New Study Reveals Sports with Highest Concussion Rates
Tue, April 20, 2021

New Study Reveals Sports with Highest Concussion Rates

Football was recorded with the highest concussion rates, among other sports / Photo Credit: 123RF


A study published in the journal Pediatrics named football, soccer, ice hockey, and cheerleading as some of the sports with the most concussion incidences. Repeat concussion is also occurring less across high school sports, but such injuries on game day are still on the rise when it comes to football.

Avinash Chandran, an author of the study, told CNN that the findings are crucial for parents, coaches, student-athletes, and even researchers involved in high school sports.

"This study updates our understanding of concussion patterns in high school sports using injury surveillance data," he said. "It adds to our existing understanding by providing the most recent 'time-stamp' in concussion incidence in high school sports."


Concussion rates in high school sports

It's important to continuously monitor concussion rates and distribution to assess temporal patterns, the researchers said, adding that there's a need to update the examinations of such injuries in high school sports.

The researchers looked at data of 9,542 concussions across 20 high school sports that occurred between the 2013-2014 and 2017-2018 school years from the National High School Sports-Related Injury Surveillance Study database, or HS RIO.

These include football, wrestling, soccer, basketball, baseball, cross country, lacrosse, swimming and diving, and track and field for both boys and girls. They also looked into boys' ice hockey, girls' field hockey, and coed cheerleading.



According to Reuters, the study analyzed injuries per athlete exposure (AE) with one practice or competition counting as one exposure for every athlete. Data showed an overall injury rate of 4.17 concussions per 10,000 AEs.

Repeat concussion rates dropped from 0.47 to 0.28 per 10,000 AEs across all high school sports examined—with football showing the most notable decrease. Football practice concussions became less common, from 5.47 to 4.44 per 10,000 AEs over the study period.

However, football game-day concussion rates increased from 33.19 to 39.07 per 10,000 AEs. Reuters says it's unclear if more reporting or more injuries are causing the rise of game day concussion rates for football.

Football was among the three sports with the highest concussion rates along with girls' soccer (8.19 per 10,000 AEs) and boys' ice hockey (7.69 per 10,000 AEs).

Overall, the study found that girls showed higher concussion rates than boys at 3.35 against 1.51 injuries per 10,000 AEs in sex-comparable sports (sports in which both sexes participated). 


The highest rate during practice

The study found that 67 percent of concussions across all high school sports occurred during game day—and only cheerleading showed higher numbers in practice than in competition.

Findings show that the concussion rate for cheerleading practice was at 3.60 per 10,000 AEs, while in competition, it was at 2.22 per 10,000 AEs. Where and how cheerleaders practice may attribute to the finding, according to the researchers, but they quickly added that more research is needed.

"For instance, unfortunately, not all states recognize cheerleading as a sport—which may impact the conditions in which cheer squads may practice," Chandran told CNN. This means practice may take place in hallways or asphalt, which puts them at a higher risk of concussion.

"It is also possible that cheer squads have less access to medical care and coaching support than other high school sports," the author added, as per the observed practice patterns.



Recurrent concussions

Among the sex-comparable sports, recurrent concussions were found to be higher in girls (9.3 percent) than in boys (6.4 percent) even though the sport with the highest proportion was boys' ice hockey (14.4 percent).

The second sport with the highest concussion rate was boy's lacrosse (12.1 percent), followed by girls' field hockey (12.1 percent), boys' baseball (11 percent), girls' basketball (10.8 percent), and boys' wrestling (10.3 percent).

The study also found evidence of a decrease in the recurrent concussion rate across the study period. Data showed that the annual average change was most notable in boy's football (-0.13 per 10,000 AEs) while other sports were also observed to experience a decrease (-0.03 per 10,000 AEs).


A helpful guide

The study still had its limitations such as only using data from high schools with athletic trainers, and most information was based on athletes showing symptoms during a competition or a practice.

"Underreporting may have occurred if players chose not to disclose concussion symptoms, thus compromising our ability to fully understand athlete injury histories," the researchers noted in the study.

Still, they believe that the results of their study will provide benefits to healthcare experts by "helping guide future prevention and research directions."


The recurrent concussion was higher in girls than in boys / Photo Credit: 123RF


With the growing population of high school athletes and the rapidly changing field of concussion management, the researchers noted the importance of understanding the incidence of concussions and how to prevent them.

"Our study updates previous literature on high school sports concussion incidence2, and provides additional information about emerging trends in incidence," they said, although the results did not directly analyze the causes of the rise in concussion incidence nor the effects of previous efforts on prevention.