• Zachary Y Kerr, Janet E Simon, Dustin R Grooms, Karen G Roos, Randy P Cohen, and Thomas P Dompier.
• Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA.
• Orthop J Sports Med. 2016 Sep 1; 4 (9): 2325967116664500.

BackgroundResearch has found that injury rates in football are higher in competition than during practice. However, there is little research on the association between injury rates and type of football practices and how these specific rates compare with those in competitions.PurposeThis study utilized data from the National Collegiate Athletic Association Injury Surveillance System (NCAA ISS) to describe men's collegiate football practice injuries (academic years 2004-2005 to 2008-2009) in 4 event types: competitions, scrimmages, regular practices, and walkthroughs.Study DesignDescriptive epidemiological study.MethodsFootball data during the 2004-2005 to 2008-2009 academic years were analyzed. Annually, an average of 60 men's football programs provided data (9.7% of all universities sponsoring football). Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (RRs), 95% CIs, and injury proportions were reported.ResultsThe NCAA ISS captured 18,075 football injuries. Most injuries were reported in regular practices (55.9%), followed by competitions (38.8%), scrimmages (4.4%), and walkthroughs (0.8%). Most AEs were reported in regular practices (77.6%), followed by walkthroughs (11.5%), competitions (8.6%), and scrimmages (2.3%). The highest injury rate was found in competitions (36.94/1000 AEs), followed by scrimmages (15.7/1000 AEs), regular practices (5.9/1000 AEs), and walkthroughs (0.6/1000 AEs). These rates were all significantly different from one another. Distributions of injury location and diagnoses were similar across all 4 event types, with most injuries occurring at the lower extremity (56.0%) and consisting of sprains and strains (50.6%). However, injury mechanisms varied. The proportion of injuries due to player contact was greatest in scrimmages (66.8%), followed by regular practices (48.5%) and walkthroughs (34.9%); in contrast, the proportion of injuries due to noncontact/overuse was greatest in walkthroughs (41.7%), followed by regular practices (35.6%) and scrimmages (21.9%).ConclusionInjury rates were the highest in competitions but then varied by the type of practice event, with higher practice injury rates reported in scrimmage. In addition, greater proportions of injuries were reported in regular practices, and greater proportions of exposures were reported in regular practices and walkthroughs. Efforts to minimize injury in all types of practice events are essential to mitigating injury incidence related to both contact and noncontact.

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