Overuse injuries can impose a significant burden on college and high school athletes. Interventions addressing prevention of overuse injury are needed.

Objectives:To determine if athletes with a self reported history of previous injury have a higher incident injury rate than athletes without a self reported injury history.Methods:A prospective cohort study of Classic League soccer players playing at the level under 12 through under 18. Injury history forms were mailed to all registering Classic League soccer players in the North Carolina Youth Soccer Association during 1997–2000 (n  =  7000); 1483 (19%) returned the baseline questionnaire and were followed up for injuries.Results:There were 5139 player-seasons of follow up and an estimated 171 957 athlete-exposures. More than half self reported an injury history (59.7%). Overall, the unadjusted incidence rate was 4.6 (95% confidence interval (CI) 4.3 to 4.9) incident injuries per 1000 athlete-exposures. Multivariate generalised Poisson regression modelling indicated that players with one previous injury had a twofold greater risk of incident injury (IRR  =  2.6; 95% CI 2.0 to 3.3), and those with two or more previous injuries had a threefold greater risk of incident injury (IRR  =  3.0; 95% CI 2.3 to 3.8) compared with athletes with no previous injuries.Conclusions:Injury history was associated with an increased injury rate. This suggests that, even in these youth soccer players, those with an injury history may be at higher risk.

ObjectiveTo investigate the aetiology and incidence of sudden cardiac arrest and death (SCA/D) in US competitive athletes.MethodsProspective surveillance was conducted from 1 July 2014 to 30 June 2018 through the National Center for Catastrophic Sports Injury Research in collaboration with national sports organisations. Autopsy reports, death certificates, and medical records were reviewed by an expert panel to determine aetiology. Athlete participation statistics from the National Federation of State High School Associations and the National Collegiate Athletic Association (NCAA) were used to calculate incidence rates per athlete-years (AY). Comparisons of incidence rates were calculated using incidence rate ratios (IRR) with 95% CIs.Results331 cases of confirmed SCA/D (158 survivors; 173 fatalities) were identified; 15.4% in middle school, 61.6% in high school and 16.6% in college and professional athletes. Average age was 16.7 (11–29) years, and the majority were in male (83.7%), basketball (28.7%) or American football (25.4%) athletes. Common causes included hypertrophic cardiomyopathy (20.6%), idiopathic left ventricular hypertrophy (13.4%), coronary artery anomalies (12.0%) and autopsy-negative sudden unexplained death (9.6%). Coronary anomalies were more common in middle school athletes (28%), while cardiomyopathies (hypertrophic, arrhythmogenic, dilated, non-compaction or restricted) accounted for 47% of cases in college and professional athletes. Incidence was higher in male versus female athletes at the high school (1:43 932 AY (95% CI 1:38 101 to 1:50 907) vs 1:203 786 AY (95% CI 1:145 251 to 1:293 794); IRR 4.6 (95% CI 3.1 to 7.2)) and NCAA (1:34 906 AY (95% CI 1:25 385 to 1:49 173) vs 1:123 278 AY (95% CI 1:66 078 to 1:249 853); IRR 3.5 (95% CI 1.5 to 9.5)) levels. African American male NCAA Division I basketball players had the highest annual incidence rate of SCA/D (1:2087 AY (95% CI 1:1073 to 1:4 450)).ConclusionsCardiomyopathies account for nearly half of SCA/D cases in college and professional athletes, while coronary artery anomalies play a more prominent role than expected in middle school athletes. Over half of SCA cases in athletes result in sudden death, calling for improved prevention strategies.

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Context:Few validation studies of sport injury-surveillance systems are available.Objective: To determine the validity of a Web-based system for surveillance of collegiate sport injuries, the Injury Surveillance System (ISS) of the National Collegiate Athletic Association's (NCAA).Design: Validation study comparing NCAA ISS data from 2 fall collegiate sports (men's and women's soccer) with other types of clinical records maintained by certified athletic trainers.Setting: A purposive sample of 15 NCAA colleges and universities that provided NCAA ISS data on both men's and women's soccer for at least 2 years during 2005-2007, stratified by playing division.Patients or Other Participants: A total of 737 men's and women's soccer athletes and 37 athletic trainers at these 15 institutions.Main Outcome Measure(s): The proportion of injuries captured by the NCAA ISS (capture rate) was estimated by comparing NCAA ISS data with the other clinical records on the same athletes maintained by the athletic trainers. We reviewed all athletic injury events resulting from participation in NCAA collegiate sports that resulted in 1 day or more of restricted activity in games or practices and necessitated medical care. A capture-recapture analysis estimated the proportion of injury events captured by the NCAA ISS. Agreement for key data fields was also measured.Results: We analyzed 664 injury events. The NCAA ISS captured 88.3% (95% confidence interval = 85.9%, 90.8%) of all time-lost medical-attention injury events. The proportion of injury events captured by the NCAA ISS was higher in Division I (93.8%) and Division II (89.6%) than in Division III (82.3%) schools. Agreement between the NCAA ISS data and the non-NCAA ISS data was good for the majority of data fields but low for date of full return and days lost from sport participation.Conclusions: The overall capture rate of the NCAA ISS was very good (88%) in men's and women's soccer for this period.Key Words: capture-recapture analysis, injury epidemiology, time loss, collegiate athletes Key Points• Overall, the capture rate of the National Collegiate Athletic Association Injury Surveillance System was 88% for men's and women's soccer injuries during the study period.• Thus, this injury-surveillance system is capable of providing reliable and valid injury statistics, at least for men's and women's soccer.