Injury risk-workload associations in NCAA American college football

John A. Sampson, Andrew Murray, Sean Williams, Travis Halseth, J Hanisch, G Golden, Hugh Fullagar

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Objectives: To determine injury risk-workload associations in collegiate American Football. Design: Retrospective analysis. Methods: Workload and injury data was recorded from 52 players during a full NCAA football season. Acute, chronic, and a range of acute:chronic workload ratios (ACWR: 7:14, 7:21 and 7:28 day) calculated using rolling and exponentially weighted moving averages (EWMA) were plotted against non-contact injuries (regardless of time lost or not) sustained within 3- and 7-days. Injury risks were also determined relative to position and experience. Results: 105 non-contact injuries (18 game- and 87 training-related) were observed with almost 40% sustained during the pre-season. 7–21 day EWMA ACWR's with a 3-day injury lag were most closely associated with injury (R 2 = 0.54). Relative injury risks were >3× greater with high compared to moderate and low ratios and magnified when combined with low 21-day chronic workloads (injury probability = 92.1%). Injury risks were similar across positions. ‘Juniors’ presented likely and possibly increased overall injury risk compared to ‘Freshman’ (RR: 1.94, CI 1.07–3.52) and 'seniors’ (RR: 1.7, CI 0.92–3.14), yet no specific ACWR – experience or – position interactions were identified. Conclusions: High injury rates during college football pre-season training may be associated with high acute loads. In-season injury risks were greatest with high ACWR and evident even when including (more common and less serious) non-time loss injuries. Substantially increased injury risks when low 21-day chronic workloads and concurrently high EWMA ACWR highlights the importance of load management for individuals with chronic game- (non-involved on game day) and or training (following injury) absences.

Original languageEnglish
Pages (from-to)1215-1220
Number of pages6
JournalJournal of Science and Medicine in Sport
Issue number12
Early online date22 May 2018
Publication statusPublished - 1 Dec 2018


  • GPS playerload
  • Injury prevention
  • Load monitoring
  • Muscle injuries

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation


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