There was a recent study released that has turned some heads in regards to where all the concussions come from in sports. In this JAMA Pediatrics study appearing at the beginning of the month the investigators have concluded that American football practices were “a major source of concussions” for all three levels of participation studied (youth, high school and collegiate).

Often when we see this type of information released there can be confusion due to the limitation of each individual study. The above data reflects a single sport, football, as compared to other data often cited that deals with all sports. Case in point this National Institute of Health study; which reports “athletes tend to have a higher risk of concussion in competition as compared to practice.”

The discussion topic of where concussion occurs more is not only often debated but it is an important set of data because we can control for one side of this equation, practice.

Reading the JAMA article one might be confused about the conclusions if you were to look only at the data and not have complete context of both the sport and participation. The rate of concussion was extremely higher in competition versus practice yet the majority of overall concussions came from practice. This can be explained by noting that there are far fewer games – thus exposure – and fewer participants in games – thus exposure. The sample set for the data (JAMA) was fairly robust: 118 youth football teams, 96 secondary school football programs and 24 collegiate programs. Ages of athletes exposed were 5 to 23, presenting a very good cross-section of the sport at all levels it is being played at. This information was collected in 2012 and 2013, and the researchers collected over 1,100 concussions over that time frame.

The NIH study breaks down the information for 13 different sports in high school and college only. Their findings Continue reading →