The Epidemiology Of Fractures In Ncaa Women’S Sports: 2009/10-2018/19

Abstract

PURPOSE: Sport-related fracture is a concern among National Collegiate Athletic Association (NCAA) athletes, and previous research has shown higher rates of certain fractures in NCAA women’s sports than men’s sports. Yet, few studies have examined the relative burden of fractures across women’s sports. We described the epidemiology of sport-related fractures across women’s NCAA sports. METHODS: Sport-related fractures reported to the NCAA Injury Surveillance Program by athletic trainers during 2009/10-2018/19 in 12 women’s sports were analyzed. Injury incidence (rates per 10,000 athlete exposures (AEs)) was examined overall and by event type (practices/competitions). Specific fracture diagnoses and the distribution of fractures by injury mechanism (player-, non-contact, other) and injury history (new/recurrent) were examined using frequencies (%s). Time loss (TL; ≥1 day) following fractures was characterized using means (±SD). Differential injury incidence was examined across event types using Injury Rate Ratios (IRR); IRRs with 95% Confidence Intervals (CI) excluding 1.00 were considered statistically significant. RESULTS: A total of 944 sport-related fractures were reported during the study period (Rate = 2.0/10,000AEs), and fracture rates were highest in gymnastics (5.7/10,000AEs), and cross country (3.7/10,000AEs). The competition injury rate was higher than the practice rate (IRR = 2.1; 95%CI = 1.9, 2.4). The foot (24.1%) and hand/wrist (23.9%) accounted for the largest proportions of fractured body parts; phalangeal fractures (10.3%), nasal fractures (9.4%), and tibial stress fractures (9.2%) were the most common fractures. Fractures were most prevalently attributed to overuse (28.6%) and apparatus contact (22.3%) mechanisms; most player contact fractures were reported in soccer (38.5%) and basketball (35.8%). TL fractures accounted for 42.3% of all reported fractures (TL was not reported in ~36% of fractures) and average TL following fractures was ~36.7 days (SD = 39.4). CONCLUSIONS: Fracture incidence in women’s gymnastics warrants particular attention. The prevalence of nasal fractures is also noteworthy. Given the interest in female athlete bone health, the dynamics of overuse/gradual onset fractures in women’s sports also may be targets for focused research.