Back when I played if you had a headache you were almost expected to return to play, no questions asked, in all sports. This did not just go for the boys, the girls had to be tough too. There was very little in the way of concussion prevention/education for sports, particularly at the high school setting. Very few schools in the early to mid 90’s had athletic trainers or medical professionals dedicated to the high school, and even fewer that had AT’s that were progressive in head injury management.
Have have you seen the specimens we call kids these days on the playing fields/courts? Sure when you were in school you had the “fast” or “big” friend that played sports, how many of us had the “huge-fast” or the “monster” friend? How bout the style of play in sports? I am positive that we were aggressive in sports, but not to the level we see it today. The graph is from Langlois JA, Rutland-Brown W, Wald MM (2006). “The epidemiology and impact of traumatic brain injury: A brief overview”. Journal of Head Trauma Rehabilitation 21 (5): 375–8, and indicates that concussions are by far a bigger problem for the developing brain than adults.
There are a variety of reasons why we have seen an increase, but I do not believe we are seeing all of the brain injuries. It is a great start and a wonderful job being done all over the place in terms of education. The research of the brain, the concussion, and the long lasting effects of this injury and concurrent injuries is getting better each year. Along with that the recommendations from the medical professional and concussion societies are getting more and more protective of the individual.
One thing is for certain, we will continue to see the increase until we as professionals have attained a firm grasp on the mechanism and lasting effects on the growing brain.