(2) YEARLY INJURY RATES AND TYPES AMONG NCAA DIVISION I FOOTBALL PLAYERS

Purpose: Injury surveillance can aid in maintaining optimal health and performance in American football players. Specifically, identifying injury characteristics and periods of increased injury risk through yearly and seasonal injury monitoring can help inform targeted prevention strategies and maximize health and in-season performance. The purpose of this study was to outline the differences in the rate and type of injury across two consecutive years in NCAA Division I football players. Methods: Football-related athlete exposure (AE) and injury data were collected from 168 athletes from a large Southeastern Conference football program throughout 2023 (n=120, age=20.9±1.7 y, height=188.0±5.9 cm, weight=107.7±21.3 kg) and 2024 (n=117, age=20.5±1.7 y, height=188.4±6.8 cm, weight=109.5±22.2 kg). One AE represents one athlete participating in one exposure event, which includes team strength and conditioning, practice, and game sessions. An injury was defined as an occurrence that required medical attention during a given exposure event. Injury characteristics were compiled and categorized by the segment of the season during which they occurred: winter off-season, spring season, summer off-season, preseason, and in-season. Injury rates (IR) are presented as the number of injuries per 1000 AEs. Poisson rate ratio tests were used to determine the difference in injury rates within each season segment and between two consecutive years (α=0.05). Effect sizes were calculated using Cohen’s d (d). Results: The overall IR in 2023 was 6.52 per 1000 AEs compared to 5.42 per 1000 AEs in 2024 (P >0.05). The IR in the winter off-season decreased from 2023 to 2024 (0.19 vs 0; P< 0.001, ES=0.2). The IR in the spring increased from 2023 to 2024 (0.69 vs. 1.13; P< 0.001, ES=-0.45). Conversely, the IRs decreased from 2023 to 2024 in summer (4.73 vs. 4.49, P< 0.001, ES=0.25), preseason (12.34 vs. 10.76, P< 0.001, ES=1.63), and in-season (11.48 vs 9.3, P< 0.001, ES=2.24), respectively. In 2023, knees (24.0%), shoulders (13.7%), and ankles (9.8%) were the most common injuries; while hamstrings (18.1%), ankles (16.1%), and knees (14.8%) were the most common in 2024. Conclusions: Yearly IRs among NCAA Division I football players decreased from 2023 to 2024, with all season segments exhibiting a decreased IR except for the spring season, which had a moderate increase. The decreases in preseason and in-season from 2023 to 2024 were large, which may be particularly important. Hamstring and ankle injuries were the most common injuries in 2024 whereas knee and shoulder injuries were the most common in 2023. Modifications in workload management, practice structure, and injury prevention strategies based on the results from the previous season likely influenced the observed trends in the rate and type of injuries. Practical Applications: Monitoring injury trends across season segments provides insight for coaches to refine training programs to help mitigate injury risk. The change in IR between season segments across years suggests that training modifications had a positive impact. Unsurprisingly, preseason and in-season exhibited the highest IRs in both years. Implementing periodized training programs to adjust for the heightened risk of injury during preseason and in-season competition remains an important component of macrocycle planning. Future studies should monitor changes in external and internal workloads to further elucidate the cause of the observed differences in injury rate and type. Acknowledgements: None