Between 2005 and 2012, concussions among high school athletes became more common with every passing academic year, according to a new U.S. study.
“It’s an observational study so we can’t draw any conclusions,” said Dr. Joseph A. Rosenthal of Wexner Medical Center at The Ohio State University in Columbus who led the research.
The results are consistent with other studies noting an increase in high school concussions in the last 10 years, though it’s still not clear whether the rise is real or due to increased awareness of the symptoms and dangers of concussions - leading to more kids with blows to the head being noticed and cared for, he told Reuters Health.
“We think increased attention has led to more awareness among everyone, parents, teachers and coaches, which has led to people not blowing it off as kids ‘getting their bell rung’,” he said.
Rosenthal and his team analyzed data from a nationwide high school injury surveillance system including 100 representative schools. Athletic trainers at each school reported all injuries to players during practices or games on a weekly basis through an electronic system.
In this case, the certified athletic trainers decided whether an athlete had sustained a concussion based on their own expertise and experience.
Between 2005 and 2012, there were 4,024 concussions among high school athletes in the database. Less than 1 in 1,000 athletes suffered a concussion, but the rate did nearly double from .23 concussions per 1,000 kids in 2006 to .52 per 1,000 in 2012.
The data included specific details for boys’ football, soccer, basketball, baseball and wrestling as well as girls’ volleyball, soccer, basketball and softball.
Concussions were most common in boys' football. For girls, concussions happened most frequently during soccer.
Concussions in football, basketball, baseball, wrestling and soccer increased over the course of the study. They were least common in boys’ baseball.
The increase in concussions seems to have started around 2008, according to the results published in the American Journal of Sports Medicine.
Rosenthal noted that the Centers for Disease Control and Prevention ‘Heads Up’ awareness program was going on in the mid-2000s, and many states were adopting legislation around that time requiring coaches and parents to be educated about handling kids who have injuries.
This was also the time when the media started covering concussion in the NFL in-depth, he said.
“I think it would be very interesting to find out if these state laws are making students safer,” he said. One way to do that would be to see if the rate of second or third concussion has gone down since the legislation, but the current study did not address that point.
Rosenthal’s study mirrored one that followed concussion rates in a single school district in Fairfax, Virginia, from 1997 through 2008.
Andrew E. Lincoln, director of the MedStar Sports Medicine Research Center in Baltimore, Maryland, led that research, which was published in the same journal in 2011.
“I was really intrigued to see the study replicated,” Lincoln told Reuters Health by phone. “A gradual increase in concussion awareness is probably the bigger factor in the increase.”
But there have also been many advancements in the understanding and clinical management of concussion over the same period, he said.
His study found an increase in the concussion rate earlier than 2008, but that could be due to its focus on a single school district where each school had two certified athletic trainers who would have been on the forefront of concussion awareness and management changes in the country, Lincoln said.
At most high schools in the nation, kids would be lucky to have access to one athletic trainer, he said.
These results shouldn’t alarm parents, but should reinforce the idea that concussion at the high school level in many sports, not just football, deserves attention, Rosenthal said.
“I don’t want to say that kids should be held back from competition, but I think parents and athletes need to be aware of the possibility of concussion and be able to recognize it and get the resources and recovery that they need,” he said.