Descriptive Epidemiology of Non-Time-Loss Injuries in Collegiate and High School Student-Athletes

J Athl Train. 2017 May;52(5):446-456. doi: 10.4085/1062-6050-52.2.15. Epub 2017 Mar 30.


Context: Research on non-time-loss (NTL) injuries, which result in less than 24 hours of restriction from participation, is limited.

Objective: To describe the epidemiology of NTL injuries among collegiate and high school student-athletes.

Design: Descriptive epidemiology study.

Setting: Aggregate injury and exposure data collected from a convenience sample of National College Athletic Association varsity teams and 147 high schools in 26 states.

Patients or other participants: Collegiate and high school student-athletes participating in men's and boys' baseball, basketball, football, lacrosse, soccer, and wrestling and women's and girls' basketball, field hockey, lacrosse, soccer, softball, and volleyball during the 2009-2010 through 2013-2014 and the 2011-2012 through 2013-2014 academic years, respectively, participated. Collegiate student-athletes participating in men's and women's ice hockey were also included.

Main outcome measure(s): Injury data from the National Collegiate Athletic Association Injury Surveillance Program and the National Athletic Treatment, Injury and Outcomes Network were analyzed. Injury counts, rates per 1000 athlete-exposures (AEs), and rate ratios were reported with 95% confidence intervals (CIs).

Results: A total of 11 899 and 30 122 NTL injuries were reported in collegiate and high school student-athletes, respectively. The proportion of NTL injuries in high school student-athletes (80.3%) was 1.61 times greater than that of collegiate student-athletes (49.9%; 95% CI = 1.59, 1.63). The NTL injury rate in high school student-athletes (8.75/1000 athlete-exposures [AEs]) was 2.18 times greater than that of collegiate student-athletes (4.02/1000 AEs; 95% CI = 2.13, 2.22). Men's ice hockey (5.27/1000 AEs) and boys' football (11.94/1000 AEs) had the highest NTL injury rates among collegiate and high school athletes, respectively. Commonly injured body parts in collegiate and high school student-athletes were the hip/thigh/upper leg (17.5%) and hand/wrist (18.2%), respectively. At both levels, contusions, sprains, and strains were the most frequent diagnoses. Contact with another player was the most cited injury mechanism (college = 38.0%, high school = 46.3%).

Conclusions: Non-time-loss injuries compose large proportions of collegiate and high school sports injuries. However, the NTL injury rate was higher in high school than in collegiate student-athletes. Tracking NTL injuries will help to better describe the breadth of injuries sustained by athletes and managed by athletic trainers.

Keywords: injury incidence; injury surveillance; sports.

MeSH terms

  • Adolescent
  • Athletes / statistics & numerical data
  • Athletic Injuries* / classification
  • Athletic Injuries* / epidemiology
  • Female
  • Humans
  • Incidence
  • Male
  • Population Surveillance
  • Schools / statistics & numerical data
  • Sports / classification
  • Students / statistics & numerical data
  • United States / epidemiology
  • Universities / statistics & numerical data
  • Young Adult