Middle School Sports Have Overall Higher Rate of Concussion Than Reported in High School and Collegiate Settings During the 2015-2016 to 2019-2020 School Years 

Thursday, June 24, 2021 

DALLAS, TX – New research presented at the National Athletic Trainers’ Associations’ 2021 NATA Virtual Clinical Symposia & AT Expo, which is being held virtually this year due to COVID-19, found that middle school sports have an overall higher rate of concussion than reported in high school and collegiate settings. 

The research also concluded that middle school athletes playing football had the greatest overall concussion rate, girls suffered concussions twice as much as boys participating in sex-comparable sports and overall concussion rate was higher in competition than practice. Sports with the highest concussion rates were football, girls’ soccer and wrestling. 

“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, PhD, 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 aquisition may also contribute the higher rates of concussion” 

Athletic trainers recorded injury and athlete exposure (AE) data from public middle schools in Virginia. Concussion rates were calculated for 12 school-sponsored sports (baseball, football, wrestling, boys’ and girls’ basketball, cheerleading, boys and girls’ soccer, softball, boys’ and girls’ track, and volleyball). Sex-comparisons were conducted for sports played by boys and girls (e.g., soccer, track and field, basketball and softball/baseball). 

The findings reinforce the value and importance of on-site, appropriate medical care within middle school sport settings. The study abstract is also published in the Journal of Athletic Training, the scientific journal of the National Athletic Trainers’ Association. 

Research was conducted as part of the Advancing Healthcare Initiatives for Underserved Students (ACHIEVES) project at George Mason University. Led by Dr. Shane Caswell this innonovative project works to address health care disparities by providing Virginia Commonwealth Board of Medicine Licensed Athletic Trainers (ATs) to increase accessibility to health care for a diverse population of more than 21,000 students in 16 middle school communities. 

Additional middle-focused research presented at the 2021 NATA Virtual Clinical Symposia & AT Expo 
The Epidemiology of Injuries in Middle School Baseball Between the 2015-16 and 2018-19 School Years 
Dewey KL, Hacherl SL, Kelshaw PM, Erdman NK, Martin, J, Dunn, R, Lincoln AE; Caswell, SV 

This study examined the epidemiology of injuries among middle school baseball players as few studies have investigated baseball-related injury rates unique to the middle school age athletic population. 

  • Overall and “time loss” injury rates in middle school baseball athletes were greater than previously reported for high school and collegiate populations. 
  • The proportion of overall injuries by event type was lower for competition (26.2%) than practice (73.8%). 
  • There was a greater proportion of “nontime loss” injuries (61.9%) than “time loss injuries” (37.3%). 
  • The injury rate for “time loss injuries” was similar for competitions and practices. 
  • The most common “time loss injuries” were contusions (29.8%) and strains (29.8%), followed by concussions (6.4%). 

This retrospective descriptive epidemiology study reviewed injury data for nine middle schools as part of the Advancing Healthcare Initiatives for Underserved Students (ACHIEVES) project located in northern Virginia between the 2015/16 and 2018/19 school years. 
The Epidemiology of Injuries in Middle School Wrestling Between the 2015-16 and 2019-20 School Years 
Fleming PR, Hacherl SL, Kelshaw PM, Erdman NK, Martin J, Dunn R, Lincoln AE; Caswell, SV 
This study describes the epidemiology of injuries sustained by middle school age wrestlers in a large metropolitan school division as limited data about wrestling existed at the middle school level. 

  • Middle school wrestlers have a higher overall injury rate than previously reported among middle school, high school, and collegiate wrestlers. 
  • The “time loss” injury rate was similar in competition and practice. 
  • The most common “time loss” injuries were strains (23.3%), contusions (21.8%), general medical conditions (13.5%) and concussions (7.6%). 

This retrospective descriptive epidemiology study was conducted as part of the Advancing Healthcare Initiatives for Underserved Students (ACHIEVES) project. Data was examined from competitive wrestling seasons at nine (2015/16 to 2018/19) and 16 (2019/20) middle schools, respectively. 

About NATA: National Athletic Trainers’ Association – Health Care for Life & Sport 

Athletic trainers are health care professionals who specialize in the prevention, diagnosis, treatment and rehabilitation of injuries and sport-related illnesses. They prevent and treat chronic musculoskeletal injuries from sports, physical and occupational activity, and provide immediate care for acute injuries. Athletic trainers offer a continuum of care that is unparalleled in health care. The National Athletic Trainers' Association represents and supports more than 40,000 members of the athletic training profession.  Visit nata.org for more information. 

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