) of the variance in the ACL-RSI, while the other hop tests did not add to the predictive model.ConclusionsPhysical function has the capacity to influence psychological status after ACLR. Clinicians should recognize that SLVH, SHD, THD, and CHD are correlated with ACL-RSI and improvements in physical function during rehabilitation may improve psychological status and optimize RTS after ACLR.Level of evidenceLevel 3

BackgroundKnee function deficits may persist after anterior cruciate ligament reconstruction (ACLR). Return to sport (RTS) testing batteries assess recovery after ACLR and can guide RTS progression, but the ideal test components are debatable. The single leg vertical hop for height (SLVH) test using a commercially available jump mat may provide a valuable assessment of knee function.Hypothesis/PurposeThe purpose of this study was to compare the limb symmetry index (LSI) of SLVH to horizontal hop testing in a cohort of National Collegiate Athletic Association (NCAA) Division 1 collegiate athletes after ACLR. The hypothesis was the SLVH would elicit significantly lower LSI than horizontal hop tests.Study designCross-Sectional StudyMethodsEighteen National Collegiate Athletic Association (NCAA) Division 1 collegiate athletes (7 males, 11 females) at 7.33 ± 2.05 months after ACLR were included in this retrospective study. LSI was calculated for single hop for distance (SHD), triple hop for distance (THD), cross-over hop for distance (CHD), timed 6-meter hop (T6H), and SLVH. A repeated measures ANOVA was performed to identify differences in LSI for each test. Spearman’s Rho correlation coefficient was calculated to examine the relationship between LSIs for each test.ResultsThe LSI for SLVH (84.48% ± 11.41%) was significantly lower than LSI for SHD (95.48 ± 8.02%, p = 0.003), THD (94.40 ± 3.70%, p = 0.002), CHD (95.85 ± 7.00, p = 0.007), and T6H (97.69 ± 6.60%, p = 0.001). The correlation of LSI between SLVH and the horizontal hop tests was weak and non-significant for SHD (rs = 0.166, p = 0.509), CHD (rs = 0.199, p = 0.428), and T6H (rs = 0.211, p = 0.401) and moderate and non-significant for THD (rs = 0.405, p = 0.096).ConclusionsIndividuals after ACLR had lower LSI on the SLVH than on horizontal hop tests and weak to moderate correlations between the tests suggest SLVH detects performance deficits not identified by the horizontal hop tests.Level of evidence3

Although overuse injuries are gaining attention, epidemiologic studies on overuse injuries in male and female collegiate athletes are lacking. To report the epidemiology of overuse injuries sustained by collegiate athletes and to compare the rates of overuse and acute injuries. Descriptive epidemiology study. A National Collegiate Athletic Association Division I university. A total of 1317 reported injuries sustained by 573 male and female athletes in 16 collegiate sports teams during the 2005-2008 seasons. The injury and athlete-exposure (AE) data were obtained from the Sports Injury Monitoring System. An injury was coded as either overuse or acute based on the nature of injury. Injury rate was calculated as the total number of overuse (or acute) injuries during the study period divided by the total number of AEs during the same period. A total of 386 (29.3%) overuse injuries and 931 (70.7%) acute injuries were reported. The overall injury rate was 63.1 per 10 000 AEs. The rate ratio (RR) of acute versus overuse injuries was 2.34 (95% confidence interval [CI] = 2.05, 2.67). Football had the highest RR (RR = 8.35, 95% CI = 5.38, 12.97), and women's rowing had the lowest (RR = 0.75, 95% CI = 0.51, 1.10). Men had a higher acute injury rate than women (49.8 versus 38.6 per 10 000 AEs). Female athletes had a higher rate of overuse injury than male athletes (24.6 versus 13.2 per 10,000 AEs). More than half of the overuse injuries (50.8%) resulted in no time loss from sport. Additional studies are needed to examine why female athletes are at greater risk for overuse injuries and identify the best practices for prevention and rehabilitation of overuse injuries.

Reviewed by: The New Plantation: Black Athletes, College Sports, and Predominantly White NCAA Institutions by Billy Hawkins Alvin Curette Jr., Doctoral Student Billy Hawkins. The New Plantation: Black Athletes, College Sports, and Predominantly White NCAA Institutions. New York, NY: Palgrave Macmillan, 2010. 242 pp. Paperback: $27.62. ISBN: 978-1137035349. In The New Plantation, Billy Hawkins examines the relationship between predominantly white National Collegiate Athletic Association (NCAA) Division I institutions and black male athletes and discusses how the economic, political, social and cultural structures within colleges and athletic departments shape the experiences of these young men. Ultimately, the author’s goal is to position the experiences of black male athletes at NCAA Division I predominantly white institutions (PWIs) within the historical and social context of American capitalistic exploitation of the black body (e.g., slavery and sharecropping). Hawkins asserts that the “intercollegiate athletic industrial complex” at PWIs and the “prison industrial complex” are new plantation models that have been redesigned to exploit black bodies for economic gain (p. 83). The book opens with a historical account of the educational experiences of black people, dating back to ancient African civilization. Hawkins states that education has been valued in the black community throughout history; however, he highlights the use of American colonialism and slavery in stripping blacks of their educational rights. Also, the book chronicles the importance of historically black colleges and universities (HBCUs) in educating blacks since the 1800s and recognizes HBCUs as the main collegiate venues through which black athletes competed in the late 19th century. Nevertheless, Hawkins argues that HBCUs struggle to recruit high-profile athletes in the 21st century because their athletic budgets and facilities pale in comparison to predominantly white NCAA Division I institutions. Additionally, he suggests that unless HBCUs increase their “commercialization (i.e., corporate sponsorship, media rights sales…),” prominent black male athletes will continue to attend PWIs (p. 30). Hawkins uses two concepts to illustrate the relationship between black male athletes and PWIs. First, internal colonialism, a system through which a subordinate minority group is transplanted to a foreign land and is controlled by a dominant group, is used to demonstrate the oppressive relationship between black male athletes and athletic departments at PWIs. Internal colonialism requires the colonizer (NCAA and PWIs) to be characterized as superior to the colonized (black male athletes). In addition, the colonizer believes that their elevated position is legitimate, and the colonized accept their inferior status. The author suggests that the colonizer-colonized relationship exists because athletes rely upon PWIs to increase their chances for upward social mobility (e.g., degree attainment and/or becoming a professional athlete), while the NCAA and athletic departments believe they have the right to profit from athletes’ labor. Secondly, Hawkins compares the experiences of black male athletes to oscillating migrant laborers. As do migrant laborers, black male athletes sell their skills to buyers and leave their communities with “hopes of improving their financial conditions back at home” (p.126). In both cases, the transplanted groups are forced to adapt to a new cultural environment, which devalues their native culture. Moreover, the buyer (e.g., NCAA and athletic departments) holds the power to make decisions and profits from cheap labor. Hawkins suggests that black males freely relinquish their individual rights to predominantly white NCAA Division I institutions because many view athletics as their only way out of poverty. Similarly, Conchas (2006) found that despite high school students’ participation in a college-preparatory career academy, low-income black males continued to place a higher value on collegiate football and basketball, perceiving degree attainment as a back-up plan. Though the book acknowledges individual racism encountered by black males at PWIs, the main focus is on the covert institutional racism that is carried out by the NCAA and athletic departments. Hawkins’ objective is to characterize the NCAA and athletic departments at Division I PWIs as racist organizations that exploit black male athletes for economic gain. This claim is supported by tables that display the large revenues reported by the top NCAA Division I football and basketball programs and data that show that black males comprise the majority of NCAA Division I basketball and football...

The COVID-19 pandemic initially led to the abrupt shutdown of collegiate athletics until guidelines were established for a safe return to play for student athletes. Currently, no literature exists that examines the difference in SARS-CoV-2 test positivity between student athletes and nonathletes at universities across the country. To identify the difference in risk of COVID-19 infection between student athlete and nonathlete student populations and evaluate the hypothesis that student athletes may display increased SARS-CoV-2 test positivity associated with increased travel, competition, and testing compared with nonathletes at their respective universities. In this cross-sectional analysis, a search of publicly available official university COVID-19 dashboards and press releases was performed for all 65 Power 5 National Collegiate Athletic Association (NCAA) Division I institutions during the 2020 to 2021 academic year. Data were analyzed at the conclusion of the academic year. Schools that released at least 4 months of testing data, including the fall 2020 football season, for student athletes and nonathlete students were included in the analysis. Power 5 NCAA Division I student athletes and their nonathlete student counterparts were included in the analysis. Designation as a varsity student athlete. The main outcome was SARS-CoV-2 test positivity for student athletes and nonathlete students at the included institutions for the 2020 to 2021 academic year, measured as a relative risk for student athletes. Among 12 schools with sufficient data available included in the final analysis, 555 372 student athlete tests and 3 482 845 nonathlete student tests were performed. There were 9 schools with decreased test positivity in student athletes compared with nonathlete students (University of Arkansas: 0.01% vs 3.52%; University of Minnesota: 0.63% vs 5.96%; Penn State University: 0.74% vs 6.58%; Clemson University: 0.40% vs 1.88%; University of Louisville: 0.75% vs 3.05%; Purdue University: 0.79% vs 2.97%; University of Michigan: 0.40% vs 1.12%; University of Illinois: 0.17% vs 0.40%; University of Virginia: 0.64% vs 1.04%) (P < .001 for each). The median (range) test positivity in these 9 schools was 0.46% (0.01%-0.79%) for student athletes and 1.04% (0.40%-6.58%) for nonathlete students. In 1 school, test positivity was increased in the student athlete group (Stanford University: 0.20% vs 0.05%; P < .001). Overall, there were 2425 positive tests (0.44%) among student athletes and 30 567 positive tests (0.88%) among nonathlete students, for a relative risk of 0.50 (95% CI, 0.48-0.52; P < .001). There was no statistically significant difference in student athlete test positivity between included schools; however, test positivity among nonathlete students varied considerably between institutions, ranging from 133 of 271 862 tests (0.05%) at Stanford University to 2129 of 32 336 tests (6.58%) at Penn State University. This study found that in the setting of SARS-CoV-2 transmission mitigation protocols implemented by the NCAA, participation in intercollegiate athletics was not associated with increased SARS-CoV-2 test positivity. This finding suggests that collegiate athletics may be held without an associated increased risk of infection among student athletes.

Neuromuscular training programs can reduce the rate of noncontact anterior cruciate ligament (ACL) injuries, particularly in female athletes. To assess the awareness of, experience with, and factors associated with participation in preventive training programs (PTPs) among female collegiate athletes and their knowledge of ACL injuries. Cross-sectional study. National Collegiate Athletic Association (NCAA) sports programs. A total of 440 female NCAA athletes (age = 20 ± 1 years) representing 20 sports during the 2017-2018 academic year. We used a 12-item survey to collect data on each participant's age, sport, position, college, NCAA division, and awareness of and experience with PTPs. We performed descriptive statistics and used odds ratios (ORs) to assess relationships between demographic data and awareness of or interest in PTPs. Of the 440 respondents, 85% (n = 373) knew that female athletes were at higher risk for sustaining ACL injuries than male athletes, and 89% (n = 391) knew that ACL injuries were preventable. Thirty-three percent (n = 143) were familiar with the concept of ACL PTPs. Only 15% (n = 64) had ever performed PTPs, but 89% (n = 391) reported they would perform a daily PTP if it could prevent ACL injuries. Fifty-two of the 64 respondents (81%) who had performed PTPs said athletic trainers or coaches oversaw the PTPs. Participants were more likely to be familiar with ACL PTPs if they (OR = 3.5; 95% confidence interval [CI] = 2.0, 5.8) or a teammate (OR = 4.6; 95% CI = 2.1, 9.8) had sustained an ACL injury. Respondents were more willing to perform PTPs if they (OR = 2.3; 95% CI = 0.80, 6.6) or a teammate (OR = 3.4; 95% CI = 1.8, 6.6) had sustained an ACL injury. Although 89% of respondents expressed interest in performing daily ACL PTPs, only 15% had performed such programs, and only 33% were familiar with the concept of ACL PTPs.

Background:Youth sports specialization has become more prevalent despite consequences such as increased injury rates and burnout. Young athletes, coaches, and parents continue to have misconceptions about the necessity of sports specialization, giving athletes the encouragement to focus on a single sport at a younger age.Purpose:To characterize the motivations for specialization and determine when elite athletes in various individual and team sports made the decision to specialize.Study Design:Cross-sectional study; Level of evidence, 3.Methods:A Likert-style survey was developed and distributed to athletes from two National Collegiate Athletic Association (NCAA) Division I institutions. The survey’s Flesch-Kincaid grade level was 6.3. Statistical analysis was performed via the Student t test, where a P value less than .05 was considered significant.Results:A total of 303 athletes with a mean ± SD age of 19.9 ± 1.52 years across 19 sports were surveyed; 94.7% of specialized athletes had previously played another organized sport prior to college, and 45% of athletes had played multiple sports up to age 16 years. The mean age of specialization was 14.9 years, with a significant difference between athletes competing in team (15.5 years) and individual (14.0 years) sports (P = .008). Males in individual sports specialized earlier than those in team sports (P ≤ .001). Nearly one-fifth (17.4%) of athletes reported specializing at age 12 years or earlier. Personal interest, skill level, time constraints, and potential scholarships were the most important reasons for specialization overall. For individual sports, the motivations for specialization were similar, but collegiate (P < .001) or professional (P < .001) ambitions were significantly larger contributing factors.Conclusion:Early sports specialization is uncommon among NCAA Division I athletes for most team sports, whereas individual sports tend to have athletes who specialize earlier and are more motivated by professional and collegiate goals. This study characterized the timing of specialization among elite athletes, providing a basis for understanding the motivations behind youth sports specialization. Physicians should be prepared to discuss the misconception that early sports specialization is necessary or common among most team-focused collegiate-level athletes. Knowing the motivations for sports specialization will guide clinicians in their discussions with youth athletes.

Background Female collegiate athletes have been reported to have a higher rate of anterior cruciate ligament injury compared to male collegiate athletes. This finding has spawned a branch of research focused on understanding and preventing this injury pattern. Purpose To determine if the trends reported in 1994 have continued. Study Type Descriptive epidemiology study. Methods The National Collegiate Athletic Association Injury Surveillance System database was reviewed for all data relating to men's and women's basketball and soccer anterior cruciate ligament injuries for 1990 to 2002. Results No significant difference was seen in basketball comparing frequency of contact versus noncontact injuries between men (70.1%) and women (75.7%). Male basketball players sustained 37 contact injuries and 78 noncontact injuries. Female basketball players sustained 100 contact injuries and 305 noncontact injuries. In soccer, there was a significant difference in frequency of injury for male (49.6%) and female (58.3%) athletes when comparing contact and noncontact injuries (χ2 = 4.1, P <. 05). Male soccer players sustained 72 contact injuries and 66 noncontact injuries. Female soccer players sustained 115 contact injuries and 161 noncontact injuries. The magnitude of the difference in injury rates between male and female basketball players (0.32-0.21, P =. 93) remained constant, whereas the magnitude of the difference in the rate of injuries between male and female soccer players (0.16-0.21, P =. 08) widened. Comparing injury within gender by sport, soccer players consistently sustained more anterior cruciate ligament injuries than did basketball players. The rate of anterior cruciate ligament injury for male soccer players was 0.11 compared to 0.08 for male basketball players (P =. 002). The rate of anterior cruciate ligament injury for female soccer players was 0.33 and for female basketball players was 0.29 (P =. 04). The rates for all anterior cruciate ligament injuries for women were statistically significantly higher (P <. 01) than the rates for all anterior cruciate ligament injuries for men, regardless of the sport. In soccer, the rate of all anterior cruciate ligament injuries across the 13 years for male soccer players significantly decreased (P =. 02), whereas it remained constant for female players. Conclusions In this sample, the rate of anterior cruciate ligament injury, regardless of mechanism of injury, continues to be significantly higher for female collegiate athletes than for male collegiate athletes in both soccer and basketball. Clinical Relevance Despite vast attention to the discrepancy between anterior cruciate ligament injury rates between men and women, these differences continue to exist in collegiate basketball and soccer players. Also demonstrated is that although the rate of injury for women is higher than for men, the actual rate of injury remains low and should not be a deterrent to participation in sports.