ATSNJ Secondary School Sports 2011 Concussion Survey

ATSNJ Secondary School Sports Concussion Survey

Fall 2010, Fall 2011

Results from ATSNJ Online Survey

Download the Slide Presentation of this page.

Fall 2010 – 100 Schools reporting, 93 schools w/ football – 1066 reported concussions

• Recurrent Concussions 79/1066 (7.4%)
• Athletes w/ symptoms > 2 weeks - 245/1066(23%)
• Pilot study (not used as part of comparison)
• Not reporting Gym,Cheering

Fall 2011 – 89 Schools reporting, 84 schools w/ football – 1054 reported concussions

• 66/89 (74%) completed 2010 survey
• Includes reported concussions for cheering and gymnastics
• Recurrent Concussions 69/1054 (6.5%) {Athletes w/ >1 concussion in same season}
• Athletes w/ symptoms > 2 weeks – 269/1054(26%)

Concussion Breakdowns by SPORT

Football

Survey Response to question “Why has there been a Change of incident in FB?”:

• Better Education – 32/89 (36%)                                                
• Luck – 27/89 (30%)
• Other – 20/89 (22%)
• Coaching 4/89 (4%)

Girls Soccer

• 26% increase in reported concussions
• 18% of total reported concussions
• Greatest incidence in games (88%)
• Varsity Athletes at greatest risk (57% of total concussions)

Boys Soccer

• 141 Concussions 2011,   (13% of total)
• 18% increase of reported concussions 2010-2011
• 77% of boys soccer concussions occur during games
• Varsity Athletes have greatest risk of injury. (69% )

Comparative Mechanism of Injury; Girls vs Boys Soccer:

• Collisions account for the most of concussions
• High rate of concussions in games for both girls & boys.
• Girls higher rate of concussion from heading the ball.

Field Hockey:

• 44 vs 52    Decreased incidence (18%)
• Lower incidence rate then GSoc and Cheer.
• Most concussions occur in games

Literature Review:

According to Study published in Am J Sports Medicine by Marar M, Published April 2012

• By  National Children’s Hospital, Columbus, OH
• Utilizing RIO (Report Information Online)
• 20 HS w/ ATs, 2008-2010

Injury Rate during games/10,000 Athletic Exposures

• Football  22.9
• Girls Soccer – 9.2
• Boys Soccer – 5.3

Football:

• Running Plays accounted 48.5% of concussion
• Player to Player contact – 88% of concussions
• Defensive Players – LB highest incidence 58.9%
• DB highest proportion of concussions on defense (23.7%)
• Offensive Players – RB highest incidence 46%
• TE highest proportion of injury.

Girls Soccer

• Higher rate then Boys (3.4/10k exposures vs. 1.9/10k exp)
• Heading the ball was high for boys and girls (31 vs 27%)
• 60.8% of injuries sustained while heading the ball were concussions.
• Player to player contact caused 58% of concussions.

In General – Girls had a higher rate of recurrent concussions

• Concussions represented 13.2% of all injuries sustained during the study period.
• Other studies note 8.9% of total injuries – Gessel LM, J Athletic Training 2007; Schultz, Published study of 12 NC HS – 7.5%, pub 2004
• Paper NOTES: The need for better enforcement of rules limiting contact.
• Note that officials play a key role in games to limit, decrease dangerous activity and aggressive play.

What can we learn from this ATSNJ Survey?

1. Concussions are a significant problem in sports, particularly football, but not limited to just football.
2. Incidence of concussion is on the rise (18% higher) 2011 vs 2010
3. Incidence of concussions that were symptomatic > then 2 weeks was 23%.  This coincides with published literature.
4. Position of greatest risk is OL in HS football, add in DL (since linemen often go both ways) and that position accounts for over 40% of concussions in HS football.
   * This is different than Marar study in AJSM which sites LB and RB, but could be consistent with their notation that running plays having highest incidence of concussion.
5. Concussion occurrence in FB was basically 50/50 games/practices.  Need to get better officiating in games to reduce incidence. (Point of emphasis w/ officials, continue to educate players)
6. Girls Soccer incidence is second to football. There was a significant increase in reported girls soccer injury. Most soccer injuries occur in games. Girls have more heading injury then boys. (Marar paper sited near equal incidence of heading issues B/G)  I think this is some data that adds credence to the need for better officiating in games, better technique/neck strengthening/decreased heading for girls.  Closer officiating of aggressive play.
7. Boys Soccer incidence increased.  Not as much as girls.  Most injuries occurred in games.  Collisions result in over 50% of soccer concussions.  Heading the ball has relatively low incidence of concussion in boys soccer according to our data (contradicated by Marar’s paper). Again, it illustrates the need to reduce contact, aggressive play during games in boys soccer. ( more stringent officiating to limit collisions and aggressive play)
8. Cheering injury declined 2010-2011. May not be statistically significant? We didn’t gather data as when concussions in cheer are occurring.  Marar article only had 1 year of cheer data. They noted stunting was major activity that caused 90% of concussions.  player to player contact accounted for 65% of concussions in cheering. 33% involved contact w/ elbow, 20% contact w/ knee, 20% w/ another head.  Stunting involved triple base 43%, 50% were spotted by teammate, 4.5% were spotted by coach.
9. FH has a relatively lower injury rate than other sports.  Injury rate actually decreased in our survey.    highest incidence of injury was in games.  Officials need to continue to assertively manage the games for aggressive play, high sticks
10. In General, recommendations need to be made to improve (make point of emphasis) w/ officials to enforce rules of the game, be more assertive officiating rough play, and dangerous activity.
11. Neck Strengthening should be encouraged for all athletes.
12. General fitness and conditioning should not be overlooked.
13. Football can learn some lessons from soccer.  Reduce contact in practices.  Accumulative contact can impact concussions. Soccer has a relatively low concussion rate in practices.
14. Proper technique needs to be encouraged and practiced frequently.