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Background: There were 18,844 volleyball players in the National Collegiate Athletic Association (NCAA) in the 2014-2015 academic year. Little research has examined sex-based differences among these athletes.Purpose: To examine injury epidemiology in NCAA men’s and women’s volleyball athletes.Study Design: Descriptive epidemiology study.Level of Evidence: Level 3.Methods: Injury surveillance data from the 2013-2014 through 2014-2015 academic years were obtained from the NCAA Injury Surveillance Program for 6 men’s and 33 women’s collegiate volleyball teams. Injury rates per 1000 athlete-exposures (AEs) and injury rate ratios (IRRs) with 95% CIs were calculated. Time-loss (TL) injuries resulted in participation restriction for at least 24 hours, and non-time-loss (NTL) injuries resulted in participation restriction of less than 24 hours.Results: Overall, 83 and 510 injuries were reported in men and women, respectively, leading to injury rates of 4.69 and 7.07 per 1000 AEs. The injury rate was greater in women than men (IRR, 1.51; 95% CI, 1.19-1.90). TL injury rates were 1.75 and 2.62 per 1000 AEs for men and women, respectively. The ankle was the most commonly injured body part among TL injuries (men, 25.8%; women, 24.3%); the knee was the most commonly injured body part among NTL injuries (men, 25.5%; women, 16.3%). Among TL injuries, common diagnoses included sprains (men, 25.8%; women, 31.2%) and concussions (men, 19.4%; women, 14.8%). Most TL concussions were due to ball contact (men, 83.3%; women, 53.6%). Compared with men, women had a greater NTL overuse injury rate (IRR, 3.47; 95% CI, 1.61-7.46). Compared with women, men had a greater TL injury rate associated with ball contact (IRR, 2.24; 95% CI, 1.07-4.68).Conclusion: There are differences in injury patterns and rates between male and female intercollegiate volleyball players. Although a limited-contact sport, a notable number of concussions were sustained, mostly from ball contact.Clinical Relevance: Understanding injury patterns may aid clinicians in injury diagnosis, management, and prevention.

Context:Data on high school (HS) rowing injuries are lacking.Objective:To describe the epidemiology of HS boys' and girls' rowing injuries during the 2011–2012 through 2013–2014 academic years.Design:Descriptive epidemiology study.Setting:Injury and exposure data from 8 and 11 boys' and girls' rowing programs providing 13 and 17 team-seasons of data, respectively.Patients or Other Participants:High school boys' and girls' varsity rowing student-athletes.Intervention(s):High school rowing data from the National Athletic Treatment, Injury and Outcomes Network.Main Outcome Measure(s):Injury rates and rate ratios were reported with 95 confidence intervals (CIs).Results:In HS boys' and girls' rowing, 59 and 190 injuries were reported, respectively, for rates of 2.39/1000 athlete-exposures (95 CI 1.78, 3.00) and 8.60/1000 athlete-exposures (95 CI 7.38, 9.82). The girls' rowing injury rate was 3.60 times that of boys' (95 CI 2.69, 4.82).Conclusions:These findings suggest a higher injury rate among HS female rowers than HS male rowers. Additional research exploring reasons for the sex difference is warranted.

Context: Anecdotal and qualitative evidence has suggested that some clinicians face pressure from coaches and other personnel in the athletic environment to prematurely return athletes to participation after a concussion. This type of pressure potentially can result in compromised patient care.Objective: To quantify the extent to which clinicians in the collegiate sports medicine environment experience pressure when caring for concussed athletes and whether this pressure varies by the supervisory structure of the institution's sports medicine department, the clinician's sex, and other factors.Design: Cross-sectional study.Setting: Web-based survey of National College Athletic Association member institutions.Patients or Other Participants: A total of 789 athletic trainers and 111 team physicians from 530 institutions.Main Outcome Measure(s): We asked participants whether they had experienced pressure from 3 stakeholder populations (other clinicians, coaches, athletes) to prematurely return athletes to participation after a concussion. Modifying variables that we assessed were the position (athletic trainer, physician) and sex of the clinicians, the supervisory structure of their institutions' sports medicine departments, and the division of competition in which their institutions participate.Results: We observed that 64.4 (n 580) of responding clinicians reported having experienced pressure from athletes to prematurely clear them to return to participation after a concussion, and 53.7 (n 483) reported having experienced this pressure from coaches. Only 6.6 (n 59) reported having experienced pressure from other clinicians to prematurely clear an athlete to return to participation after a concussion. Clinicians reported greater pressure from coaches when their departments were under the supervisory purview of the athletic department rather than a medical institution. Female clinicians reported greater pressure from coaches than male clinicians did.Conclusions: Most clinicians reported experiencing pressure to prematurely return athletes to participation after a concussion. Identifying factors that are associated with variability in pressure on clinicians during concussion recovery can inform potential future strategies to reduce these pressures.

The goal of this study was to examine the clinical presentation of chronic traumatic encephalopathy (CTE) in neuropathologically confirmed cases.

Undiagnosed concussions increase risk of additional injuries and can prolong recovery. Because of the difficulties recognizing concussive symptoms, concussion education must specifically target improving athlete concussion reporting. Many concussion education programs are designed without significant input from athletes, resulting in a less enjoyable athlete experience, with potential implications on program efficacy. Athlete enjoyment of previous concussion education programs moderates the improvement in concussion-reporting intention after experiencing the research version of CrashCourse (CC) concussion education. Prospective cohort study. Level of evidence: Level IV. Quantitative assessment utilizing ANOVA with moderation analysis of 173 male high school football players, aged 13 to 17, who completed baseline assessments of concussion knowledge, concussion reporting, and attitudes about prior educational interventions. Athletes were subsequently shown CC, before a follow-up assessment was administered assessing the same domains. At baseline, only 58.5% of athletes reported that they enjoyed their previous concussion education. After CC, athletes were significantly more likely to endorse that they would report a suspected concussion (from 69.3% of athletes to 85.6%; P< .01). Enjoyment of previous concussion education moderated concussion-reporting intention after CC (P= .02), with CC having a greater effect on concussion-reporting intention in athletes with low enjoyment of previous concussion education (b= 0.21, P= .02), than on individuals with high enjoyment of previous concussion education (P= .99). Enjoyment of CC did not have a moderating effect on concussion-reporting intention. Athletes who previously did not enjoy concussion education exhibited greater gains in concussion-reporting intention than athletes who enjoyed previous education. Given the potential risks associated with undiagnosed concussions, concussion education has sought to improve concussion reporting. Because most athletes participate in concussion education programs due to league or state mandates, improving concussion-reporting intention in these low-enjoyment athletes is of particular relevance to improving concussion-reporting intention broadly.

IMPORTANCE: Despite increased concern about the health consequences of contact sports, little is known about athletes’ understanding of their own risk of sports-related injury. OBJECTIVE: To assess whether college football players accurately estimate their risk of concussion and nonconcussion injury and to identify characteristics of athletes who misestimate their injury risk. DESIGN, SETTING, AND PARTICIPANTS: In this survey study, questionnaires were given to 296 current college football players on 4 teams from the 3 of the 5 most competitive conferences of the US National Collegiate Athletic Association. Surveys were conducted between February and May 2017. Data were analyzed from June 2017 through July 2020. MAIN OUTCOMES AND MEASURES: Multiple approaches were taken to compare athlete perceptions of their risks of concussion and nonconcussion injury with individual probabilities of these risks, which were modeled using logistic regression. RESULTS: Of 296 male college-aged athletes from 4 football teams who participated in the survey, 265 (89%) answered all questions relevant for this study. Participating teams were similar to nonparticipating teams across nearly all measured characteristics. One hundred athletes (34%) had sustained 1 or more concussions, and 197 (68% of the 289 who responded to the question) had sustained 1 or more injuries in the previous football season. Logistic regression models of single-season injury and concussion had reasonably good fit (area under the curve, 0.75 and 0.73, respectively). Of the 265 participants for whom all relevant data were available, 111 (42%) underestimated their risk of concussion (?2?=?98.6; P?=?.003). A similar proportion of athletes (113 [43%]) underestimated their risk of injury, although this was not statistically significant (?2?=?34.0; P?=?.09). An alternative analytic strategy suggested that 241 athletes (91%) underestimated their risk of injury (Wilcoxon statistic, 7865; P?&lt;?.001) and 167 (63%) underestimated their risk of concussion (Wilcoxon statistic, 26?768; P?&lt;?.001). CONCLUSIONS AND RELEVANCE: The findings of this survey study suggest that college football players may underestimate their risk of injury and concussion. The implications for informed participation in sport are unclear given that people generally underestimate health risks. It is necessary to consider whether athletes are sufficiently informed and how much risk is acceptable for an athlete to participate in a sport.