Middle School Athletes More Vulnerable To Concussion

Orthopedics This Week

July 13, 2021

Middle school sports had a higher rate of concussion than high school and college counterparts in new study.

The research, which was presented at the National Athletic Trainers’ Associations’ 2021 NATA Virtual Clinical Symposia & AT Expo, also found that middle school football players had the highest overall concussion rate, while girls experienced concussions twice as often as boys in sex-comparable sports.

Besides football, girls’ soccer and wrestling also had high rates of concussion in middle school sports. Concussion rates were higher in competition than practices, the researchers also reported.

“The higher rates of concussion observed in middle school may in part be due to the unique and highly variable neuro-biopsychosocial characteristics of these rapidly developing children,” said research author, lead of the Advancing Healthcare Initiatives for Underserved Student (ACHIEVES project), Shane V. Caswell, Ph.D., ATC.

“Additionally, other distinct differences associated with the middle school sport setting itself, such as, the large variations in player size and skill, coaching, or the shorter sports seasons providing less time to skill acquisition may also contribute the higher rates of concussion.”

Caswell told Orthopedics This Week, “With the exception of the first two years of life, middle school age children’s’ brains and bodies are changing more than any other time in life. To date very little is understood about if and how the unique neurobiological (e.g., brain development /physiological, genetics), psychological (e.g., thoughts, emotions and behaviors) and social (socio-economic, environmental, and socio-cultural) factors, or the interactions between them, may impact concussion rates in middle school children. One obvious example is the large differences in physical size, coordination, and skill levels common among middle school athletes that may contribute to increased concussion rates.

“The increased rates we observed in our study are likely due a number of factors. In our study, having the athletic trainers onsite to recognize and provide care for injuries at all practices and games is a resource that the school system prioritized. This is rare at the middle school level and it is possible that the vigilance of the athletic trainers contributed to the increased rate of concussions observed in our study,” he added.

Their findings underscore the importance of on-site medical care within middle school sports settings, the researchers said.

For the study, athletic trainers recorded injury and athlete exposure (AE) data from public middle schools in Virginia. Concussion rates were determined for 12 school-sponsored sports (baseball, football, wrestling, boys’ and girls’ basketball, cheerleading, boys’ and girls’ soccer, softball, boys’ and girls’ track, and volleyball. They also did sex-comparisons for sports played by both girls and boys.

The research is also published in the Journal of Athletic Training, the scientific journal of the National Athletic Trainers’ Association. The study was conducted as part of the Advancing Healthcare Initiatives for Underserved Students (ACHIEVES) project at George Mason University.


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