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A new study conducted by the Big Ten Sports Medicine Committee finds that a National Collegiate Athletic Association (NCAA) rule change, instituted in 1998, limiting the number and type of spring football practice sessions did not have the desired effect of reducing the spring injury rates to levels equal to or lower than those of fall practices.
In 1998, in light of evidence that injury rates for collegiate spring football practice were significantly higher than injury rates for fall practices, the NCAA legislated a decrease in the number of scrimmages and full-contact practices allowed in the spring. The new study confirms the NCAA reason for the rule change in that spring injury rates were indeed higher than in the fall, but the study indicates that the rule changes have not been successful in lowering spring injury rates. In fact, in the three years following the rule changes, the spring injury rates actually increased from almost two times the fall injury rate to more than three times the fall rate, according to the findings.
"Our hypothesis was that the rule changes would not reduce the injury rate back down to the level seen in the fall," said John Albright, M.D., University of Iowa professor in the Sports Medicine Center in the Department of Orthopaedics and Rehabilitation in the UI Roy J. and Lucille A. Carver College of Medicine and first author on the study. "We found that the injury rate for spring practices after the rule changes was three times that of fall practices. We also discovered some interesting characteristics about the injury rates."
Firstly, the study showed that the spring game was not as bad as expected and was more injury-free than most scrimmages. However, the two remaining spring scrimmages had the highest injury rates. Interestingly, limited-contact practices defined as "practice with pads but without tackling" actually produced a higher injury rate than full-contact practices.
"The NCAA rule change presumed that limited-contact scrimmages would be the safest type of practice, but instead these turned out to be more dangerous that any other type of practice except scrimmages," Albright said.
Albright also observed that playing football at full speed but attempting to avoid contact led to different patterns of injury such as broken fingers or dislocated elbows or shoulders rather than the usual lower extremity injuries.
The study results indicate that the way to reduce spring injury rates is to eliminate or reduce scrimmages and limited-contact practices leaving just regular contact practices where players play normally and are protected by the equipment specifically designed for that purpose.
However, even if those changes were made, Albright cautions that another factor makes spring practices inherently more dangerous than fall practices.
"Spring is the time of year when players are trying to impress the coaches and prove that they are better than the person in front of them on the roster. So it is a relatively competitive time among players," Albright said. "During the fall playing season the practices are very careful to ensure that people do not get injured between games. In the spring, it is much harder to control the safety of the practices because everyone is competing for the playing spots."
The study also shows that while increases in injury rates during spring practices are significant, the actual number of injuries per team is not very great because there are not that many spring practices. The study found that the spring "risk factor" caused an average of 13 additional injuries per team per year and that the majority of these injuries resulted in time lost from competition of six days or fewer.
"If you accept that this is a violent sport, then maybe you can justify the risk of injury for the educational and performance benefit that each player gets from the spring practices," Albright said. "That's a philosophical question that I don't have an answer to.
"However, if the NCAA is truly interested in reducing injuries in the spring, they should try again on changing the rules to achieve that and they can use the data from our study to guide the new rules."
The study, published in the September issue of the American Journal of Sports Medicine, was divided into two parts. First, the researchers retrospectively investigated the spring and fall injury rates for Big Ten football teams in the five years preceding the NCAA rule changes. In the second part of the study, the team tracked injuries in the three years following the rule changes to determine if the changes had been successful in reducing the spring injury rates. This was accomplished by analyzing the Big Ten Conference Sports Injury Surveillance System database for reportable injuries incurred during fall and spring practices over the study periods.
Albright noted that the surveillance system database, which has been in place for 20 years and consists of injury data collected by athletic trainers at each of the Big Ten schools, was a critical resource for the study, allowing the researchers to analyze and compare injury data for the years preceding and following the NCAA rule changes. In addition, because the database was already in place, the researcher were able to collect very specific data for the period following the rule changes that allowed them to break down the injury risks related to specific practice types and specific player positions and strings.
In addition to the information about injury rates associated with different practice types, the study also found that players in skill position such as defensive back, running back and wide receiver are at greater risk of injury in the spring practices than are linemen or line backers and tight ends. In both spring and fall, non-players have the highest risk of injury of all the string groups.
Albright noted the unique nature of the study, which represents a multi-institutional, conference-wide effort and praised the athletic staff and trainers of the Big Ten Sports Medicine Committee for their role in maintaining the surveillance database.
"These individuals are dedicated to improving the safety of all college sports and learning how to take better care of injuries that occur," Albright said.
In addition to Albright, Ed Crowley, former UI head athletic trainer, also was part of the research team. Crowley recently joined the staff of the UI Department of Rehabilitation Therapies and works in conjunction with the medical and professional staff of the Department of Orthopaedics and Rehabilitation in providing services to patients.
University of Iowa Health Care describes the partnership between the UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide. Visit UI Health Care online at http://www.uihealthcare.com.
STORY SOURCE: University of Iowa Health Science Relations, 5135 Westlawn, Iowa City, Iowa 52242-1178
CONTACT(S): Jennifer Brown (writer), 319-335-9917, Mailto:jennifer-l-brown@uiowa.edu
PHOTOS/GRAPHICS: A photos of Dr. Albright is available for downloading at http://www.uihealthcare.com/depts/med/orthopaedicsurgery/faculty/albright.html