New research on concussions reports mixed news for kids playing high school sports.
The good news? Concussions are down during football practices. And the number of recurrent concussions is down in all sports.
Bad news for girls
The bad news? Concussions are on the rise during high school football games, and football continues to have the highest concussion rates in high school sports.
The study also reported bad news for girls playing comparable sports, such as soccer. Girls were more than twice as likely as boys to have a concussion. They were also more likely to have a recurrent concussion.
As to why concussion rates are going down in football practices, but not in games, it's hard to pinpoint one reason, according to study author Avinash Chandran. He is a postdoctoral research associate at the University of North Carolina at Chapel Hill.
"There is heightened sensitivity to concussion, so we're getting better at detection, but what we're seeing is likely multidimensional," he said.
"Coaches may be becoming more nuanced in concussion, and we might be seeing more athletic trainers in practice settings," Chandran said. "The science has always been pretty clear that having clinical care on the sidelines contributes to the larger sports safety culture."
More people attuned to concussion
Dr Victor Khabie is chief of sports medicine at Northern Westchester Hospital in Mount Kisco, New York, and a college football sideline physician. He pointed to several possible reasons for the increase in concussions during games.
"In games, there are more people attuned to concussion, and there are more people around to watch for concussion," said Khabie, who wasn't involved with the study. "You don't have referees in practice. There isn't always an athletic trainer in practice. Parents aren't on the sidelines in practice."
Plus, he said, kids realise now that a concussion is serious.
"Kids used to hide concussions so they could keep playing – now, they realise it can affect them," Khabie said. "They're being more honest, because they realise there are long-term implications."
Concussions have become a major health issue, particularly in high school sports where they can lead to significant short- and long-term consequences, according to background information in the study. All 50 US states and the District of Columbia now have laws related to concussion management, the researchers said.
20 sports included
For the study, Chandran and his colleagues looked at national high school sports data during five school years from 2013 to 2018.
The study included 20 sports: boys' football, wrestling, soccer, basketball, baseball, cross country, ice hockey, lacrosse, swimming and diving, and track and field; girls' volleyball, soccer, basketball, softball, cross country, field hockey, lacrosse, swimming and diving, track and field; and co-ed cheerleading.
Overall, more 9 500 concussions were reported during the five years studied. Slightly less than two-thirds occurred during competition.
The authors said future research should continue monitoring concussion rates and effects of concussion prevention programmes.
The findings were published in Pediatrics.
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