Epidemiology of Shoulder Instability Injuries in Collision Collegiate Sports From 2009 to 2014

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Abstract
Purpose: To describe the types, mechanisms, and severity of shoulder instability injuries in collegiate collision athletes during the 2009‐2010 through 2013‐2014 academic years using the National Collegiate Athletic Association Injury Surveillance Program; to compare the injury incidence between men's collision sports and their women's non‐collision counterparts, when possible; and to compare injury outcomes between Divisions I, II, and III. Methods: Data regarding men's football, wrestling, ice hockey, and lacrosse, as well as women's ice hockey and lacrosse, were obtained. Injuries requiring attention from a health care provider were reported. Incidence rates per 100,000 athlete‐exposures (AEs) were calculated with 95% confidence intervals (CIs). Analysis of variance was used to compare time loss (TL), and χ 2 analysis was used to compare surgery rates between divisions. Results: A total of 445 shoulder instability injuries occurred in 1,421,561 AEs from 2009‐2010 to 2013‐2014 (incidence rate, 31.30 injuries/100,000 AEs; 95% CI, 28.4‐34.21 injuries/100,000 AEs). Subluxation accounted for 59.1% of injuries, with anterior subluxation (35.3%) being the most common injury. Dislocation resulted in the most TL per injury (17.58 days). Mean TL for all injuries was 8.17 days (standard deviation, 7.21 days). When non–time‐loss injuries were excluded from analysis, players experienced a mean TL of 18.34 days (standard deviation, 8.44 days). Divisions I (4.77 days), II (20.52 days), and III (11.23 days) differed significantly in mean TL ( P = .01). Of the injuries, 29.3% required surgery. The surgery rates for Divisions I (32.9%), II (38.1%), and III (19.4%) also differed significantly ( P = .04). Men's ice hockey and lacrosse players sustained a 2.17‐fold (95% CI, 1.04‐4.50) higher incidence of shoulder instability than their female counterparts. Conclusions: Anterior subluxation and dislocation accounted for 52.1% of all shoulder instability injuries. Injured athletes missed 8 days on average, and nearly 30% of injuries required surgery. Surgery rates and TL were significantly different between Divisions I, II, and III. Female athletes playing non‐collision ice hockey and lacrosse experienced significantly lower shoulder instability rates than their male counterparts. Level of Evidence: Level III, retrospective cohort study.
Funding Information
  • National Collegiate Athletic Association

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