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 May 4 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.
"The number of people exposed during practice is always higher than in games," says Tom Dompier, president of Datalys and lead author of the study, "because not all kids at the high school and college level will play in games." Players at that level log many more hours of practice time than do younger athletes.
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.
Chris Merritt, the head football coach at Christopher Columbus High School in Miami, has helped pilot USA Football's Heads Up program, which teaches blocking and tackling techniques that keep the head out of the way.
"You can't just sit there and line up four days a week and go full-go and tackle, bring to the ground," Merritt says. "There are too many opportunities that someone is going to hit helmet on helmet or helmet on the ground."
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 athletes.
Since boys start learning tackle football as young as age 5, it's vital that youth coaches teach safer techniques, Merritt says. Getting the message out can be tough, he says, because "they're not professionals for the most part; they're volunteers."
The NCAA was one of the funders of the study, along with USA Football and the National Athletic Trainers Association Research and Education Foundation.
An earlier version of this story ran in Shots on May 4. This version includes interviews from the May 11 Morning Edition story.
RENEE MONTAGNE, HOST:
There's increasing concern that football players don't seek enough treatment when their heads hurt. The concern is over concussions. And a new study of college and high school football players has found that most concussions happen not in games but during practice. Here's NPR's Nancy Shute.
NANCY SHUTE, BYLINE: This is the sound of California high school football players running the Oklahoma drill.
(SOUNDBITE OF OKLAHOMA DRILL)
SHUTE: It's a full-speed, full-impact drill that one coach described as knocking the snot out of each other.
(SOUNDBITE OF OKLAHOMA DRILL)
SHUTE: So maybe it's not surprising that the study found that more than half of high school football concussions happen during practice. Tom Dompier, president of the Datalys Center, led the study. He says that's because they spend so much time in practice.
TOM DOMPIER: The number of people exposed during practice is always higher than in games because not all kids at the high school and college level will play in games.
SHUTE: High school students had the highest rate of concussions during practices, while for college students it was during games.
DOMPIER: College coaches understand. They don't want their players missing a Saturday game, so practices are often more focused on tactics and strategy. There's less player-to-player contact.
SHUTE: High school coaches are also getting the message. Chris Merritt is the head football coach at Christopher Columbus High School in Miami. He says a good coach limits direct contact during practices.
CHRIS MERRITT: You can't just sit there and line up four days a week and go full-go and tackle, bring to the ground. There's too many opportunities that someone's going to, you know, hit a helmet on helmet or helmet on the ground.
SHUTE: Merritt says it's important to get coaches to limit full contact and teach safer tackling.
MERRITT: Keep your head up, keep your eyes up, and keep the head out of the tackle. That's what the goal is.
SHUTE: Now, Merritt says, it's crucial to get the message out to youth football, where the coach is often someone's dad.
MERRITT: Getting these youth coaches to schedule their practices the right way, to teach the right technique - 'cause they're the hardest ones 'cause they're not professionals. For the most part, they're volunteers.
SHUTE: And with players starting tackle football as young as age 5, it's never too soon to get it right. Nancy Shute, NPR News. Transcript provided by NPR, Copyright NPR.