High school football sees drop in concussion rates during practice, but an increase during games

Do you have a child who plays football? Or maybe you’re just a fan of your local high school team. Either way, a study released by the American Academy of Pediatrics this week shines new light on the risks players will encounter tonight as they take the field for Friday Night Lights.

“Concussion Incidence and Trends in 20 High School Sports,” to be published in the November issue of Pediatrics, found good news and bad news for high school football. The study tracked decreasing concussion rates during football practices, dropping from 5.47 to 4.44 concussions per 10,000 athletic exposures between the 2013-14 and 2017-18 academic years; the authors surmise this could be due to efforts to limit contact exposure in practices. However, rates of concussion during competitions increased from 33.19 to 39.07 concussions per 10,000 athletic exposures, signaling a need for continued prevention strategies.

In addition, football remained the high school sport with the highest rates of concussion overall, at 10.40 concussions per 10,000 athletic exposures, which include practices and games. The study, using data from the National High School Sports-Related Injury Surveillance Study (High School Reporting Information Online), also looked at concussion rates in other high school sports, including boys’ wrestling, soccer, basketball, baseball, cross country, ice hockey, lacrosse, swimming/diving, and track and field; and girls’ volleyball, soccer, basketball, softball, cross country, field hockey, lacrosse, swimming/diving, and track and field. It also looked at concussion rates in co-ed cheerleading. Among all sports, 9,542 concussions were reported during the study period. Of these, a majority — 63.7 percent — occurred during competitions and 36.3 percent occurred during practices. Repeat or recurrent concussions decreased for all sports.

Among sex-comparable sports (soccer, basketball, baseball/softball, cross country, track, swimming), concussion rates were more than twice as high in girls than boys (3.35 versus 1.51 per 10,000 athletic exposures). The study authors said future research should continue to monitor trends and examine the effect of ongoing concussion prevention strategies in high school sports. All 50 U.S. states and the District of Columbia now have legislation related to concussion management.