Low rate of serious upper-spine injuries in NCAA football players

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Collegiate football players have low rates of serious or disabling  injuries of the cervical spine, concludes an analysis of a National Collegiate Athletic Association (NCAA) database, reported in the journal Spine. The journal is published in the Lippincott portfolio by Wolters Kluwer.

While cervical spine injuries are “not uncommon” in NCAA football players, the vast majority are non-severe injuries resulting in little time lost from play, reports the study by Anikar Chhabra (Mayo Clinic Arizona, Phoenix, USA) and colleagues. They believe their findings provide useful information for continuing efforts to reduce the risk and impact of these potentially career-ending injuries.

Using the NCAA Injury Surveillance Program database from Datalys Center for Sports Injury Research and Prevention, the researchers estimated the rates and characteristics of cervical spine injuries in collegiate football players from the 2009–10 to 2013–14 seasons. The analysis suggested that nearly 7,500 upper-spine injuries occurred in players at all levels of NCAA football during this time. The rate of cervical spine injuries was calculated as 2.91 per 10,000 athlete-exposures (that is, practices or games).

By far, the most common type of cervical spine injury was “stingers”—a nerve injury that causes sharp pain, but usually resolves in a short time: 1.87 per 10,000 practices/games. The next most frequent injury was strains of the cervical (neck) muscles: 0.8 per 10,000 practices/games.

“Injuries were almost nine times more likely to occur during competition when compared to practice settings,” the researchers write. More than 90% of cervical spine injuries resulted from direct contact; the rate was highest in Division 1 football programs, the highest level of competition.

Linebackers accounted for about 20% of cervical spine injuries and defensive linemen for 18%. “Interestingly, quarterbacks were the least likely to sustain an injury of any type,” Chhabra and coauthors write. “This may be related to stricter targeting rules in NCAA football.”

Most cervical spine injuries were non-serious, leading to little missed time. About 65% of athletes returned to play within 24 hours. Only about three percent remained out of play for longer than 21 days.

More severe upper-spine injuries were rare—rates of disc injury and fracture were both under 2%. None of these injuries required surgery, although they were much more likely to result in longer time lost from play. Notably, linebackers had the highest rates of cervical spine fractures and other more-severe injuries.

“Fortunately, more severe cervical spine injuries appear to be less common in the collegiate football athlete than the professional football athlete,” Chhabra and colleagues write. However, they note that even less-serious types of upper-spine injury can have an “immense” impact on the athlete’s career—especially those with aspirations of playing at the professional level.

Within the limitations of their study, the authors believe it provides the most up-to-date look at the rates, characteristics, and associated factors of cervical spine injuries in NCAA football players. They draw attention to the finding that most injuries occur in games, rather than practice, and that linebackers are at highest risk of upper-spine injuries overall, and of more-severe injuries. Chhabra and colleagues highlight the need for continued efforts to prevent these injuries, including safer tackling techniques, appropriate protective gear, and injury prevention programs continuing throughout the regular season.


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