JAMA: A slight majority of concussions happened during youth football games
but most concussions at the high school and college levels occurred
during practice, according to an article published online by JAMA Pediatrics. Football is a popular youth sport with approximately 3 million youth
athletes, 1.1 million high school athletes and 100,000 college athletes
playing tackle football each year. A report on concussion by the
Institute of Medicine highlighted the need for more extensive data on
incidence in athletes from youth to college.
Thomas P. Dompier, Ph.D, used
data collected as part of three large injury surveillance systems: the
Youth Football Surveillance System included 118 youth football teams,
providing 4,092 athlete seasons (one player participating in one
season); the National Athletic Treatment, Injury and Outcomes Network
included 96 secondary school football programs, providing 11,957
athlete-seasons; and the National Collegiate Athletic Association Injury
Surveillance Program included 24 member institutions, providing 4,305
athlete-seasons.
The study found that during the 2012 and 2013 seasons there were
1,198 concussions reported with 141 (11.8 percent) of them in youth
athletes, 795 (66.4 percent) in high school athletes and 262 (21.9
percent) in college athletes. Concussions accounted for 9.6 percent, 4
percent and 8 percent of all injuries reported in the youth, high school
and college football groups, respectively.
The results indicate 53.9 percent of concussions occurred during
youth football games but in high school and college most concussions
(57.7 percent and 57.6 percent, respectively) happened during practice.
No concussions were reported in youth football players who were ages 5
to 7 years, although the young players accounted for more than 7,000
athlete exposures (AEs, one player participating in one game or one
practice).
In games, the college concussion rate (3.74 per 1,000 AEs) was higher
than those reported in high school (2.01 per 1,000 AEs) and youth
athletes (2.38 per 1,000 AEs). In practice, the college concussion rate
(0.53 per 1,000 AEs) was lower than that in high school (0.66 per 1,000
AEs), according to the study.
Youth football had the lowest one-season concussion risks in 2012
(3.53 percent) and 2013 (3.13 percent). The one-season concussion risk
was highest in high school (9.98 percent) and college (5.54 percent) in
2012.
“The rate of concussion in youth players was generally not different
from those in high school and college players compared with other
injuries. However, football practices were a major source of concussion
at all three levels of competition. Concussions during practice might be
mitigated and should prompt an evaluation of technique and head impact
exposure. Although it is more difficult to change the intensity or
conditions of a game, many strategies can be used during practice to
limit play-to-player contact and other potentially injurious behaviors,”
the study concludes.
(JAMA Pediatr. Published online May 4, 2015. doi:10.1001/jamapediatrics.2015.0210. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor’s Note: An author made a conflict of interest
disclosure. Funding for this study was provided by USA Football, the
National Athletic Trainers’ Association Research and Education
Foundation, BioCrossroads in partnership with the Central Indiana
Corporate Partnership Foundation, and the National Collegiate Athletic
Association. The authors made conflict of interest and funding/support
disclosures. Please see article for additional information, including
other authors, author contributions and affiliations, etc.