Between the academic years 2015 and 2017, the average proportion of concussions annually significantly increased 1.012-fold compared to the previous four academic years, according to a new study.
Concussions Continue to Increase Among High School Athletes
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The study, “The Incidence of Reported Concussions Sustained by High School Athletes Continues to Increase,” was released as part of the American Academy of Orthopaedic Surgeon’s (AAOS) Virtual Education Experience.
Data for the study were culled from High School Reporting Information Online (RIO) surveillance system annual reports. Wellington Hsu, M.D, professor of orthopedics at Northwestern University’s Feinberg School of Medicine and his colleagues collected injury data from 100 high schools for nine sports, including football, soccer, basketball, wrestling and baseball for boys, soccer, basketball, volleyball and softball for girls.
Overall, approximately 300,000 teens suffer concussions or mild traumatic brain injuries each year while playing high school sports.
“It’s understandable to think that with increased awareness among practitioners who diagnose concussions, the incidence would naturally rise; however because we’ve studied and reported on concussions for a number of years now, I feel that enough time has passed and I would have expected to see the numbers start to level out,” Hsu said.
“What we found was that the overall average proportion of concussions (total estimated concussions proportionate to all other injuries for a particular sport) reported annually in all sports increased significantly, as did the overall rate of concussions (the number of concussions per 10,000 athlete exposure).”
The researchers were surprised to also find that girls’ soccer players continue to have more concussions than boys’ football players (29.8% vs. 25.2%), and that girls’ volleyball had the largest increase in concussions overall.
“Since volleyball is generally considered a ‘low risk’ sport for concussions, this was an unexpected discovery compared to what we saw three years ago,” Dr. Hsu added. “The jump in both girls’ soccer and volleyball is likely due to increased participation in the sports and concussion awareness.”
The data also revealed that in gender matched sports, girls continue to sustain concussions at a higher rate than boys. In addition, concussions continue to increase in boys’ football despite a 3.25 decrease in participation.
Hsu plans to continue his research in the hopes of more preventive measures being put in place.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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