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Study: Most Youth-Football Concussions Occur in Games, Not Practices

Youth football players between ages 8 and 12 are significantly more likely to sustain a concussion during a game than a practice, according to a study published online today in The Journal of Pediatrics.

The study, conducted by researchers from the University of Pittsburgh and Cornell University, examined 468 players 8-12 years of age from four nonscholastic youth tackle-football leagues in western Pennsylvania during the 2011 season. In total, 18 of the 22 teams from the youth leagues participated in the study, with four declining due to "perceived time requirements or disinterest in the study."

Researchers sought to determine how many concussions the players sustained per 1,000 athletic exposures, which are defined as one athlete participating in one game or one practice during which he is exposed to the possibility of athletic injury. In total, there were 11,338 athletic exposures throughout the study period (8,415 in practice, 2,923 in games). During that time, 20 different players sustained a medically diagnosed concussion.

Of the 20 concussions recorded, only two occurred in practice, while the remaining 18 happened during a game. The concussion incidence rate for practices ended up being 0.24 concussions per 1,000 athletic exposures, while the incidence rate during games was significantly higher, at 6.16 concussions per 1,000 athletic exposures. The researchers determined the combined incidence rate for practices and games to be 1.76 concussions per 1,000 athletic exposures.

Nine of the 20 concussions resulted from head-to-head contact, while head-to-ground contact and head-to-body contact each caused one of the 20 concussions sustained. The cause of the remaining nine concussions was "indiscernible due to the context of play" (such as large group tackling), according to the study.

The researchers also broke down the number of concussions suffered by particular age groups. The 8- to 10-year-olds suffered five medically diagnosed concussions during a total of 5,398 athletic exposures (3,970 in practice and 1,428 in games), while the 11- to 12-year-olds suffered 15 medically diagnosed concussions in a total of 5,940 athlete exposures (4,445 in practice and 1,495 in games). The combined incidence rate for the 8- to 10-year-olds (in both practice and games) ended up being 0.93 concussions per 1,000 exposures, while the 11- and 12-year-olds sustained 2.53 concussions per 1,000 exposures.

The respective incidence rates suggest that 11- and 12-year-olds were nearly three times as likely to sustain concussions as the 8- to 10-year-olds, the researchers surmise.

Last summer, Pop Warner implemented new restrictions on the amount of contact allowed in youth-football practices. Based on the findings of this particular study, the authors conclude that "reducing contact exposures in youth football will likely have little effect on reducing concussion risk, as few concussions actually occur in practice." In fact, such restrictions may end up having unintended consequences, they suggest, as practice time is when youth players learn proper tackling techniques.

Previous research, however, has found that unlike in high school and college football, the hardest hits for younger football players typically occur during practice.

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