By Tom Keppeler, Shoulder1 StaffA program to revise the way colleges report their injuries may change the face of collegiate athletics—and may help to save your shoulders in the future.
Early last year, the National Collegiate Athletic Association (NCAA), the governing body for nearly every college athletic program in the country, commissioned three groups to examine its Injury Surveillance System (ISS). When the groups convened in June, the response was overwhelming: the system needs to change.
The current ISS works like this: a sampling of about 15 percent of the nearly 1,000 schools in the association submit occasional written injury reports by mail. NCAA staff then enter them into a central computer system, creating a sizable database of injury data from 16 sports. Officials use the data to determine whether a new rule or policy may reduce a type of injury. ISS data has shown in the past that anterior cruciate ligament injuries are higher in women than in men, and that spring football injuries occur at rates of 3 to 5 times those of fall football.
The system, while the largest of its kind, still has flaws, according to Randy Dick, the NCAA's assistant director for health and safety. "In any given year, we are not getting every injury at every school, in every sport," Dick says. "With the new system, that will be eliminated."
The challenge in revising the system lies in the fact that the NCAA encapsulates such different schools, from 30,000-student Division-1 powerhouses to small Division-3 schools. Computer access, medical resources, and athletic training staff numbers vary greatly from school to school. Since athletic trainers input the data, the system needs to be simple to use, but still produce accurate and precise injury data.
The University of South Carolina (USC), one of the three groups to look at the system, proposed that the revised system be four-tiered. Athletic trainers at the first level, primarily smaller schools, would enter simple demographic data on all their players: the height, weight, sport, ethnicity, gender, and date of birth of every player at the school. Second-level schools would enter all the information that the current ISS requests, including how the athlete was injured, the type of practice or game he or she was injured in, and the condition of the playing surface. Large schools in the third level would be asked for detailed data on the injury—whether the player tore his or her rotator cuff completely or partially, how long he or she was sidelined, or perhaps even the method of treatment.
At the highest level would be "special watch" injuries, according to Tom Terrell, with USC's Department of Family and Preventative Medicine. For example, if the NCAA were to consider a rule requiring field hockey players to wear facemasks, they may ask a representative sample of schools to track facial injuries in the sport, Terrell say. Such a request hearkens back to the NCAA's founding in 1905, when President Teddy Roosevelt commissioned it to examine whether football should be banned due to its high rates of paralysis and death. Better rules made it a safer sport. In the 1970s, however, the rates spiked again, causing the association to outlaw "spearing," when a player topples another by ramming him with his head. The original ISS was created in 1982 to better monitor injuries in sports. By giving the association better tools to analyze injuries, the new system would modernize the NCAA's ultimate goal of making sports safer.
In addition to the four tiers, the system USC proposed would boast online technical assistance, a tutorial, regional presentations explaining how trainers can use the system, and some level of data sharing between the schools. Instituting a better definition of "injury" is also necessary, according to Terrell. The NCAA now defines an injury as anything that happens during a game, requires a trainer's intervention, and causes the player to miss at least one day of participation. By having such a limited definition, Terrell says, some injuries—like a subluxed shoulder that pops back into place so that a player can play in the next game—are overlooked. According to Dick, the University of North Carolina and a Utah-based group submitted similar proposals.
The new ISS may hold hope for the general public with orthopedic problems, as well. By creating a bigger database that details the mechanics and outcomes of nearly every type of sport-related injury, the NCAA may be able to help researchers better understand how they happen. In addition, the data may point to what schools are better than others at preventing injury and whether lower injury rates may be due to preseason training or post-game cool-down habits. "This data should be able to show you what sports you would want to avoid, what behaviors you might want to avoid, if you are prone to a certain type of injury," Dick says.
For now, however, the ball remains in the NCAA's court, so to speak, to decide which modifications it will adapt for its system of reporting injuries. "We are trying to put together a plan of attack and decide how much of the recommendations we will incorporate," Dick says. "We have not gotten down to the nuts and bolts of it."
