Understanding Concussion Risks Across Sports: Insights from Complete Concussions
Concussions, a form of mild traumatic brain injury, are a significant concern in the realm of sports. They can occur in various athletic activities, but some sports present a higher risk than others. Recognizing which sports have elevated concussion rates is crucial for athletes, coaches, parents, and healthcare professionals aiming to ensure safety and effective management.
Top Sports by Concussion Rate
Concussion rates are often measured per 1,000 athlete exposures (AE), where one AE represents a single athlete participating in one game or practice. According to data from Complete Concussions, the following sports exhibit the highest concussion rates:
Rank | Sport | Concussions per 1,000 AE
1 | Mixed Martial Arts (MMA) | 147.00
2 | Australian Rules Football | 9.53
3 | Rugby (Elite) | 9.05
4 | American Football (High School) | 5.01
5 | Women’s Ice Hockey | 2.27
6 | Men’s Ice Hockey | 1.63
7 | Women’s Soccer | 1.40
8 | Men’s Soccer | 0.83
These statistics highlight the varying levels of risk associated with different sports, emphasising the need for tailored preventive measures.
Factors Contributing to Higher Concussion Rates
Several elements influence the likelihood of concussions in sports:
- Nature of the Sport: Contact sports like MMA, rugby, and football inherently carry higher risks due to frequent physical collisions.
- Gender Differences: Studies have shown that female athletes, particularly in sports like soccer and ice hockey, may experience higher concussion rates than their male counterparts. Factors such as neck strength and hormonal differences might contribute to this disparity.
- Level of Play: Elite or professional levels often involve faster-paced and more aggressive play, potentially increasing the risk of injury.
Preventive Measures and Management
Understanding the risks is the first step toward prevention. Strategies include:
- Education: Informing athletes, coaches, and parents about concussion symptoms and the importance of reporting injuries.
- Proper Equipment: Ensuring athletes use well-fitted, sport-specific protective gear.
- Rule Enforcement: Implementing and strictly enforcing rules that minimise dangerous play.
- Medical Protocols: Having clear protocols for assessment, treatment, and return-to-play decisions, ideally guided by healthcare professionals trained in concussion management.
Why Female Athletes Are More at Risk
In sex-comparable sports like soccer and basketball, studies show that female athletes sustain significantly more concussions. Potential reasons include neck strength differences, hormonal influences, and underreporting in male athletes (8).
This highlights the urgent need for standardised baseline testing and evidence-based return-to-play protocols—especially for youth athletes.
Sports with Unexpectedly High Concussion Rates
- Cheerleading: A 2019 study by Kerr et al. found cheerleading accounted for a surprising share of concussion-related ER visits, particularly due to falls during stunts (9).
- Horseback Riding: Falls from height and high-speed impacts can result in severe TBIs. Rates in some cohorts exceed 8 per 1,000 athlete exposures.
- Snowboarding & Skiing: Paediatric head injuries from skiing and snowboarding have risen, with concussion being among the top diagnoses in snow sport ER visits.
Even in non-contact sports, falls, whiplash injuries, or equipment collisions can result in concussions. This underscores the importance of having robust sideline concussion protocols and baseline data
How to Reduce the Risk: What Coaches, Schools, and Clinics Can Do
- Implement Education & Awareness Programs
- Baseline Testing & Real-Time Reporting
- Baseline testing allows clinicians to assess true recovery.
- Schools and sports organisations can streamline injury management with the Complete Concussions Software.
- Train Your Team
Conclusion
While participation in sports offers numerous physical and psychological benefits, it’s essential to balance these with awareness and proactive management of injury risks.
By staying informed and implementing comprehensive safety measures, we can help protect athletes across all levels of play.
If you are interested in our concussion services? Get in touch today and a member of the team would be delighted to help
References
- Hutchison MG, Lawrence DW, Cusimano MD, Schweizer TA. Head trauma in mixed martial arts. Am J Sports Med. 2014;42(6):1352–8.
- Makdissi M, Davis G, McCrory P. Updated guidelines for the management of sports-related concussion in Australian football. J Sci Med Sport. 2014;17(6):511–3.
- Gardner AJ, Iverson GL, Levi CR, et al. A systematic review and meta-analysis of concussion in rugby union. Sports Med. 2014;44(12):1717–31.
- Rafferty J, Ranson C, Oatley G, Mostafa M, Mathema P, Crick T, et al. On average, a professional rugby union player is more likely than not to sustain a concussion after 25 matches. Br J Sports Med. 2019;53(15):969–73.
- Kerr ZY, Collins CL, Comstock RD. Epidemiology of football injuries among youth, high school, and collegiate players. J Athl Train. 2011;46(2):152–9.
- Dick R, Agel J, Marshall SW. National Collegiate Athletic Association Injury Surveillance System. J Athl Train. 2007;42(2):173–82.
- Bretzin AC, Covassin T, Fox ME, et al. Sex differences in concussion rates and recovery among collegiate soccer players. J Athl Train. 2021;56(1):19–27.
- Cheng J, Bastien J, Collins CL, et al. Epidemiology of concussions among United States high school athletes in 20 sports. Am J Sports Med. 2019;47(5):1134–42.
- Kerr ZY, Lynall RC, Roos KG, et al. Injury epidemiology of cheerleading: A 20-year analysis. J Athl Train. 2019;54(10):1037–43.
