U.S. Council for Athletes' Health
Athletics Healthspace



Interassociation Recommendations for the Prevention of Catastrophic Injury and Death in Collegiate Athletes: A New Perspective for the Mandatory Compliance Requirements and Best Practices

The number of student athlete deaths occurring in collegiate athletics, specifically during training sessions and workouts mainly directed by strength and conditioning personnel, led to a watershed decision by the NCAA Board of Governors in April 2019. In an unprecedented and unanimous vote they approved the Interassociation Recommendations: Preventing Catastrophic Injury and Death in Collegiate Athletes association wide policy. This policy was the first legislation approved by the NCAA Board of Governors as an association wide policy that was implemented outside of the standard policy ratification process and without input and feedback from the member institutions of the NCAA. These recommendations became effective for all NCAA member institutions (Division 1, 2 and 3) on August 1, 2019.  

The significance of the passing of the Interassociation Recommendations policy cannot be minimalized. Initially, the Interassociation Recommendations were sent to the designated athletics healthcare administrators at all NCAA member institutions.  However, they were largely perceived as recommendations and not requirements, and as such, institution compliance was low.  However, in an email sent by the NCAA Sports and Science Institute on April 14, 2020, it was stated that, …all three divisions are now required to comply with the Interassociation Recommendations: Preventing Catastrophic Injury and Death in Collegiate Athletes…”.

The Interassociation Recommendations are based on two powerful premises: first, to prevent collegiate athlete catastrophic injury and death and second, to identify best practices that when implemented will help prevent catastrophic injury and death. The best practices are organized in six key areas: 1) Sportsmanship, 2) Protective Equipment, 3) Acclimatization and Conditioning, 4) Emergency Action Planning, 5) Responsibilities of Athletics Personnel, and 6) Education and Training.

The recent notification this spring from the NCAA affirms member institution compliance with the Interassociation Recommendations is mandatory, not optional. With this directive of mandatory compliance schools must now implement organizational changes in the department of athletics, changes that directly impact how student athletes will train, who provides the training, and how the training programs will be approved and monitored. 

 Further, many of the requirements will directly impact the strength and conditioning staff. For example:

  • Strength and conditioning personnel are now required to have a direct reporting line into sports medicine or the sports performance staff. No longer will they report directly to a head coach.
  • The requirements indicate student athlete workout programs must now be published, scientifically based, and made available to medical staff prior to the workout.
  • Strict rules now govern the progression of conditioning and strengthening following transitions periods, including both individual and team transitions.
  • Annual education programming—comprised of a minimum of 12 subject areas for athletes, coaches, administrator, and athletics healthcare personnel—is also now required.

These requirements can become a daunting task for even the most resourced member institution.  It is imperative that member institutions engage with collaborative programming to meet these requirements without overwhelming their personnel and distracting them from their important duties. Clearly the confirmed mandates from the NCAA indicate just how it importance for member institutions to immediately think differently about how to meet these requirements and provide the programming required to do so.

The experts at the U.S. Council for Athletes Health have included a comprehensive checklist to provide guidance for NCAA member institutions to address the six areas of the NCAA Interassociation Recommendations for Prevention of Catastrophic Injury and Death in Collegiate Athletes.

Download the checklist here. 

For additional information and programming to ensure your institution meets the NCAA Interassociation Requirements contact and collaborate with USCAH.

Looking for more insights on the Interassociation Recommendations? Listen to the USCAH podcast here. 

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