Perspective from
September 23, 2015
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High rates of concussion seen with youth, high school, college football practice

An emphasis on proper tackling technique may help decrease the rate of concussion at all three levels of play.

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Concussion rates in football athletes at the youth, high school and collegiate levels were found to be highest during a game situation, but practice sessions also posed a major concussion risk for these same groups of athletes, according to the results of a study published in Journal of the American Medical Association Pediatrics.

During practice, athletes at the high school and collegiate levels had concussion rates of 0.8 per 1,000 athlete exposures and 0.53 per 1,000 athlete exposures, respectively, which were lower than the game rates, but still high overall, Thomas P. Dompier, PhD, ATC, told Spine Surgery Today.

“The rates of concussion are always higher in games, which is true of most injuries, except for general overuse, which will get reported at practice. Because there are more practices overall, generally practices will either contribute as many or sometimes more concussions over the course of a season. That is why practices seem to stand out in some aspects,” Dompier said.

Data gathered by trainers

Dompier and colleagues analyzed concussion data collected by athletic trainers at youth, high school and collegiate football practices, as well as games. These data were collected during the 2012 and 2013 football seasons.

The data were obtained from the Youth Football Surveillance System, which included 118 youth football teams for 4,092 athlete-seasons, and the National Athletic Treatment, Injury and Outcomes Network program, which included 96 secondary school football programs, provided data for 11,957 athlete-seasons at the high school level.

The National Collegiate Athletic Association Injury Surveillance Program, which included 24 member institutions, was the source of the data for 4,305 collegiate athlete-seasons.

The trainers recorded all injuries, regardless of severity, including concussions, during both football seasons that Dompier and colleagues studied.

Proper technique reduced concussions

The investigators found concussion injuries comprised 9.6% of all injuries at the youth level. Concussions accounted for 4% of all athletic injuries at the high school level and 8% of all athletic injuries at the collegiate level.

Based on the findings, games posed the highest threat of concussion. The results showed collegiate athletes had concussion rates of 3.74 per 1,000 athlete exposures. This rate was greater than that for high school athletes, who showed a concussion rate of 1.86 per 1,000 athlete exposures (95% CI, 1.50-2.31).

The Youth Football Surveillance System showed a concussion rate of 1.57 per 1,000 athlete exposures.

The researchers noted that youth football participants had the lowest chance of receiving a concussion during a season, as well as the lowest one-season concussion risks in 2012 at 3.53% and in 2013 at 3.13%. By comparison, high school athletes had the highest one-season concussion risk in 2013 at 9.98% and college had the highest one-season concussion risk in 2012 at 5.54%.

Practice culture can be changed

The researchers concluded it may be too difficult for coaches to reduce concussion risks in a game.

“Games are harder to change unless you make drastic rule changes. Whereas, in practice, coaches and parents and others can do a lot of things to help mitigate not only concussions, but all injuries, by using sensible tackling technique, proper tackling and using drills where you can teach tackling without children running into each other. I think the main finding here is that there are still a lot of concussions occurring in practice. Let’s figure out strategies to reduce them in practice, assuming it is going to be harder to change the game conditions,” Dompier said. – by Robert Linnehan

Disclosure: Dompier reports no relevant financial disclosures.