The Super Bowl: Inspiring traumatic brain injury since 1966!

It’s Super Bowl Sunday. Most of us spend the day eating nachos and wings, drinking beer, and acting rowdy in front of the television. For those of us who don’t have a television or snack foods in the vicinity (gasp!), we may chose to spend the day looking up scientific articles with a mention of football and writing blogs. I’m going to let you guess what I did.

High school can be a dangerous place: many will go through those few years carefully balancing social life, self-esteem, some sort of learning and the inevitable characterization of every single person into a specific group (you might be surprised to find out that I fit in the “jock” category). For the athletes, high school can also be dangerous for something very precious: their brains.

In a recent study, researchers looked at the incidence of concussions in high school sports over eleven years (1997 to 2008). They wanted to know whether certain sports had higher rates of concussions, and whether the incidence of concussions varied by gender, and over time. So they followed 25 high schools in a large public school district and recorded every instance of concussions for twelve sports: football, lacrosse, wrestling, soccer, basketball and baseball for boys, and field hockey, lacrosse, soccer, basketball, cheerleading and softball for girls.

The researchers reported a few interesting findings. They recorded nearly eleven million instances of a student playing a given sport, and out of those, identified 2651 instances of concussions. While boys accounted for just over half of the instances of students playing a sport, they accounted for three quarters of all concussions. Perhaps not surprisingly, football accounted for more than half of all instances of concussions. Baseball was the boy’s sport with the lowest incidence of concussions. For girls, soccer took the lead with the highest incidence of concussions, while cheerleading had the lowest incidence. Unfortunately for all my Canadian readers, the researchers left out our national sport, so I’m not sure how hockey would compare. But hey, we can talk about hockey when the Stanley Cup rolls around.

What surprised me the most in this study is that the overall rate of concussions increased significantly over time (a 4-fold increase between 1997 and 2008). Football showed the greatest increase in concussion rates over time, but it’s important to note that all twelve sports showed an increased concussion rate over time.

As for sex differences, the researchers found that for sports that are the same for girls and boys (like soccer and basketball), girls had a higher rate of concussions. However, in lacrosse, where the girl’s game has different rules, protective equipment and nature of play when compared with the boy’s game, girls had a lower concussion rate than boys.

There are several factors that could explain some of these results: an increase in concussion rates over time could be explained by a greater awareness of this medical phenomenon, and thus an increase in the reporting of concussions. Girls could be showing higher concussion rates for the sports they share with the boys because evidence shows that girls tend to be more willing to report injuries. However, even when all these factors are considered, the study highlights a need to prevent, detect and treat concussions across all sports, not just football. Concussions can be a serious brain injury, especially if complications develop, and repeated concussions are particularly dangerous, as they can lead to dementia.

In the heat of the Super Bowl, I don’t want to be a complete downer, though: being active during your teenage years can have numerous benefits, and can lead to habits that will last a lifetime and play an important role in preventing a whole load of diseases. So play away, but just make sure to protect that noggin’ (and parents: chose that extracurricular activity wisely)!

Reference: Trend in concussion incidence in high school sports: a prospective 11-year study. (2011) Lincoln AE and al. Am J Sports Med [Epub ahead of print].