Concussions May Be on the Rise in High Schoolers

March 01, 2011

By Leigh Krietsch Boerner

NEW YORK (Reuters Health) Feb 25 - High school athletes are four times more likely to suffer a concussion today than they were about a decade ago, with football players leading the pack, a new study says.

In 2008, there were about five concussions for every 10,000 times kids got on the playing field. This compares to slightly more than one per 10,000 in 1997, researchers reported online January 29th in the American Journal of Sports Medicine.

Exactly what has driven the number up isn't clear, but it's likely to be a combination of things, said study author Andrew Lincoln, who heads the Sports Medicine Research Center at Union Memorial Hospital in Baltimore, Maryland.

"Certainly the recognition of signs and symptoms of concussion have increased dramatically among the players, coaches, athletic trainers and physicians," he told Reuters Health. "Also, there's the issue of players performing better, getting stronger and getting faster."

The researchers recorded the number of concussions at 25 public schools from 1997 to 2008, in six different sports each for girls and boys.

Over the entire period, the chance that boys playing any sport would get a concussion was three in 10,000 exposures, compared to one in 10,000 exposures for girls.

Football took the prize as the riskiest sport, with a rate of about six concussions per 10,000. Boys' lacrosse and soccer came next. For girls, concussions were most common during soccer at three and a half per 10,000, followed by lacrosse and basketball.

However, when boys and girls played similar sports, girls were about twice as likely as boys to get a concussion. The same has been found in college athletes, but no one knows for sure why.

"We know that in general, females are more likely to seek medical care than males are," Lincoln said, which might explain part of the difference. Girls' bodies may also be less able to absorb a hit, but this is very speculative, he told Reuters Health.

This study "lets the conversation move forward from professional football and hockey to sports that both girls and boys play," said Douglas Weibe, who studies concussions at the University of Pennsylvania in Philadelphia, and who was not part of the study.

"It helps us realize that concussion is a problem with both boys and girls, and in sports that are traditionally thought of as both high impact and low impact," he told Reuters Health.

More than seven and a half million high school students participated in school sports in the 2009-2010 school year, according to the National Federation of State High School Associations.

Of the 2650 concussions recorded in the new study, most were one-time occurrences. However, about 290 students suffered two concussions, and 26 had three or more.

It's extremely concerning to see multiple concussions in high school kids, Weibe said.

"The risk there is second impact syndrome, which essentially means that the brain is still recovering from trauma from the first concussion, and it sustains a second impact," he said.

Sports concussions cause an average of 1.5 deaths per year, and most of these are due to a second concussion, according to the American Association of Neurological Surgeons.

In August, the American Academy of Pediatrics' Council on Sports Medicine and Fitness suggested that kids with concussions get cleared by a doctor before they head back onto the field. (See Reuters Health story of August 30, 2010.)

But concussions can be hard to diagnose sometimes, because formal guidelines about how to define them haven't been established, Weibe said.

"Right now doctors don't know how best to manage concussion and how to make decisions on when it's safe for a kid to return to play," he said. "That's an area in research that's greatly needed."

Am J Sports Med. Posted online January 29, 2011. Abstract


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