Objective: To define the time frames, measures used and modifying factors influencing recovery, return to school/learn (RTL) and return to sport (RTS) after sport-related concussion (SRC).Design: Systematic review and meta-analysis.Data sources: 8 databases searched through 22 March 2022.Eligibility criteria: Studies with diagnosed/suspected SRC and interventions facilitating RTL/RTS or investigating the time and modifying factors for clinical recovery. Outcomes included days until symptom free, days until RTL and days until RTS. We documented study design, population, methodology and results. Risk of bias was evaluated using a modified Scottish Intercollegiate Guidelines Network tool.Results: 278 studies were included (80.6% cohort studies and 92.8% from North America). 7.9% were considered high-quality studies, while 23.0% were considered high risk of bias and inadmissible. The mean days until symptom free was 14.0 days (95% CI: 12.7, 15.4; I²=98.0%). The mean days until RTL was 8.3 (95% CI: 5.6, 11.1; I²=99.3%), with 93% of athletes having a full RTL by 10 days without new academic support. The mean days until RTS was 19.8 days (95% CI: 18.8, 20.7; I²=99.3%), with high heterogeneity between studies. Several measures define and track recovery, with initial symptom burden remaining the strongest predictor of longer days until RTS. Continuing to play and delayed access to healthcare providers were associated with longer recovery. Premorbid and postmorbid factors (eg, depression/anxiety, migraine history) may modify recovery time frames. Though point estimates suggest that female sex or younger age cohorts take longer to recover, the heterogeneity of study designs, outcomes and overlap in CIs with male sex or older age cohorts suggests that all have similar recovery patterns.Conclusion: Most athletes have full RTL by 10 days but take twice as long for an RTS.PROSPERO registration number: CRD42020159928.

Background: Since 1982, the National Collegiate Athletic Association (NCAA) has collaborated with athletic trainers (ATs) to create the largest ongoing collegiate sports injury database in the world. This report provides an operational update of the NCAA Injury Surveillance Program (NCAA ISP) during the academic years 2014–2015 through 2018–2019. Surveillance system structure: The NCAA ISP used a convenience sampling technique via a rolling recruitment model. The ATs at contributing institutions voluntarily submitted data into their respective electronic medical record systems; common data elements were pushed to and maintained by the Datalys Center. The ATs provided information about all team-related activities, even if no injury occurred during that activity, as well as detailed reports on each injury, including condition and circumstances. Summary: The NCAA ISP has a long-standing role in supplying NCAA stakeholders with crucial injury surveillance data, playing a critical part in safeguarding student-athletes participating in collegiate sports.

Context: Football is among the most popular collegiate sports in the United States, and participation in National Collegiate Athletic Association (NCAA) football has risen in recent years. Background: Continued monitoring of football injuries is important for capturing the evolving burden of injuries in NCAA football. The purpose of this study was to describe the epidemiology of football-related injuries among men's NCAA football players during the 2014–2015 through 2018–2019 academic years. Methods: Exposure and injury data collected in the NCAA Injury Surveillance Program were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates. Results: The overall injury rate was 9.31 per 1000 athlete-exposures. Most injuries occurred during general play (17.5%), blocking (15.8%), and tackling (14.0%). Concussions (7.5%), lateral ligament complex tears (6.9%), and hamstring tears (4.7%) were the most commonly reported injuries. Conclusions: Results of this study were generally consistent with previous findings, though changes over time in rates of commonly reported injuries warrant attention. Continued monitoring of injury incidence is needed to appraise the effectiveness of recently implemented rules changes.

Context: The National Collegiate Athletic Association held the first women's soccer championship in 1982; sponsorship and participation have greatly increased since. Background: Routine examinations of athlete injuries are important for identifying emerging temporal patterns. Methods: Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014–2015 through 2018–2019 seasons were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differential injury rates. Results: The overall injury rate was 8.33 per 1000 athlete-exposures. Lateral ligament complex tears (ankle sprains) (8.6%), concussions (8.3%), and quadriceps tears (5.0%) were the most commonly reported injuries. Rates of lateral ligament complex tears followed an increasing trajectory during the study period, whereas quadriceps tear rates fluctuated during the early years, and concussion rates decreased then increased. Summary: The findings of this study were mostly consistent with existing evidence; notable temporal patterns were observed with regard to lateral ligament complex tears and concussions.

Anterior cruciate ligament (ACL) tears are prevalent in National Collegiate Athletic Association (NCAA) sports, and updated epidemiological evidence is needed to adequately inform prevention efforts. Purpose: This study aimed to describe the epidemiology of ACL tears in NCAA men’s and women’s sports. Methods: Injury and exposure data collected within the NCAA Injury Surveillance Program from 2014/2015 to 2018/2019 were analyzed. ACL tear frequencies, injury rates (IR), and injury proportions were used to describe injury incidence by sport, event type, injury mechanism, and injury history. Injury rate ratios (IRR) were used to examine differential injury rates, and injury proportion ratios (IPR) were used to examine differential distributions. Results: A total of 729 ACL tears were reported from 8,474,401 recorded athlete exposures (AE) during the study period (IR = 0.86 per 10,000 AE), and the competition-related ACL tear rate was higher than the practice-related rate (IRR = 5.52, 95% confidence interval [CI] = 4.75–6.39). Among men’s sports, the highest overall ACL tear rate was observed in men’s football (IR = 1.44 per 10,000 AE), whereas among women’s sports, the highest overall rate was observed in women’s soccer (IR = 2.60 per 10,000 AE). Among sex-comparable sports, ACL tear rates were higher in women’s basketball, softball, and soccer, as compared with their men’s counterparts. ACL tears were more prevalently attributed to player contact mechanisms in men’s sports than women’s sports (IPR = 1.73, 95% CI = 1.37–2.19), but more prevalently attributed to noncontact mechanisms in women’s sports than men’s sports (IPR = 1.17, 95% CI = 1.01–1.35). Conclusions: ACL tear risk in women’s sports continues to warrant attention and prevention efforts. Given the differential rates by event type, future research efforts may also evaluate initiatives to reduce competition-related injury burden in NCAA sports.

Context: The National Collegiate Athletic Association has supported men's baseball championships since 1947. Since its inception, the number of participating teams and athletes has considerably expanded. Background: Frequently conducting injury surveillance of collegiate baseball athletes is essential for identifying developing temporal patterns. Methods: Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during 2014–2015 through 2018–2019 were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics; injury rate ratios were used to examine differential injury rates. Results: The overall injury rate was 3.16 per 1000 athlete-exposures. The preseason injury rate was significantly higher than the regular season injury rate. The most commonly injured body parts were shoulder (16.1%), arm or elbow (16%), and hand or wrist (13.9%). The most reported specific injury was hamstring tear (7.9%). Conclusions: The findings of this study aligned with previous studies—most injuries were due to noncontact and overuse mechanisms, less than one-half of injuries were related to upper extremity body parts, and one-third of all injuries were reported among pitchers.