By Hannah Bilton, JHBL Staff Member

Everyone loves a good comeback story, especially the National Collegiate Athletic Association (“NCAA”), it seems.  The NCAA is an organization that governs most intercollegiate athletics across three divisions (I, II, III), having their grip over approximately 1,098 colleges and universities nationwide.[1]  The army of NCAA athletes has reached an all-time high at just over half a million student-athletes in 2022.[2]  The NCAA attributes this striking increase to its eligibility expansion and their message of togetherness and hope following the pandemic.[3]  Athletes, who donate their minds and bodies to the billion-dollar organization trust that the NCAA will ensure their safety during their 4–5-year career, in reality this is not the case.[4]  The NCAA injury incident report reached 1.3 million injuries per year.[5]  Rather than tackle the cause of these injuries and preventing such injuries in their student-athlete army, the NCAA turned to an initiative of injury insurance assistance for graduated athletes.[6]  These developments have left many to wonder whether the NCAA’s goal of “inspiring the next generation of athletes” relies too heavily on the “comeback story” of injured athletes.[7]

The NCAA made headlines when it announced its post-eligibility injury insurance program, which will launch in 2024.[8]  According to the NCAA’s president, the program is “another occasion where the NCAA can show its unwavering commitment to and support for student-athletes” as a response to the Division I Transformation Committee’s recommendation of the “holistic athlete” approach, this holistic is described by the NCAA as a plan to expand mental health and academic support to athletes at their NCAA member schools, the release does not mention injury prevention or recovery.[9]  The NCAA’s approach is not a novel idea- the National Institute of Health (“NIH”) investigated this very approach years prior to this announcement.[10]  In 2021, the NIH found that the U.S. medical system makes billions annually from the influx of injured NCAA student-athletes and further demonstrated that the associated cost of injury treatment can be reduced with athlete-based assistance programs.[11]  The research also found that while the cost of treating an injury went down using insurance assistance programs, there was no significant change in the number of injuries student-athletes sustained.[12]  Each year, an NCAA student athlete has a 75% chance of sustaining an injury. [13]  The substantial increase in athletes joining the NCAA organization in conjunction with the high likelihood of injury among these athletes, demonstrates the need for the NCAA to round out its “holistic” approach by shifting focus from insuring treatment cost assistance to preventing injury all together.

Currently, the Injury Surveillance Program, an NCAA internal organization formed in 1989, is meant to inform policy on injury prevention and provide data on injuries sustained by NCAA student-athletes.[14]  While the NCAA has extensive data on the incidence of injuries of its athletes, the organization’s prevention programs are lacking.[15]

The NCAA claims to have a multitude of regulations around practice hours, number of games, and play conditions for both games and practices. The regulations are facilitated by coaches on their respective campuses and regulated by an NCAA compliance staff member within the internal athletic department(s) of that college or university.[16]  Besides campus level regulation, the only regulatory body of the NCAA that deals with rules infractions is a committee within the NCAA headquarters which monitors the status of infractions after they are reported.[17]   The system the NCAA has in place allows coaches and sports staff at colleges and universities to go around the NCAA regulations and expose athletes to a greater risk of injury that is not under the control of the NCAA.  Moreover, the NCAA lacks a system to educate its athletes and member organizations on injury prevention and bodily health, leaving this crucial topic up to each individual member school to cover at their own discretion.

Why is this the case when the NCAA promotes such a student-athlete first narrative? The answer could lie in the cost of prevention programs versus the profits of the “come back” story of injured athletes or their replacement.  If you do a quick google search on “NCAA injuries,” pages and pages of websites and news outlets including ESPN and The New York Times appear, reporting the latest injuries among college athletes. The NCAA and the general public are well aware of the dramatic increase in student-athlete injuries over the past few years, but the policies of the NCAA have yet to change as a result.[18] This could be attributed to the increase in viewership of NCAA sports and increase in sponsorship from companies from the inspirational athletes who either make a comeback from injuries or athletes who are up and coming and often replace veteran athletes who could not meet or exceed their pre-injury status.

For the rising population of athletes, the lack of preventative care and education is concerning.  On the one hand the NCAA is claiming to promote a holistic program of student-athlete care and on the other, its actions show that athletes are simply reduced to their bodily performance and that each of them is replicable. There has been a recent push by senators and coaches alike for an “Athlete Bill of Rights” which would protect NCAA athletes, under the law. [19] The “Athlete Bill of Rights”, however, is being pushed largely from the perspective of branding said athletes and the “billions of dollars in business driven by the blood, sweat and tears of college athletes, literally,” not in protecting their bodies or outlining any ethical code within the law about the treatment of athletes within NCAA sponsored practices and competition[20]  The NCAA injury assistance program is a step in the right direction, but it sheds light on the flaws of the NCAA’s overall system in injury care and prevention as well as its capitalistic view of the athlete and their body.

Disclaimer: The views expressed in this blog are the views of the author alone and do not represent the views of JHBL or Suffolk University Law School. 

*Hannah Bilton is a J.D. candidate at Suffolk University Law School. She received three Bachelor’s degrees in the fields of Biology, International Relations, and Political Science from Hobart and William Smith Colleges in 2022.


[1] What is the NCAA?, Nat’l Collegiate Athletic Ass’n https://www.ncaa.org/sports/2021/2/10/about-resources-media-center-ncaa-101-what-ncaa.aspx[https://perma.cc/NHR8-3H8N].

[2] NCAA Student-athletes surpass 520,000, set new record, Nat’l Collegiate Athletic Ass’n (Dec. 5, 2022). https://www.ncaa.org/news/2022/12/5/media-center-ncaa-student-athletes-surpass-520-000-set-new-record.aspx, archived at [https://perma.cc/YF79-5DND].

[3] Dear College Sports, Nat’l Collegiate Athletic Ass’n https://www.ncaa.org/sports/2021/6/21/dear-college-sports.aspx [https://perma.cc/79MD-RB6G].

[4]  NCAA earns $1.15 billion in 2021 as revenue returns to normal, ESPN (Feb. 2, 2022), https://www.espn.com/college-sports/story/_/id/33201991/ncaa-earns-115-billion-2021-revenue-returns-normal [https://perma.cc/5VCQ-TYQV].

[5] Gitnux, The Most Surprising College Sports Injuries Statistics And Trends in 2023 • GITNUX, The Most Surprising College Sports Injuries Statistics And Trends in 2023, Gitnux (Sept. 5, 2022), https://blog.gitnux.com/college-sports-injuries-statistics/#:~:text=According%20to%20the%20NCAA%20(n.d.,in%20the%20United%20States%20alone [https://perma.cc/9EG6-6TBJ]; Robert L. Parisien et. al., Implementation of an Injury Prevention Program in NCAA Division I Athletics Reduces Injury-Related Health Care Costs. 9 Orthopedic J. of Sports Med. (2023).

[6] Id.

[7] Mission and Priorities, Nat’l Collegiate Athletic Ass’n, https://www.ncaa.org/sports/2021/6/28/mission-and-priorities.aspx [https://perma.cc/C5GB-ZSDC].

[8] Charlie Henry, NCAA to provide schools post-eligibility injury insurance option for student-athletes, Nat’l Collegiate Athletic Ass’n (Aug. 2, 2023), https://www.ncaa.org/news/2023/8/2/media-center-ncaa-to-provide-schools-post-eligibility-injury-insurance-option-for-student-athletes.aspx [https://perma.cc/52L3-2WAS].

[9] Id; See Meghan Durham, DI Council adopts proposal for student-athlete representation (April, 2023) https://www.ncaa.org/news/2023/4/13/media-center-di-council-adopts-proposal-for-student-athlete-representation.aspx [https://perma.cc/5TUE-MZ97].

[10] Parisien et. al, supra note 5.

[11] Id.

[12] Id.

[13] The Most Surprising College Sports Injuries Statistics And Trends in 2023, Gitnux (Sept. 5, 2023), https://blog.gitnux.com/college-sports-injuries-statistics/ [https://perma.cc/9EG6-6TBJ].

[14] NCAA Injury Surveillance program, Nat’l Collegiate Athletic Ass’n, https://www.ncaa.org/sports/2018/4/9/ncaa-injury-surveillance-program.aspx [https://perma.cc/3TVV-59Z3].

[15] Anna Boustany, Lack of injury prevention on college football team raises safety concerns, The Flat Hat (Sept. 2, 2019), https://flathatnews.com/2019/09/02/lack-of-injury-prevention-on-college-football-team-raises-safety-concerns/ [https://perma.cc/K8U8-DU59].

[16] Mike Savino, Blumenthal Pushes for Comprehensive “College Athletes Bill of Rights” Amidst NCAA Season, CT News Junkie (Sept. 11, 2023), https://ctnewsjunkie.com/2023/09/11/blumenthal-pushes-for-comprehensive-college-athletes-bill-of-rights-amidst-ncaa-season/ [https://perma.cc/YV2R-CNYC].

[17] Infractions Process, Nat’l Collegiate Athletic Ass’n, https://www.ncaa.org/sports/2021/6/28/infractions-process.aspx [https://perma.cc/Y6H4-3RKH].

[18] Hunter S. Anglleri et. al., Injury Rates at an NCAA Division I Institution After the COVID-19 Lockdown: A Descriptive Epidemiological Study, 11 Orthopedic J. of Sports Med. 2, 8 (2023).

[19]Savino, supra note 15.

[20] Id.