Researchers at the Datalys Center for Sports Injury Research studied data that athletic trainers collected on nearly 20,000 youth, high school and college football players during the 2012 and 2013 football seasons. The athletic trainers documented player injuries, such as concussions, during practices and games
The researchers found that football practices were a major source of concussion at all three levels of competition. The data revealed that 54 percent of concussions on the youth level occurred during games. But 58 percent of concussions on the high school and college levels happened during practice.
High school football had the highest concussion risk overall. The proportion of concussions that occur in practices was lower in youth football teams. The risks also were lower in youth leagues than in college and high school.
The researchers theorize this may be because of the fewer number of players and practices per week at the youth level. Youth football teams generally practice once or twice a week and have an average of 20 to 25 players per team. High school and college teams practice more times each week, play more games and have an average of 77 and 107 players per team, respectively.
The Centers for Disease Control and Prevention estimates that 1.6 million to 3.8 million concussions occur in sports and recreational activities annually. However, these figures likely underestimate the total numbers, the researchers say, because many individuals who sustain concussions may not seek medical advice.
A recent study of 120 high school football players by Cincinnati Children’s Hospital Medical Center showed that fewer than half of the players would tell their coach or athletic trainer if they had concussion symptoms.
Part of the reason is that a concussion is somewhat subjective. A hit that causes a concussion in one person might not in another because of differences in body structure, such as neck musculature, from person to person. And there is no definitive test for concussion – it is diagnosed based on what symptoms the patient reports.
“We should be sensitive that symptoms may occur after practice instead of just raising concern about concussion that occurs on Friday night, says neurologist Andrew Russman, DO. “We should be concerned about concussion that may occur during the week, especially given the intensity of some contact practices.”
Although it is more difficult to change the intensity or conditions of a game, the researchers say, coaches can use many strategies during practice to cut down the amount of player-to-player contact and other behaviors that might cause injury.
Researchers say the findings should prompt coaches to consider implementing strategies that restrict player contact during practices. Dr. Russman agrees.
“We should be looking at the number of practices at the high school level and potentially reducing those contact practices,” Dr. Russman says. “In this way, we can reduce concussions that occur in practice — and potentially, concussions that happen during game time because of the cumulative effect of repeated collisions that occur throughout the week.”