National Collegiate Athletic Association Soccer Research Articles

Gender-specific hip strength disparities correlate with injury patterns in NCAA men's and women's soccer players.

In National Collegiate Athletic Association (NCAA) soccer athletes, men have higher rates of hip and groin strains, whereas women have higher rates of knee ligament injuries. Strength imbalances of the hip and thigh, specifically in agonist-antagonist muscles, are known risk factors for these injuries. To perform hip and thigh strength assessments in NCAA soccer players to evaluate for differences between genders and correlations with gender-specific injury patterns. With a handheld dynamometer, weight-normalized isometric strength of six muscle groups (hip abductors, hip adductors, hip flexors, hip extensors, knee flexors, knee extensors) was calculated in NCAA soccer players. The strength ratio of each agonist-antagonist muscle was also calculated (hip abductors/adductors, hip flexors/extensors, knee extensors/flexors). Thirty-six NCAA soccer players (18 men, 18 women) from a single NCAA Division III institution. Not applicable. Weight-normalized strength of six muscle groups and their agonist-antagonist strength ratios were compared between genders using linear mixed-effects models. Compared with male players, female players had decreased weight-normalized strength for hip abduction (0.170 vs. 0.204, p = .012) and hip extension (0.172 vs. 0.211, p = .021). Otherwise, weight-normalized strength was similar between genders. When comparing agonist-antagonist strength ratios, there was a significant difference between female and male players for hip flexion:extension (1.70 vs. 1.35, p = .008), whereas the hip abduction: adduction ratio did not reach statistical significance (1.45 vs. 1.62, p = .080). NCAA male and female soccer players had different hip strength profiles that fit their injury patterns. Male NCAA soccer players have higher rates of hip and groin strains, and men in the cohort had strength ratios that were deficient in the hip flexors and adductors compared with women. Female NCAA soccer players have higher rates of knee sprains and anterior cruciate ligament tears, and women in the cohort had strength ratios that were deficient in the hip abductors and extensors, which function to stabilize the knee. These strength disparities could be the focus of future gender-specific soccer injury prevention programs.

A Fraction of Recommended Practices: Implementation of the FIFA 11+ in NCAA Soccer Programs

Background and Objectives: National Collegiate Athletic Association (NCAA) soccer coaches implement numerous warm-up and flexibility strategies to prepare athletes for training and competition. The Fédération Internationale de Football Association (FIFA) developed the 11+ injury prevention program to reduce non-contact injuries. This study aimed to analyze the level of familiarity with and implementation of the evidence-based FIFA 11+ amongst NCAA Division I (DI) and Division III (DIII) men’s and women’s soccer coaches. Materials and Methods: NCAA soccer coaches in the United States received an Institutional Review Board—approved survey hyperlink. A total of 240 coaches completed the survey. The respondents represented 47.5% men’s and 52.5% women’s teams distributed within DI and DIII programs. Descriptive statistics are reported as frequency counts and mean ± standard deviation where applicable. Pearson’s chi-square tests were performed to assess potential differences with a significance level set at α < 0.05. Results: The results indicated that approximately 62% of the respondents reported being familiar with the FIFA 11+ program. Of those coaches familiar with the program, 15.0% reported full implementation, 57.5% reported partial implementation, and 27.5% reported no implementation. Chi-square analyses revealed significant differences in FIFA 11+ implementation based upon division level (χ2 = 4.56, p = 0.033) and coaching certification levels (χ2 = 13.11, p = 0.011). Conclusions: This study indicates that there is a gap between FIFA 11+ knowledge and actual implementation. To reduce the risk of non-contact injury, there is a need to educate coaches and athletic trainers on the purpose of the FIFA 11+ program and how to perform the exercises correctly.

Epidemiology of Anterior Cruciate Ligament Injury on Natural Grass Versus Artificial Turf in Soccer: 10-Year Data From the National Collegiate Athletic Association Injury Surveillance System.

Background:Anterior cruciate ligament (ACL) injury is prevalent among National Collegiate Athletic Association (NCAA) soccer players. Controversy remains regarding the effect of the surface type on the rate of ACL injury in soccer players, considering differences in sex, type of athletic exposure, and level of competition.Hypothesis:Natural grass surfaces would be associated with decreased ACL injury rate in NCAA soccer players. Sex, type of athletic exposure (match vs practice), and level of competition (Division I-III) would affect the relationship between playing surface and ACL injury rates.Study Design:Cohort study; Level of evidence, 3.Methods:Using the NCAA Injury Surveillance System (ISS) database, we calculated the incidence rate of ACL injury in men and women from 2004-2005 through 2013-2014 seasons. The incidence was normalized against athletic exposure (AE). Additional data collected were sex, athletic activity at time of injury (match vs practice), and level of competition (NCAA division) to stratify the analysis. Statistical comparisons were made by calculating incidence rate ratios (IRR). Statistical significance was set at an alpha of .05.Results:There were 30,831,779 weighted AEs during the study period. The overall injury rate was 1.12 ACL injuries per 10,000 AEs (95% CI, 1.08-1.16). Women comprised 57% of the match data (10,261 games) and 55% of practice data (26,664 practices). The overall injury rate was significantly higher on natural grass (1.16/10,000 AEs; 95% CI, 1.12-1.20) compared with artificial turf (0.92/10,000 AEs [95% CI, 0.84-1.01]; IRR, 1.26 [95% CI, 1.14-1.38]) (P < .0001). This relationship was demonstrated consistently across all subanalyses, including stratification by NCAA division and sex. The injury rate on natural grass (0.52/10,000 AEs; 95% CI, 1.11-1.26) was significantly greater than the injury incidence during practice on artificial turf (0.06/10,000 AEs; 95% CI, 0.043-0.096). Players were 8.67 times more likely to sustain an ACL injury during practice on natural grass compared with practice on artificial turf (95% CI, 5.43-12.13; P < .0001). No significant difference was found in injury rates between matches played on grass versus turf (IRR, 0.93; 95% CI, 0.84-1.03; P = .15).Conclusion:NCAA soccer players who practice on natural grass have increased risk of ACL injury compared with the risk of those practicing on an artificial surface, regardless of sex or NCAA division of play. No difference in risk of ACL injury between playing surfaces was detected during matches. Further research is necessary to examine the effect of multiple factors when evaluating the effect of the surface type on the risk of ACL injury in soccer players.

Epidemiologic Assessment of Concussions in an NCAA Division I Women's Soccer Team.

Background:Among collegiate sports, ice hockey and wrestling have been reported to have the highest rates of concussion injury. Recent literature has shown that among all sports, female soccer players had the highest rate of concussion injury at the high school level. Sport-specific analysis will increase our knowledge of epidemiologic characteristics of this serious injury in young soccer players, where “heading” is commonly involved during participation.Hypothesis:Heading during soccer will be associated with increased frequency of concussion injury in collegiate female players compared with other mechanisms of injury, and concussion injury mechanism and rates will differ by setting of injury (practice or match) and player position.Study Design:Descriptive epidemiologic study.Methods:This was a retrospective review and epidemiologic analysis of all concussions documented from a single National Collegiate Athletic Association (NCAA) Division I female collegiate soccer team between 2004 and 2017. A total of 381 participants were reviewed, and concussion injury mechanism, setting (practice or match), player position, and number of games and practices missed due to injury were analyzed.Results:Overall, 25 concussions in 22 players from the 2004 to 2017 seasons were identified, for an annual rate of 1.79 concussions per year. Collisions (36%) followed by headers (20%) were the most common mechanisms. Forwards sustained the most concussions (32%). Injuries were more common in games (56%) than practice (40%). Of note, the most common cause of concussion during practice was headers (40%). Of the concussions documented, 20 (91%) were the player’s first concussion. On average, each concussion resulted in a player missing 3.96 games and 12.46 practices.Conclusion:Our results demonstrate that concussion rates in female NCAA soccer players vary by position and occur with different frequencies and mechanisms in practice and games. Interventions for concussion avoidance should aim to limit exposure to high-risk activity, including player-to-player contact in games and headers in practice. Although gameplay and collisions can be unpredictable and difficult to control, practice settings can be modified in an attempt to decrease risk.

Sleep Dysfunction and Mood in Collegiate Soccer Athletes.

Sleep and mood are critical factors that contribute to health and wellness and are of particular interest to collegiate athletes who are juggling high physical, academic, and social demands. The aim of this study was to examine how psychological measures, player status, and sex-related factors were associated with perceived sleep quality. Higher levels of global sleep dysfunction will be related to poor mood and increased anxiety, and there will be differences in sleep dysfunction in male compared with female athletes as well as regarding playing status. Prospective cohort study. Level 4. During the 2016 through 2018 National Collegiate Athletic Association (NCAA) seasons, the Pittsburgh Sleep Quality Index (PSQI), Profile of Mood States, and Sports Anxiety Scale-2 questionnaires were administered to 230 soccer athletes at 6 separate time points throughout each season. PSQI results yielded scores ≥5 in 54% of observations. Increased sleep dysfunction was significantly related to decreased vigor and increased tension, depression, anger, fatigue, somatic anxiety, worry, and concentration disruption, although effect sizes (ES) were trivial (ES, -0.03 to 0.15). The odds ratio (OR) of reporting global sleep dysfunction increased by 8%, 9%, and 25% for every 1-unit increase in tension (OR, 1.08; 95% CI, 1.02-1.16; P = 0.015), fatigue (OR, 1.09; 95% CI, 1.03-1.16; P = 0.002), and concentration disruption (OR, 1.25; 95% CI, 1.09-1.45; P = 0.002), respectively. The odds of reporting global sleep dysfunction were 55% lower for males than females (OR, 0.45; 95% CI, 0.25-0.79; P = 0.006). Global sleep dysfunction was prevalent in NCAA soccer players and was related to negative mental health outcomes. Female participants experienced increased odds of reporting global sleep dysfunction. Regular monitoring allows for a greater understanding of the interrelatedness between sleep and mental health in athletes.

Hip and Groin Injuries in National Collegiate Athletic Association Women's Soccer Players.

Background:Hip and groin injuries are common in competitive soccer players and have been shown to be significant sources of time loss. There are few studies describing the epidemiology of hip and groin injuries in female National Collegiate Athletic Association (NCAA) soccer players.Purpose:To describe the epidemiology of hip and groin injuries in women’s collegiate soccer players.Study Design:Descriptive epidemiology study.Methods:The NCAA Injury Surveillance System/Program (ISS/ISP) was analyzed from 2004 through 2014 for data related to hip and groin injuries in female collegiate soccer players. Injuries and athlete-exposures (AEs) were reported by athletic trainers. Data were stratified by time of season, event type, injury type, treatment outcome, time loss, and player field position.Results:Between 2004 and 2014, there were 439 recorded hip or groin injuries in female soccer players and an overall rate of injury of 0.57 per 1000 AEs. Injuries were 12.0 times more likely to occur during the preseason (4.41/1000 AEs) as opposed to during the regular season (0.37/1000 AEs) (injury rate ratio [IRR], 12.01; 95% confidence interval [CI], 9.92-14.55) or postseason (0.38/1000 AEs) (IRR, 11.55; 95% CI, 7.06-18.91). Rates of injury were similar during the regular season and postseason (IRR, 0.96; 95% CI, 0.59-1.58). Rates of injury were higher during competition (0.69/1000 AEs) than during practice (0.52/1000 AEs) (IRR, 1.33; 95% CI, 1.08-1.63). Most injuries were new (87.5%; n = 384) and unlikely to recur (12.5%; n = 55).Conclusion:Hip and groin injuries in female NCAA soccer players are uncommon, and fortunately, most players return to play quickly without recurrence. Future prospective studies should evaluate the effectiveness of strength and conditioning programs in preventing these injuries.

Ten-Year Epidemiology of Ankle Injuries in Men's and Women's Collegiate Soccer Players.

Data from the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) have indicated that ankle injuries are the most common injuries among NCAA soccer players. To review 10 years of NCAA-ISP data for soccer players' ankle injuries to understand how the time period (2004-2005 through 2008-2009 versus 2009-2010 through 2013-2014), anatomical structure injured, and sex of the athlete affected the injury rate, mechanism, and prognosis. Descriptive epidemiology study. Online injury surveillance. The NCAA-ISP was queried for men's and women's soccer ankle data from 2004 to 2014. Ankle-injury rates were calculated on the basis of injuries per 1000 athlete-exposures. Rate ratios (RRs) were used to compare injury rates. Injury proportion ratios (IPRs) were used to compare injury characteristics. When compared with the 2004-2005 through 2008-2009 seasons, the 2009-2010 through 2013-2014 seasons showed a similar rate of injuries (RR = 0.94, 95% confidence interval [CI] = 0.85, 1.04) but fewer days missed (P < .001) and fewer recurrent injuries (IPR = 0.55, 95% CI = 0.41, 0.74). The 4 most common ankle injuries, which accounted for 95% of ankle injuries, were lateral ligament complex tears (65.67%), tibiofibular ligament (high ankle) sprains (10.3%), contusions (10.1%), and medial (deltoid) ligament tears (9.77%). Of these injuries, high ankle sprains were most likely to cause athletes to miss ≥30 days (IPR = 1.9, 95% CI = 1.24, 2.90). Men and women had similar injury rates (RR = 1.02, 95% CI = 0.94, 1.11). Men had more contact injuries (IPR = 1.28, 95% CI = 1.16, 1.41) and contusion injuries (IPR = 1.34, CI = 1.03, 1.73) but fewer noncontact injuries (IPR = 0.86, 95% CI = 0.78, 0.95) and lateral ligamentous complex injuries (IPR = 0.92, 95% CI = 0.86, 0.98). Although the rate of ankle injuries did not change between the 2004-2005 through 2008-2009 seasons and the 2009-2010 through 2013-2014 seasons, the prognoses improved. Among the 4 most common ankle injuries, high ankle sprains resulted in the worst prognosis. Overall, male and female NCAA soccer players injured their ankles at similar rates; however, men were more likely to sustain contact injuries.

Match Demands of National Collegiate Athletic Association Division I Men's Soccer.

Curtis, RM, Huggins, RA, Looney, DP, West, CA, Fortunati, A, Fontaine, GJ, and Casa, DJ. Match demands of National Collegiate Athletic Association Division I men's soccer. J Strength Cond Res 32(10): 2907-2917, 2018-This study aimed to profile positional movement characteristics of National Collegiate Athletic Association (NCAA) Division I male soccer players. Eighteen Division I male soccer players were monitored using global positioning systems, inertial movement, and heart rate (HR) technology during 24 matches over a full competitive season (N = 235 observations). Positional groups were classified as either a forward (F), center midfielder (CM), wide midfielder (WM), or defender (D). Movement was profiled by locomotor (walking [0-7.19 km·h], jogging [7.20-14.39 km·h], running [14.40-21.59 km·h], and sprinting [>21.6 km·h]), and acceleration/deceleration characteristics (low intensity [0-1.99 m·s], moderate intensity [2-3.99 m·s], and high intensity [>4 m·s]). Players averaged distances of 9,367 ± 2,149 m per match at speeds of 91 ± 20 m·min and physiological intensities of 78 ± 8 %HRmax. Center midfielder demonstrated the highest average speeds (97 ± 20 m·min) and covered the most distance (9,941 ± 2,140 m). Wide midfielder accumulated the most sprint distance (391 ± 145 m) and high-intensity accelerations (129 ± 30 n)/decelerations (96 ± 24 n). Several practically meaningful differences exist between positions for internal and external load metrics. Match loads seen in NCAA Division I soccer vary from reports of professional soccer; however, the effects of match regulation, structure, and congestion, which are unique to NCAA soccer, require further investigation. Physical and physiological load monitoring of NCAA soccer may aid coaches and practitioners in the periodization of training programs leading up to and during a competitive soccer season. These data speak to the necessity for examining both internal and external loads by position.

Shoulder and elbow injuries in soccer goalkeepers versus field players in the National Collegiate Athletic Association, 2009–2010 through 2013–2014

ABSTRACTObjectives: Examination of the incidence of shoulder and elbow injuries in the collegiate soccer player population is limited, as is comparison between goalkeepers and field players. We hypothesized that goalkeepers would have a higher incidence of shoulder and elbow injuries than field players. Furthermore, we sought to determine the incidence of shoulder and elbow injuries among National Collegiate Athletic Association (NCAA) soccer players, and to determine injury risk factors.Methods: The NCAA Injury Surveillance Program database was analyzed for injuries to NCAA men’s and women’s soccer players during the 2009–2010 through 2013–2014 academic years. The incidence of injury was calculated per 10,000 athletic exposures (AE) for goalkeepers versus field players, activity, and injury characteristics, and compared using univariate analysis and risk-ratios to determine injury risk factors.Results: While the overall incidence of shoulder and elbow injuries in soccer players was 2.7/10,000AE [95% CI 2.62–2.78], the incidence among goalkeepers was 4.6-fold higher (8.3 vs. 1.8/10,000AE, p < 0.0001). Goalkeepers had significantly higher incidences of injury in practice (21.3-fold) and in the preseason (16.1-fold) than field players. Women goalkeepers were disproportionately affected, with injury incidences 7.7-fold higher than women field players, and 1.9-fold higher than male goalkeepers. Acromioclavicular joint injuries, rotator cuff tears/sprains, and elbow and shoulder instability constituted the majority of the goalkeeper injuries.Conclusions: Shoulder and elbow injuries in NCAA soccer players are significantly more common in goalkeepers than field players. Incidence varies widely by position and injury, with a number of associated risk factors. Soccer players sustaining these injuries, along with their coaches and medical providers, may benefit from this injury data to best manage expectations and outcomes. Soccer governing bodies may use this to track injury incidence and response to preventative measures.

Injury and Illness in College Outdoor Education

Many colleges offer outdoor education courses such as rock climbing, kayaking, and mountain biking. Since these sports may be perceived as dangerous, we describe the prevalence of injuries and illnesses in a large, university-based outdoor education program. We also compare composite incident rates from this outdoor program to those of traditional college sports. Cohort of college students participating in either Cornell Outdoor Education (COE) or National Collegiate Athletic Association (NCAA) sports and comparison of incident rates. COE data were prospectively collected in the field; and NCAA data were prospectively collected through the Association's Injury Surveillance System. By definition, a COE injury or illness required follow-up care, prescription medication, or limited course participation. Similarly, a NCAA injury limited further practice or play. Incident rates were calculated as injuries and illnesses per 1000 participant-days (COE) or injuries per 1000 athlete-exposures (NCAA). Included COE courses during 2002-2007 totaled 74 005 participant-days. There were 111 injuries and illnesses, rate = 1.50/1000 participant-days (95% CI 1.24-1.81). The NCAA reported 32 646 899 athlete-exposures during 1988-2004 and 181 476 injuries, rate = 5.56/1000 athlete-exposures (95% CI 5.53-5.58). Compared to COE, the relative risk of injury in NCAA sports was 3.7 (95% CI 3.1-4.5) overall and 3.3 (95% CI 2.8-4.0) after excluding the high-contact sports of football, ice hockey, and wrestling. For COE, mountain biking had the highest incident rate (7.5/1000), which was significantly lower than game injury rates in NCAA football and soccer. The most common injuries for both NCAA and COE were soft-tissue injuries such as sprains and strains. Outdoor education at this university-sponsored program was at least as safe as traditional college sports. Overall, college students were less likely to be injured while participating in COE courses than while participating in NCAA sports, even after excluding high-contact sports from the comparison.

Preseason Fitness Testing in National Collegiate Athletic Association Soccer

THE PURPOSE OF THIS ARTICLE IS TO PROVIDE THE STRENGTH AND CONDITIONING PROFESSIONAL WITH THE INFORMATION TO EFFECTIVELY IMPLEMENT A BATTERY OF SOCCER-SPECIFIC FITNESS TESTS DURING THE NATIONAL COLLEGIATE ATHLETIC ASSOCIATION SOCCER PRESEASON PERIOD, YIELDING A DETAILED AND APPROPRIATE PHYSICAL EVALUATION OF THE ATHLETE. RATIONALE FOR THE CHOICE OF TESTS, DETAILED DESCRIPTIONS OF EACH TEST, A TIMELINE FOR IMPLEMENTATION, AND REASONS FOR IMPLEMENTATION WILL BE DISCUSSED.

EFFECT OF HAMSTRING-EMPHASIZED RESISTANCE TRAINING ON HAMSTRING

A decreased hamstring:quadriceps (H:Q) ratio may put the hamstrings and anterior cruciate ligament (ACL) at increased risk of injury. Therefore, the purpose of this study was to evaluate H:Q ratios of 12 female National Collegiate Athletic Association soccer players, and to test the effects of a 6-week strength training program on these ratios. Each subject completed 2 practice sessions before a pretest. Subjects then completed 6 weeks of strength training that included the addition of 2 hamstring specific exercises, followed by a posttest. Peak torque during concentric and eccentric actions for both hamstrings and quadriceps was measured with an isokinetic dynamometer. Each muscle action was tested at 3 angular velocities in the following order: concentric 240, 180, and 60°·s−1 and eccentric 60, 180, and 240°·s−1. The H:Q strength ratio was evaluated using concentric muscle actions (concentric hamstrings: concentric quadriceps). This method is commonly used and is thus called the conventional ratio. Because concentric actions do not occur simultaneously in opposing muscles, a more functional assessment compares eccentric hamstring actions to concentric quadriceps actions. This functional ratio was also analyzed. Mean conventional and functional H:Q ratio data were analyzed using separate analysis of variance procedures with repeated measures on all factors (2 [Test] × 2 [Leg] × 3 [Angular Velocity]). The results revealed a significant main effect for factor (F test) with the functional ratio (p < 0.05) but not for the conventional ratio. The mean functional ratio increased from 0.96 ± 0.09 in pretest to 1.08 ± 0.11 in posttest. These results suggest that 6 weeks of strength training that emphasizes hamstrings is sufficient to significantly increase the functional ratio. The functional ratio after training exceeded 1.0, which is specifically recommended for prevention of ACL injuries.

Effect of Hamstring-Emphasized Resistance Training on Hamstring:Quadriceps Strength Ratios

A decreased hamstring:quadriceps (H:Q) ratio may put the hamstrings and anterior cruciate ligament (ACL) at increased risk of injury. Therefore, the purpose of this study was to evaluate H:Q ratios of 12 female National Collegiate Athletic Association soccer players, and to test the effects of a 6-week strength training program on these ratios. Each subject completed 2 practice sessions before a pretest. Subjects then completed 6 weeks of strength training that included the addition of 2 hamstring specific exercises, followed by a posttest. Peak torque during concentric and eccentric actions for both hamstrings and quadriceps was measured with an isokinetic dynamometer. Each muscle action was tested at 3 angular velocities in the following order: concentric 240, 180, and 60 degrees x s(-1) and eccentric 60, 180, and 240 degrees x s(-1). The H:Q strength ratio was evaluated using concentric muscle actions (concentric hamstrings:concentric quadriceps). This method is commonly used and is thus called the conventional ratio. Because concentric actions do not occur simultaneously in opposing muscles, a more functional assessment compares eccentric hamstring actions to concentric quadriceps actions. This functional ratio was also analyzed. Mean conventional and functional H:Q ratio data were analyzed using separate analysis of variance procedures with repeated measures on all factors (2 [Test] x 2 [Leg] x 3 [Angular Velocity]). The results revealed a significant main effect for factor (F test) with the functional ratio (p < 0.05) but not for the conventional ratio. The mean functional ratio increased from 0.96 +/- 0.09 in pretest to 1.08 +/- 0.11 in posttest. These results suggest that 6 weeks of strength training that emphasizes hamstrings is sufficient to significantly increase the functional ratio. The functional ratio after training exceeded 1.0, which is specifically recommended for prevention of ACL injuries.