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High School Football Sees Drop In Concussion Rates During Practice, but an Increase During Games


A study in the November 2019 Pediatrics, “Concussion Incidence and Trends in 20 High School Sports” (published online Oct. 15), 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, which according to the authors, may 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.  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; girls’ volleyball, soccer, basketball, softball, cross country, field hockey, lacrosse, swimming/diving, and track and field; and co-ed cheerleading. Among all sports, 9,542 concussions were reported during the study period. Of these, 63.7% occurred during competitions and 36.3% occurred during practices. Repeat or recurrent concussions decreased for all sports (0.47 to 0.28 concussions per 10,000 athletic exposures). Among sex-comparable sports (soccer, basketball, baseball/softball, cross country, track, swimming), concussion rates were higher 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.


The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit and follow us on Twitter @AmerAcadPeds