The Impact of EXSS in Preventing Catastrophic Sports Injury

For over 30 years the Department of Exercise and Sport Science has housed the National Center for Catastrophic Sports Injury Research (NCCSIR).  This center was founded and directed by Dr. Frederick Mueller, an emeritus professor and former chair of our department.  The data collected by the NCCSIR has served as an invaluable source of epidemiological information which has led to rules, conditioning and safety equipment changes in numerous sports.

Kristen Kucera, PhD, ATC  Director, National Center for Catastrophic Sports Injury Research

Kristen Kucera, PhD, ATC

We were fortunate to welcome Dr. Kristen Kucera as the new Director of the NCCSIR this academic year.  She joined our faculty after serving as an assistant professor in the Division of Occupational and Environmental Medicine at Duke University Medical Center.  An epidemiologist and certified athletic trainer, Kristen’s research interests include sport and occupational injury epidemiology with an emphasis in musculoskeletal disorders, ergonomics, and return to work.   She also focuses on the evaluation and improvement of surveillance for sports and work-related injuries as another area of current and future focus.

Under her direction, the NCCSIR is poised to continue it’s role as a leading source of data to shape policies and procedures for improved sport safety.  In this week’s EXSS Impact blog post, Dr. Kucera provides an overview of the impactful work that is being conducted through the NCCSIR.

1) Why conduct surveillance of catastrophic sports injuries?

Although rare, the death of an athlete on a sports field is tragic and has enormous significance for the athlete and everyone involved.  The most common types of fatal events are acute trauma to the head/neck/spine, exertional-related heat events, exertional-related cardiac events, and disruption of cardiac rhythm due to blunt chest impacts (commotio cordis).  Most recently, concussion and traumatic brain injury safety has come to the forefront of our nation’s legislative agenda.  To date, all 50 states have passed legislation pertaining to prevention and management of concussion.  These measures reflect the importance that society places on minimizing the risk of head injury in youth and adult sports.

National surveillance of catastrophic sports-related injuries conducted by the National Center for Catastrophic Sports Injury Research (NCCSIR) over the last thirty years has facilitated the introduction of numerous sports safety interventions.  These include changes to the pole vault equipment, limitations on pyramid formations in spirit squads/cheering, and rule and coaching changes in football.  The information from the surveillance conducted by the NCCSIR has considerable potential to save lives and prevent permanent disability.

The NCCSIR has historically obtained data largely from news media reports and from a short 2-page questionnaire completed by school officials (coach or athletic trainer).  Given the complexities surrounding the prevention of catastrophic events, there is a need for an expanded data collection (i.e. more variables) in order to add more case details to catastrophic events.

National Center for Catastrophic Sports Injury Research Consortium Organization Chart

National Center for Catastrophic Sports Injury Research Consortium Organization Chart

During the last year a research consortium – the Consortium for Catastrophic Injury Monitoring in Sport has formed to collaborate with the NCCSIR and expand the surveillance and investigation of catastrophic death, disability or severe sports-related injury and illness.  In the near future, our hope is that injured athletes and their family members, athletic trainers, coaches, or other witnesses to the event will be able to report catastrophic events and the details surrounding the event via the NCCSIR’s reporting website.  This website is in the final stages of development.  The activities of the NCCSIR and the Consortium are funded by four national organizations (see photo) including the American Football Coaches Association (AFCA), the National Athletic Trainers’ Association (NATA), National Collegiate Athletic Association (NCAA), and the National Federation of State High School Associations (NFHS).

Previous studies have looked at basic information surrounding the events (e.g., what happened), but we don’t know much about details of the equipment used, clothing worn, playing surface, and environmental factors. Information about the equipment used, medical reports, and imaging post-event may help professionals to better prevent and manage catastrophic injuries.

2) What will be done and what will be found?

In response to this need, the National Operating Committee on Standards for Athletic Equipment (NOCSAE) has funded the NCCSIR and the Consortium to conduct a 2-year research study “Detailed Epidemiology of Selected Characteristics of Catastrophic Injuries.”  The purpose of this study is to enhance our understanding of sports-related catastrophic injuries through expanded surveillance.  The aims of this study are to: 1) collect detailed data on equipment, clothing, surface, and environmental characteristics, 2) acquire and archive the actual equipment and clothing for these events and, 3) for head/neck events, acquire and archive pertinent medical records and imaging.  An investigative model, built on pre-existing methods, for gathering this information and acquiring these items is being developed.  In addition, we plan to expand our investigative model on a national scale by partnering with state organizations (e.g., state athletic training organizations).  These state organizations could assist with reporting catastrophic cases to the NCCSIR and gathering more in-depth information regarding specific cases.

3) What’s the impact of surveillance of catastrophic sports injuries on the public?

Slide1The work conducted by the NCCSIR and the Consortium is important because it will bring new knowledge to the sports injury field, as well as help with the development of innovative strategies for preventing future catastrophic injuries.  Information from this research will be shared with governing sports organizations, researchers, and sport and healthcare professionals with the hopes of further reducing the risk of catastrophic injury in sports.  Continuous and expanded surveillance over time will help determine the impacts of current interventions including equipment modifications, rule changes, and state/national sport safety policies.

For the past 30 years, information from NCCSIR has been used by national sport organizations to help make decisions about coaching techniques, rule changes, safety and playing equipment, and improved emergency procedures and medical care for catastrophic injury and illness events. This information is extremely important from an intervention and policy standpoint, and helps to make recommendations on how sports participation can be safer for athletes. Given the severity of these catastrophic events, the need for additional information is high.

For more information on the National Center for Catastrophic Sport Injury Research (NCCSIR), please visit our web page at

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