National Collegiate Athletic Association Injury Research Articles

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.

To describe the epidemiology of hamstring tears in National Collegiate Athletic Association (NCAA) sports. Descriptive epidemiology study. Athletic trainers from NCAA schools reported injuries to the NCAA Injury Surveillance Program. A convenience sample of NCAA hamstring tear injuries during the 2014/2015 through 2018/2019 academic years. NCAA student-athletes. Sport, sex, event type, season segment, injury history, and activity at the time of injury. Injury counts, rates, and proportions were used. 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)]. 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.

Lower Extremity Musculoskeletal Injuries After Concussion in Collegiate Student-Athletes

Background: An association has been identified between concussion and lower extremity musculoskeletal injury (LEMSKI) after return to sports participation. However, the collegiate student-athlete studies have relied on relatively small single-institution studies, which limits generalizability. Purpose: To assess odds of, and time to, LEMSKI after concussion in US collegiate athletes, using the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP). Study Design: Descriptive epidemiology study. Methods: Data from the NCAA ISP during the 2010-2011 through 2019-2020 athletic seasons were considered for analysis. Frequency distributions were examined for details related to the initial and subsequent injuries (injuries to bone, bursa, joint, ligament, muscle, or tendon). Multivariable logistic regression models and random-effects Poisson regression models examined odds of time loss (TL) and non–time loss (NTL) LEMSKI after concussion, as well as the time interval between initial concussion and subsequent LEMSKI in a single athletic season, or initial musculoskeletal injury (MSKI) and subsequent LEMSKI in a single athletic season. Analyses were performed separately for football and other sports. Results: A total of 31,556 initial injuries were recorded (football: 11,900; other sports: 19,656), which were followed by 0 or 1 injury in the same season. Overall, first injury type was not a significant predictor of subsequent LEMSKI, although certain contrasts yielded significant estimates. In football, the odds of NTL LEMSKI were higher after concussion than after upper extremity MSKI (UEMSKI; adjusted odds ratio [ORAdj], 1.56; 95% CI, 1.06-2.31). In football, the odds of TL LEMSKI were lower after concussion than after UEMSKI (ORAdj, 0.71; 95% CI, 0.51-0.99). No other significant effect estimates were observed for football or other sports. Conclusion: First injury type, either concussion or upper extremity, was not associated with an elevated risk of LEMSKI. Specifically, the results of this study did not identify an elevated odds of LEMSKI after a concussion. However, the authors observed greater odds of NTL LEMSKI and lower odds of TL LEMSKI in football.

In National Collegiate Athletic Association Men’s and Women’s Soccer Athletes There Is a Low Rate of Lumbar Spine Injury, Women Suffer More Recurrent Injuries than Men, and Most Injuries Occur in the Preseason

PurposeTo use the National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) from the 2009-2010 through the 2014-2015 seasons to report lumbar spine injury rates, characteristics, and time lost from sport in soccer players.MethodsCharacteristics of lumbar spine injuries by season, competition/practice, and time lost from sport were determined using the NCAA-ISP database. Rates of injury were calculated as the number of injuries divided by the number of athlete exposures (AEs). AEs are any athlete participation in a competition or practice. Incidence rate ratios (IRRs) were calculated to compare rates between event types and time of season. Injury proportion ratios (IPRs) were used to evaluate differences in injury rates between men and women.ResultsThe NCAA-ISP estimated 4,464 LSIs over 5 years. The rate of LSI in men was 2.1/10,000 AEs and 3.0/10,000 AEs in women. Women were 1.43 times more likely to suffer an LSI compared to men. Women were 2.15 times as likely to suffer an LSI in competition compared to in practice while men were 1.10 times as likely. Women were 2.15 times as likely to be injured in the preseason compared to the regular season, while men were 3.76 times as likely. Non-contact injuries were the most common cause of lumbar spine injuries (LSIs) in men (35%); however, contact injuries were more common in women (33%). Most athletes both male (57%) and female (59%) returned to play within 24 hours.ConclusionThis study provides information on the characteristics of LSIs in NCAA soccer. The overall injury rate to the lumbar spine is relatively low. Injury rates are highest in the preseason and in competition. Women suffer from more recurrent LSI’s than men, and men acquired more injuries through non-contact mechanisms. More than one-half of athletes returned to sport within 24 hours.

Epidemiology of Hand and Wrist Injuries in Collegiate-Level Athletes in the United States

Hand and wrist injuries are common among competitive athletes and can have a substantial impact on playing time and future participation. The purpose of this study was to provide epidemiological data from the National Collegiate Athletic Association Injury Surveillance Program to correlate injury diagnosis with the need for surgery and time loss. Using the National Collegiate Athletic Association Injury Surveillance Program, this retrospective study extracted data of hand and wrist injuries for all 25 National Collegiate Athletic Association sports from the academic years 2004-2005 to 2013-2014. The "severe" category was defined as injuries resulting in the following: (1) surgery, (2) season-ending status, or (3) more than 30 days of playing time loss. The epidemiologic data included injury rate per 100,000 athlete exposures (defined as 1 athlete participating in 1 practice or competition) based on diagnoses and demographic information such as sports and sex. We used a Poisson regression model to estimate the incidence rate and 95% confidence interval. Overall, 4,851 hand injuries were identified, with an injury rate of 41.2 per 100,000 athlete exposures. The most common diagnoses were metacarpal or phalangeal fractures (19.9%), lacerations or contusions (15.4%), and wrist sprains (14.7%). The surgical rate was 9.6%, and the season-ending rate was 5.8%. Severe injuries occurred in 17.5% of the hand and wrist injuries; within this subset, the most common diagnoses included metacarpal or phalangeal fractures (43.8%), scaphoid fractures (12.8%), and thumb ulnar collateral ligament tears (8.7%). Scaphoid fractures and metacarpal or phalangeal fractures had the highest surgical rate and season-ending rate among all the injuries. The injury rate of hand and wrist injuries is comparable with those of other common sports injuries. Approximately one fifth of the injuries were considered severe, which led to a high surgical rate, and these had a considerable impact on the athletes' ability to finish the season. Type of study/level of evidence Outcome research level II.

Hand and wrist injuries among collegiate athletes vary with athlete division

BackgroundThe rates, severity and consequences of hand and wrist injuries sustained by National Collegiate Athletic Association athletes are not well characterized. This study describes the epidemiology of hand and wrist injuries among collegiate athletes competing in different divisions.MethodsThe National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) was accessed from 2004 to 2015 for the following sports: baseball, basketball, football, ice hockey, lacrosse, soccer, wrestling, field hockey, gymnastics, softball and volleyball. The data were used to identify all hand and wrist injuries, the specific injury diagnosis, mean time loss of activity following injury, and need for surgery following injury. These were then stratified by gender. Descriptive statistics were performed to examine the association between sports, event type and division. Student's t test was used to calculate p-values for independent variables. Chi-Square test was used to calculate odds ratio. P < 0.05 was considered significant.Results103,098 hand and wrist injuries were reported in in the studied NCAA sports from 2004 to 2015. Male athletes sustained 72,423 injuries (6.01/10,000 athlete exposure) and female athletes sustained 30,675 injuries (4.13/10,000 athlete exposure). Division I athletes sustained significantly more injuries compared to divisions II and III. Overall, 3.78% of hand and wrist injuries required surgical intervention. A significantly higher percentage of division I athletes (both male and female) underwent surgical intervention compared to divisions II and III. The mean time lost due to hand and wrist injury was 7.14 days for all athletes. Division I athletes missed the fewest days due to injury at 6.29 days though this was not significant.ConclusionsHand and wrist injuries are common among collegiate athletes. Division I athletes sustain higher rates of injuries and higher surgical intervention rates, while tending to miss fewer days due to injury. Improved characterization of divisional differences in hand and wrist injuries can assist injury management and prevention.

Women and Men National Collegiate Athletic Association Ice Hockey Players Were Similarly Likely to Suffer Lumbar Spine Injuries

PurposeTo describe and compare the epidemiology of lumbar spine injuries (LSIs) in women’s and men’s ice hockey during the 2009-2010 to 2013-2014 academic years and to investigate sex-specific differences, using data from the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) database.MethodsThe incidence and characteristics of LSIs were identified utilizing the NCAA ISP. Rates of injury were calculated as number of injuries divided by total number of athlete exposures (AEs). AEs were defined as any student participation in one NCAA-sanctioned practice or competition. Incidence rate ratios (IRRs) were calculated to compare rates of injury between season, event type, mechanism, injury recurrence, and time lost from sport, and injury proportion ratios (IPRs) were calculated to examine the differences in injury rates between men and women.ResultsThere were a total of 165 LSIs from an average of 10 and 19 women’s and men’s teams, respectively, calculated to 1,254 LSIs nationally. Women were 2.48 times more likely to suffer a noncontact injury than men (95% CI: 1.33-4.61), whereas men were more likely than women to suffer contact LSIs (IPR: .51 [95% CI: .28-.92]). In Divisions II and III, women were 6.64 (95% CI: 4.14-10.64) and 1.28 (95% CI: 1.12-1.46) times more likely to suffer LSIs than men, respectively.ConclusionsWomen and men were similarly likely to suffer an LSI, but sex-specific differences existed in a mechanism of injury and likelihood of injury within NCAA Divisions.

Epidemiology of Injuries in National Collegiate Athletic Association Women's Swimming and Diving: 2014-2015 Through 2018-2019.

The number of women's swimming and diving teams sponsored by the National Collegiate Athletic Association has increased over the last 5 years. Routine examinations of women's swimming and diving injuries are important for identifying emerging temporal patterns. Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014-2015 through 2018-2019 athletic seasons were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differences in injury rates. The overall injury rate was 1.78 per 1000 athlete-exposures in swimmers and 2.49 per 1000 AEs in divers. Shoulder (33.0%) injuries accounted for the largest proportion of all swimming injuries; most injuries were classified as overuse (51.3%). Head or face (29.4%) and trunk (20.2%) injuries accounted for the largest proportions of all diving injuries. Findings indicated that shoulder and trunk injuries, as well as injuries resulting from overuse mechanisms, warrant further attention in swimming. Given the low in the National Collegiate Athletic Association Injury Surveillance Program observed across the study period, the need for greater participation in sports injury surveillance is also apparent.

Epidemiology of Injuries in National Collegiate Athletic Association Women's Lacrosse: 2014-2015 Through 2018-2019.

Lacrosse is an increasingly popular sport; the number of teams participating in collegiate women's lacrosse has increased by 21.4% in the past 5 years. The growth of National Collegiate Athletic Association women's lacrosse, coupled with the ongoing discussions surrounding protective equipment, necessitates further epidemiologic studies in this population. Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios with 95% CIs were used to examine differential injury rates. The overall injury rate was 4.99 per 1000 athlete exposures. Less than 30% of injuries were time-loss injuries; injuries were most commonly attributed to noncontact (26.6%) and overuse (25.2%) mechanisms. The most commonly reported specific injuries were lateral ligament complex tears (ankle sprains; 9.1%), concussions (7.2%), and hamstring tears (3.8%). Findings from this study were consistent with the existing epidemiologic evidence in previous studies. Injury incidence in practices, in preseason, and as a result of player contact warrant further attention in this population.

Epidemiology of Injuries in National Collegiate Athletic Association Women's Field Hockey: 2014-2015 Through 2018-2019.

The National Collegiate Athletic Association has sponsored women's field hockey since 1981, and team membership as well as student-athlete participation has grown over time. Routine examinations of injuries sustained by athletes are important for identifying and understanding patterns that can be used to inform sport safety practices. Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program from 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates. The overall injury rate was 6.27 per 1000 athlete-exposures (AEs). Head/face injuries (16.0%) and thigh injuries (12.3%) were the most commonly injured body parts during the 2014-2015 through 2018-2019 academic years. Concussion (8.6%) was the most commonly reported injury, and concussion rates notably decreased between 2017-2018 and 2018-2019. Study findings were generally consistent with the existing epidemiologic evidence. Incidence rates and trajectories of commonly observed injuries warrant particular attention in the future.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Track and Field: 2014-2015 Through 2018-2019.

College athletes have been competing in championship track and field events since 1921; the numbers of competing teams and participating athletes have expanded considerably. Monitoring injuries of men's track and field athletes using surveillance systems is critical in identifying emerging injury-related patterns. Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014-2015 through 2018-2019 academic years were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics; injury rate ratios were used to examine differential injury rates. Overall, men's track and field athletes were injured at a rate of 2.37 per 1000 athlete-exposures; injuries occurred at a higher rate during competition compared with practice. Most injuries were to the thigh (26.2%), lower leg (17.3%), or knee (10.7%) and were caused by noncontact (37.2%) or overuse (31.5%) mechanisms. The most reported injury was hamstring tear (14.9%). The etiologies of thigh and lower-leg injuries warrant further attention in this population. Future researchers should also separately examine injury incidence during indoor and outdoor track and field seasons.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Baseball: 2014-2015 Through 2018-2019.

The National Collegiate Athletic Association has supported men's baseball championships since 1947. Since its inception, the number of participating teams and athletes has considerably expanded. Frequently conducting injury surveillance of collegiate baseball athletes is essential for identifying developing temporal patterns. Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics; injury rate ratios were used to examine differential injury rates. The overall injury rate was 3.16 per 1000 athlete-exposures. The preseason injury rate was significantly higher than the regular season injury rate. The most commonly injured body parts were shoulder (16.1%), arm or elbow (16%), and hand or wrist (13.9%). The most reported specific injury was hamstring tear (7.9%). The findings of this study aligned with previous studies-most injuries were due to noncontact and overuse mechanisms, less than one-half of injuries were related to upper extremity body parts, and one-third of all injuries were reported among pitchers.

Methods of the National Collegiate Athletic Association Injury Surveillance Program, 2014-2015 Through 2018-2019.

Since 1982, the National Collegiate Athletic Association (NCAA) has collaborated with athletic trainers (ATs) to create the largest ongoing collegiate sports injury database in the world. This report provides an operational update of the NCAA Injury Surveillance Program (NCAA ISP) during the academic years 2014-2015 through 2018-2019. The NCAA ISP used a convenience sampling technique via a rolling recruitment model. The ATs at contributing institutions voluntarily submitted data into their respective electronic medical record systems; common data elements were pushed to and maintained by the Datalys Center. The ATs provided information about all team-related activities, even if no injury occurred during that activity, as well as detailed reports on each injury, including condition and circumstances. The NCAA ISP has a long-standing role in supplying NCAA stakeholders with crucial injury surveillance data, playing a critical part in safeguarding student-athletes participating in collegiate sports.

Epidemiology of Injuries in National Collegiate Athletic Association Women's Soccer: 2014-2015 Through 2018-2019.

The National Collegiate Athletic Association held the first women's soccer championship in 1982; sponsorship and participation have greatly increased since. Routine examinations of athlete injuries are important for identifying emerging temporal patterns. Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014-2015 through 2018-2019 seasons were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates. The overall injury rate was 8.33 per 1000 athlete-exposures. Lateral ligament complex tears (ankle sprains) (8.6%), concussions (8.3%), and quadriceps tears (5.0%) were the most commonly reported injuries. Rates of lateral ligament complex tears followed an increasing trajectory during the study period, whereas quadriceps tear rates fluctuated during the early years, and concussion rates decreased then increased. The findings of this study were mostly consistent with existing evidence; notable temporal patterns were observed with regard to lateral ligament complex tears and concussions.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Soccer: 2014-2015 Through 2018-2019.

The National Collegiate Athletic Association has sponsored men's soccer programs since 1959, and the popularity of the sport has grown over time. Routine examinations of athlete injuries are important for identifying emerging temporal patterns. Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program from 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates. The overall injury rate was 8.51 per 1000 athlete exposures. Lateral ligament complex tears (ankle sprains) (9.2%), hamstring tears (7.0%), and concussions (5.2%) were the most commonly reported injuries. Rates of lateral ligament complex tears remained stable from 2014-2015 through 2018-2019, whereas hamstring tear rates decreased and concussion rates increased. The findings of this study were in line with the existing epidemiological evidence, although notable temporal patterns were observed. Incidence trajectories of commonly observed injuries warrant particular attention in the future.

Epidemiology of Injuries in National Collegiate Athletic Association Women's Track and Field: 2014-2015 Through 2018-2019.

Women's track and field events at the National Collegiate Athletic Association level have grown in popularity in recent years, and track and field athletes are vulnerable to a broad range of potential injuries. Routine examination of track and field injuries is important for identifying emerging patterns in injury incidence. Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014-2015 to 2018-2019 academic years were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates. The overall injury rate was 2.20 per 1000 athlete exposures; the competition injury rate was higher than the practice injury rate (injury rate ratio = 1.73; 95% confidence interval = 1.51, 1.97). Hamstring tears (8.9%), medial tibial stress syndrome (5.4%), and lateral ligament complex tears (4.2%) were the most reported injuries. Given the results of this study, further attention may be directed toward factors associated with noncontact injury risk in the competitions. The changing injury rates of most reported injuries also warrant monitoring post 2018-2019.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Ice Hockey: 2014-2015 Through 2018-2019.

The National Collegiate Athletic Association has supported men's ice hockey, a distinct sport that mandates high-velocity gamesmanship, since 1974. Injury surveillance systems are designed to identify evolving injury trends and their temporal qualities. Continual monitoring of collegiate men's ice hockey athletes remains essential. Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program from 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios (IRR) were used to examine differential injury rates. The overall injury rate was 7.65 per 1000 athlete-exposures. Injuries from competition occurred at a rate nearly 7 times that from practice injuries (IRR = 6.54, 95% CI = 6.08, 7.04). The most common specific injury diagnoses were concussions (9.6%), acromioclavicular sprains (7.3%), and medial collateral ligament tears (3.7%). Injury rates by event type and season segment were higher than previously reported. Contusions accounted for nearly a quarter of all injuries, and acromioclavicular sprain rates increased notably across the study period.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Basketball: 2014-2015 Through 2018-2019.

Basketball has remained a popular sport for players and spectators in the United States since before the first National Collegiate Athletic Association men's championship tournament in 1939. Routine examinations of men's basketball injuries are important for identifying emerging temporal patterns. Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during 2014-2015 through 2018-2019 athletic seasons were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differences in injury rates. The overall injury rate was 7.28 per 1000 athlete exposures, with competition rates twice those of practices (injury rate ratio = 2.07; 95% CI = 1.93, 2.22). Injuries to the ankle (22.2%), knee (13.0%), head/face (11.3%), and hand/wrist (10.1%) accounted for most reported injuries, with sprains (30.4%), contusions (14.3%), and strains (13.9%) most commonly reported. Ankle sprain rates initially trended upward and decreased between 2017-2018 and 2018-2019; concussion rates remained relatively stable during 2014-2015 through 2018-2019. Findings suggest that common injury rates are trending downward relative to previous study findings.

Epidemiology of Injuries in National Collegiate Athletic Association Men's Cross-Country: 2014-2015 Through 2018-2019.

The National Collegiate Athletic Association has sponsored men's cross-country programs since 1938, and the sport has grown greatly in scope since then. Routine examinations of men's cross-country injuries are important for identifying emerging temporal patterns. Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during 2014-2015 through 2018-2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates. The overall injury rate was 4.01 per 1000 athlete-exposures (AEs). Most reported injuries were inflammatory conditions (30.2%), strains (18.7%), and sprains (11.5%); rates of inflammatory conditions were highest in preseason. The most commonly reported injuries were lateral ligament complex tears (ankle sprains; 8.2%). Findings of this study were not entirely consistent with existing evidence; continued monitoring of competition injury rates and rates of commonly reported injuries is needed beyond 2018-2019.

Characteristics of Injury in Collegiate Rodeo.

The purpose of this study was to investigate injury occurrence sustained by collegiate rodeo athletes during practice and competition. Descriptive epidemiology. Eleven National Intercollegiate Rodeo Association member institutions across the United States. Participants included 264 male and female college rodeo athletes. Athletic trainers (ATs) from each institution reported injury and exposure data using the National Collegiate Athletic Association Injury Surveillance Program. Institutional ATs reported athlete exposures (AEs) and injuries that occurred from collegiate rodeo practices and competitions. Injury and AEs from practices and competitions for one college rodeo season were analyzed. Injury rates and ratios were calculated for non-time loss (NTL) and time loss (TL) with 95% confidence intervals (CI). Data revealed a higher proportion of TL than NTL injuries [2.47 vs 1.77 per 1000 AE; injury rate ratios (IRRs) = 1.39; 95% CI: 0.93-2.08]. There was a higher injury rate during competition as compared with practice (10.98 vs 3.09 per 1000 AE; IRR = 3.56; 95% CI: 2.36-5.35), but more injuries were reported in practice (62.2%). Although the injury rate during rodeo competition was significantly higher than during practice in this study, a greater number of injuries were reported during practice. This indicates all college rodeo athletes can potentially benefit from available medical care.

Analysis of surgery rates among 25 national collegiate athletic association sports

ABSTRACT Objectives While injuries among collegiate athletes are common and well-studied, there have been no studies comparing which sports and injury types have the highest operation rates. This information would be valuable for athlete governing bodies and providers to improve player safety. Our hypothesis was the surgery incidence rates vary substantially between sports and injury types, with football and knee injuries representing the sport and injury type with the highest respective surgery rates. Methods This was a descriptive epidemiology study of all injuries requiring surgery as recorded in the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) for academic years 2004–2005 to 2013–2014. Surgery incidence rates (and 95% confidence intervals, CI) were calculated for each sport (per 10,000 athletic exposures [AE]) and for the most common injury types, by academic year. In addition, absolute numbers of performed surgeries were calculated as well as rates of return to sport. Results Sports with the highest surgery incidence rate (per 10,000 AEs) were women’s gymnastics (8.9; 95% CI 7.2–10.9), men’s football (6.1; 95% CI 5.8–6.4), and men’s wrestling (5.3; 95% CI 4.5–6.3). Absolute numbers of injury-related surgeries performed were greatest for men’s football (n = 31,043), women’s basketball (6,625), and men’s basketball (5,717). Anterior cruciate ligament tears had the greatest surgery incidence rate per 100,000 AEs for all sports combined (7.95; 95% CI = 7.5 to 8.5), and also represented the injuries with the lowest rate of return to sport. Conclusion Women’s gymnastics, men’s football, and men’s and women’s basketball are NCAA sports with an elevated risk of injury requiring of surgery. The results from this study can guide the NCAA and providers regarding which sports should be the focus of future research, new injury prevention strategies, and healthcare personnel allocation during events.