With improved regimens and added training, it seems as if college athletes are getting larger and stronger with every passing year.
But as linebackers, power forwards and strikers increase their size and speed, some worry that they could also be increasing the risk of serious injuries on the field.
"I think the training of athletes is improving, leading to bigger, faster, stronger athletes," said Christopher Ingersoll, editor-in-chief of the Journal of Athletic Training and a professor of sports medicine at the University of Virginia.
"When you put these big, strong bodies in a situation where they're going to collide with each other and with equipment, these things are going to happen," he said. "Maybe we're playing a little rougher."
This week, sports medicine researchers gained a new tool to assess exactly how much rougher these athletes could be playing.
In a special spring issue of the Journal of Athletic Training, the National Athletic Trainers' Association and the National Collegiate Athletic Association released the largest ongoing collegiate sports injury database in the world.
The data covers injuries recorded in the NCAA Injury Surveillance System over a 16-year period, covering 15 collegiate sports.
The good news is that, as a whole, injury rates appear to be holding steady.
"It is a fairly level curve. There has been no significant increase or decrease over the years," said Randall Dick, one of the study's authors and associate director of research for the NCAA.
"Even though there has been an influx of people into intercollegiate athletics, we are still managing them well in terms of injury prevention," Ingersoll said.
But certain types of injury are still on the rise. And as young athletes train harder, becoming ever more competitive, some worry that the injuries they sustain could have lifelong implications.
Are Sports More Dangerous Today?
Numbers aside, it is hard to dispute the notion that youth and collegiate sports today are more competitive than ever.
"Sports have changed," said Dr. Edward Wojtys, chief of sports medicine at the University of Michigan Medical School.
"I don't think there's any doubt that the sports kids are playing now are not the sports they were playing 20 years ago."
This added intensity may be leading to young athletes who hit harder, turn faster, and push themselves farther than those of generations past, leading to increases in certain types of injuries.
"One of the things that stood out was the fact that injuries of the anterior cruciate ligament, or ACL, across all sports appeared to be on the rise," Dick said. "It was the same with concussions."
And this intensity isn't exclusive to the collegiate level. Wojtys says he only used to see ACL injuries in adults. Today, he says, girls as young as 12 and boys ages 13 and 14 are showing up in his clinic with this type of injury, and he says he's probably treated more than a dozen such cases so far this year.
"I think that 20 years ago, we saw some things that then were rare, but now are quite regular."
Dr. C.T. Moorman, director of sports medicine at Duke University, says that in college sports, female athletes seem to be markedly prone to debilitating ACL episodes.
"Women have been particularly hit with these injuries, especially in field sports and basketball," Moorman said. "The rate is almost double that seen in men, and in some sports, like basketball, it is almost five times higher."
Moorman says he believes proper training, in some cases, has not kept up with the influx of participants in college sports, which could lead to these injuries.
As for concussions, part of the apparent increase could be due to better detection methods for these injuries, compared to 16 years ago, Dick says.
But, citing soccer and basketball as two examples, Dick added, "There are a lot of sports that are not traditionally looked at as contact sports where the mechanism of injury is primarily player contact."
A Painful Passion
Part of the problem may also be the increasingly competitive mentality that has come to typify the pursuits of young athletes.
"The competitive level keeps getting higher and higher," Ingersoll said, adding that year-round training without seasonal breaks could lead to a rise in injuries due to overtraining without sufficient downtime.
"I don't know that these data reflect that phenomenon, and I'm very concerned about that," he said. "I think we're going to see some more overtraining injuries."
And injuries can have dire consequences for young athletes.
"A lot of people look at this stuff and say, 'no big deal.' But that's not true."
Ingersoll says in the U.S. every year, there are 400,000 ACL injuries.
Even with successful treatment, he says, the average time to early onset of osteoarthritis in these patients is seven years. If teenage and college-age athletes are getting these injuries now, he says, this means that they will likely begin to experience osteoarthritis as early as in their 20s.
"What are the chances they will be able to exercise and take care of themselves in their 40s, 50s and 60s in order to prevent diabetes, heart disease and other diseases?" he asked. "We're creating a whole generation of kids who might not be able to do this. We're starting to see the huge public health issue that this is."
Saving Young Athletes
But Dick said that, despite the fact that injuries are still an unfortunate reality in college sports, the newly released research will likely be an important tool that "will hopefully stimulate a new round of injury prevention measures."
Ingersoll agrees. "Generally, sports are safe, but we are developing the tools and ability to even further enhance health care in terms of what we provide athletes for preventing injury."