Report Details The High School Sports With the Most Concussions

There is both good and bad news concerning concussions in high school sports, according to a new study on the always controversial topic.

First, the good news: The rates of football practice concussions and recurrent concussions across all sports have gone down in recent years, according to the study, published in the journal Pediatrics.

But the bad: Concussion rates increased in football games.

"These results matter for all stakeholders involved in high school sports: parents, coaches, athletes, as well as researchers," says Avinash Chandran, a post-doctoral research associate at the University of North Carolina at Chapel Hill, who was an author of the study.

The study, which included data on 9542 concussions across 20 high school sports that occurred between the 2013-2014 and 2017-2018 school years, found trends in concussion rates not only for football but also more than a dozen other sports, including soccer, ice hockey and cheerleading. All were among the sports with the most concussion incidence. The data came from the National High School Sports-Related Injury Surveillance Study database.

For the study, a concussion was defined as occurring as a result of practice or competition, requiring medical attention and being diagnosed as a concussion.

Overall, the data showed that the three sports with the highest concussion rates were:

  • Boys' football, with 10.4 concussions per 10,000 athlete exposures.
  • Girls' soccer, with 8.19 per 10,000 athlete exposures.
  • Boys' ice hockey, with 7.69 per 10,000 athlete exposures.

When examining concussion incidence specifically in practice, the highest rates were observed in boys' football, with a rate of 5.01 per 10,000; followed by cheerleading, with a rate of 3.6 per 10,000; and boys' wrestling, with a rate of 3.12 per 10,000.

The data showed that, between the 2013-2014 and 2017-2018 school years, football concussion rates during competitions alone increased, but practice-related concussion rates dropped. The study found that across all sports, most concussions – 63.7 percent – occurred during competitions. Cheerleading was the only sport that had a concussion rate higher in practice than in competition.

The researchers noted in the study that where and how cheerleaders practice could play a role in that finding, but more research is needed.

"For instance, unfortunately, not all states recognize cheerleading as a sport, which may impact the conditions in which cheer squads may practice," Chandran says, which could be in hallways or on asphalt, putting them at higher risk of concussion. "It is also possible that cheer squads have less access to medical care and coaching support than other high school sports.”