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Concussions Are Most Likely During Practice In High School And College

Parents worry about a child getting a concussion in the heat of competition, but they also need to be thinking about what happens during practices, a study finds.

High school and college football players are more likely to suffer a concussion during practices than in a game, according a study published Monday in JAMA Pediatrics. Here are the numbers:

  • In youth games, 54 percent of concussions happened during games.
  • In high school and college, just 42 percent of concussions happened during games, with 58 percent during practices.
  • Overall, college students had the highest rate of concussions during games, with 3.74 per 1,000 games compared to 2.01 for high schoolers and 2.38 for youths. High schoolers had the highest rates during practices.

The numbers are gleaned from three large injury surveillance systems that evaluated the 2012 and 2013 seasons of 118 youth football teams, 96 high school programs and 24 college programs. They were gathered by the Datalys Center for Sports Injury Research and Prevention Inc., in Indianapolis. They don't reflect the number of concussions, but rather players who reported having at least one concussion during the season.


One reason for the higher number of injuries in practice may be that high school and college athletes practice more often, the authors note, and have more players on the teams. So there are significantly more opportunities to get injured in practice than in a weekly game.

Also, high school and college teams are larger, so younger children may be putting in a lot more game time relative to practice time.

Although it may be hard to change the intensity of a game, the authors note, "many strategies can be used during practice to limit player-to-player contact and other potentially injurious behaviors."

Some experiments are already underway. At the University of New Hampshire, half the squad practices without helmets. The school is monitoring players to see if that changes the number and force of hits.

Football is the most popular sport in the nation for high school boys, according to the National Federation of State High School Associations, with 1.1 million boys playing. Track and field is a distant second, with 580,000 players.


The National Collegiate Athletic Association was one of the funders of the study, along with USA Football and the National Athletic Trainers Association Research and Education Foundation.

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