Injury Incidence Rate During Seasonal Transitions In NCAA Fall And Spring Sports

In the NCAA, fall and spring sports are defined by the semester of their championship season, but they also have a non-championship season during the opposite semester. Transitioning into the championship and non-championship seasons involves an acute increase in physical activity associated with a greater injury rate. No study has examined the injury risk associated with the timing of transition periods related to fall versus spring sport annual cycles. PURPOSE: To quantify and compare injury incidence rates (IR) between NCAA Division I fall and spring sports during the transition into championship and non-championship seasons. METHODS: Injury data collected from ten Olympic sports (excluding American Football) were analyzed retrospectively alongside participation and seasonal transition dates from institutional records. Injuries in the first two weeks of each season were described using frequency, proportion, and IR based on 1000 athlete-days. Relative and IR risks with 95% confidence intervals were calculated to compare seasonal transition periods. RESULTS: Fall sports experienced a more significant IR when transitioning into the championship season (IR = 14.86, 95% CI [12.13,17.19]) compared to the non-championship season (IR = 7.10, 95% CI [5.17, 9.04]) (RR = 2.09, 95% CI [1.51, 2.91]). For spring sports, IR entering the championship season (IR = 6.48, 95% CI [5.25, 7.71]) was not significantly different from the transition to the non-championship season (IR = 6.59, 95% CI [5.35, 7.84) (RR = 1.02, 95% CI [0.78, 1.33]). Injury incidence for fall sports entering the championship season was also significantly greater than that for spring sports transitioning into the championship season (RR = 2.29, 95% CI [1.76, 2.99] or non-championship season (RR = 2.25, 95% CI [1.73-2.93]). IR during the transition into the non-championship season was not different between fall and spring sports. CONCLUSION: Fall sports experience the highest injury rates as they transition into the championship season. Staff for these sports could mitigate injury risk by progressing training load with incremental training volume and frequency increases, though current NCAA restrictions limit such adjustments. Policy changes to allow preparation may support the health of fall sport athletes at the start of their championship season.