High quality sports injury surveillance systems at the collegiate level are necessary to monitor student-athlete health, to identify risk factors associated with sports injuries, and to develop and evaluate injury prevention programs. The Pac-12 Health Analytics Program (HAP) addresses this need by standardizing electronic medical record entries and common data elements across all Pac-12 institutions. The literature suggests that collegiate student-athletes are at higher risk for certain injuries that have chronic effects on their health-related quality of life. The purpose of this study is to summarize lower extremity injury characteristics using the HAP database.
This study is a retrospective study of archival data from Pac-12 student-athletes followed in the HAP database from 2017-2020. The data is collected as part of the standard of care provided by varsity athletic trainers, and individual authorization forms were obtained from student-athlete participants prior to deidentification and inclusion in the database. Student-athletes who sustained a lower extremity (LE) injury were included. Data on demographics and injury characteristics were analyzed.
LE injuries account for 44.5% (14,873/33,432) of all database injuries, representing 53.5% (5,056/9,444) of injured student-athletes. Fifty-six percent of injuries (8,285) were sustained by men. Most student-athletes sustained one injury (38.3%), 21.8% sustained two, 14.0% sustained three, and the remaining students (25.9%) sustained greater than or equal to 4 injuries. Knee injuries occurred the most frequently (3,764, 25.3%), followed by ankle (2,921, 19.6%) and foot (1,712, 11.5%). Common mechanisms of injury (MOI) included contact with another player (2,369, 15.9%), running (2,210, 14.9%), and cutting/change of direction (1,120, 7.6%). MOI was unavailable for 3,229 (21.7%) student-athletes. Injuries commonly occurred during in-season (46.6%), off-season (27.7%), and pre-season (21.3%) segments of the competitive year. Most students experienced no sport interference (43.2%) or returned to activity level within the current (42.9%) or following season (7.1%).
The HAP database can systematically analyze sport injuries to a degree not previously demonstrated in collegiate-level athletics. Our preliminary analysis demonstrated that over half of injured student-athletes sustain a LE injury with roughly 25% sustaining greater than or equal to 4 injuries. Most injuries occured in the knee and ankle during pre-season or in-season suggesting an opportunity for enhanced monitoring during these periods. As institutional sports medicine providers continue to gather health data for the HAP, further investigations accounting for covariates and risk factors may inform injury prevention strategies that aid these providers in their commitment to caring for the varsity student-athlete population. While the Pac-12 HAP database is early in development and must be monitored for completeness and quality, this report demonstrates the potential value injury surveillance systems can provide for student-athlete health. The Pac-12 HAP has demonstrated the feasibility and effectiveness of creating such a database, setting the standard for other regional conferences.