Regardless of where on the head the players were hit, their symptoms
were similar, as were the length of time symptoms lasted and how
long players stayed off the field, researchers found.
“We were actually a little bit surprised,” Dawn Comstock told
Reuters Health. “Based on some of our prior research, we expected to
see some differences.”
Comstock is the study’s lead author from the Colorado School of
Public Health and the University of Colorado at Denver.
She and her colleagues write in the journal Pediatrics that few
studies have examined concussion outcomes based on where on the head
the impact occurred.
About five to six concussions occur among high school football
players per 10,000 games or practices, they add.
There has been increasing concern over any knocks to the head that
high school athletes may experience, because of how common those
hits are and the lingering problems they’re associated with (see
Reuters Health stories of May 7, 2014 here: http://reut.rs/XU9pwu
and of May 14, 2014 here: http://reut.rs/XU9uQM).
“We wanted a more complete understanding of concussion in high
school football,” Comstock said. In particular, her team wondered
whether knowing how the concussion was received could help doctors
diagnose and manage athletes more effectively.
Using data from the National High School Sports-Related Injury
Surveillance Study, from the 2008-2009 and 2012-2013 seasons, they
were able to analyze 2,526 football-related concussions that
occurred during games and practices.
About 45 percent of concussions were caused by hits to the front of
the head. The second most common hit to cause concussions was to the
side of the head, followed by back of the head and finally the top
of the head.
After reviewing the data, the researchers found that where on the
head the impact occurred made no difference in terms of the symptoms
the players had, the length of time the symptoms persisted and how
long players had to be kept off the field.
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“We can’t predict which athletes are more likely to have more severe
symptoms or worse outcomes based only on how their injuries occur,”
Comstock said. “Every clinician needs to take every concussion very
The researchers did find that players who received a concussion to
the top of their head were more likely to lose consciousness,
compared to those who received an impact to other parts of their
The vast majority of players who received impacts to the top of
their head had their heads down at the time of the hit, compared to
less than a quarter of those hit in other parts of their head.
“What we can say is that these findings definitely support the call
to take the head out of the game if you will,” Comstock said.
She added that the findings support the tackling technique that
keeps players’ heads up, compared to their heads being aimed down
while running at another player.
“We don’t ever want our work to be used to frighten and pull kids
out of sports, but this work is a kind of reminder that the coaches,
parents, physicians and everyone involved need to work together to
make those sports safe to play,” Comstock said.
Pediatrics, online August 11, 2014.
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