First-Of-Its-Kind UPMC/Pitt Study Shows Kids Get Fewer Concussions in Practices than in Games

Updated on June 4, 2013

A landmark, NFL Charities-funded study conducted by the University of Pittsburgh and UPMC found that 8- to 12-year-old youth-football players were at a low risk for getting a concussion in practice and similar to high-school and college football players in their incidence rate of concussions.

“This finding suggests that reducing contact-practice exposures in youth football, which some leagues have done recently, will likely have little effect on reducing concussion risk, as few concussions actually occur in practice,” said Anthony Kontos, Ph.D., associate professor, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, the study’s principal investigator and the assistant research director for the UPMC Sports Medicine Concussion Program. “Instead of reducing contact-practice time, youth-football leagues should focus on awareness and education about concussion. We believe that practice is when tackling technique can be taught and reinforced in a much safer environment than in games.”

In the study, encompassing 468 players on 18 youth-football teams from suburban Pittsburgh and central Pennsylvania, the researchers found that practices were relatively concussion-free (0.24 incidences per 1,000 exposures). However, these youth players were 26 times more likely to suffer a concussion in a game (6.16/1,000 exposures) than in practice. To the researchers, these data suggest that contact practices provide an appropriate, controlled environment to teach proper tackling techniques, which may decrease the incidence of concussions. Those techniques, focusing on shoulder instead of helmet contact, are being taught around USA Football and through other youth-football organizations across the United States where some 3 million children play the game.

The research, published today in the Journal of Pediatrics on the eve of UPMC’s June 7 to 9 concussion conference which will be attended by more than 400 health professionals, produced several other ground-breaking findings as the first, in-depth statistical analysis of medically diagnosed concussions in youth football:

  • The incidence rate of concussions in 8- to 12-year-old players – 1.76 per 1,000 game and practice exposures – proved comparable to the incidence rate previously reported for high-school and college players, researchers said. The 0.24/1,000 rate in practices is slightly lower than found in high school and college.
  • Age played a factor. The 8- to 10-year-olds were almost three times less likely to suffer a concussion than 11- to 12-year-olds, 0.93/1,000 exposures in games and practices among the younger group to 2.53/1,000 in the older. The pre-teens sustained three times as many concussions despite participating in 10 percent more total games and practices. The researchers added that maturation translates into bigger, stronger, faster athletes who engage in more contact than younger players.
  • Quarterback, running back and linebacker – the “skill” positions in youth football – absorbed almost all of the total concussions, 19 of 20 (95 percent). Rotating players to different positions may help to mitigate concussion risks, researchers said.

“This is the first study to examine concussion rates at such youth levels, and it echoes the message emphasized by USA Football and several national youth-football organizations,” said Michael “Micky” Collins, Ph.D., executive and clinical director of the UPMC concussion program. “So many people have added their voices to this issue, and for the first time, this study shows there’s no scientific evidence concerning concussions to support limiting practice time for young football players. In fact, we encourage practice as a safety and concussion-education precaution.”

In this video interview, Dr. Collins discusses the youth football study.

“The health and safety of every youth football player is USA Football’s No. 1 priority. New findings from our research and that of UPMC propel behavior change for a better, safer game for our kids,” said Scott Hallenback, executive director of USA Football.

“We welcome UPMC’s research, which complements our ongoing, two-year, youth football safety surveillance study to advance player health. The UPMC study’s conclusions underscore the value of our Heads Up FootballSM program, lending more evidence that youth players are safer when they — as well as their coaches and parents — are taught: better tackling techniques, Center for Disease Control-approved protocols for concussion recognition and response, and proper equipment fitting. Heads Up Football addresses each of these points and establishes a national standard for coach certification,” added Hallenback.

The researchers noted that their study, covering the youth-football season from August to December 2011, is a good first step, but more research is needed. Little is known about the potential for long-term effects from repetitive exposures to sub-concussive impacts that might occur in practices and games. Therefore, more scrutiny is warranted overall, to include more seasons, a wider sample size and older, middle-school players aged 13 to 14.

The grant, totaling $100,000, was among 16 awarded by NFL Charities in Dec. 2010 to different research or medical organizations – $988,000 of that $1.6 million in donations was earmarked toward the study of concussions.

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