Expert Commentary

Brain injury risks for high school football players

2010 study in Journal of Neurotrauma on effects of head impacts for a high school football team during one season.

During every high school football season, an estimated 43,000 to 67,000 players endure a concussion. Because players often want to remain on the field and neglect to self-report symptoms, the actual number of concussions suffered annually at the high school level may exceed 100,000, researchers say. Moreover, those statistics may not tell the full story of the impact on young brains of repetitive blows to the head, even with a protective helmet. Moreover, the issue of football concussions at all levels has emerged as one of the gravest areas of health-related concern in all of sports.

A 2010 study by Purdue University and Indiana University published in the Journal of Neurotrauma, “Functionally-Detected Cognitive Impairment in High School Football Players Without Clinically Diagnosed Concussion,” examined the health of 21 players throughout the course of a season. The study focused particularly on 11 of these adolescent/late-teen subjects.

The study’s findings include:

  • The 21 players experienced 15,264 significant collision events across 48 practices and games (an average of 15.5 collision events per player per organized activity); four of the 21 players were diagnosed with a concussion.
  • Four of the players with no clinically observable signs of concussion still showed significant functional impairments when observed with MRI technology or verbal/cognitive testing. This suggests that a new category of brain-related injury problem needs to be diagnosed.
  • If this new diagnosis is applied to 23 players in a parallel scientific study, 12 of the players would be considered functionally impaired.
  • In particular danger are lineman, “who experience helmet-to-helmet contact on nearly every play from scrimmage, often to the top front of the head.” Players in such positions are more likely to suffer multiple sub-concussive blows leading to increased risk of long-term neurological degeneration.

Overall, the data suggest “the presence of a previously unknown, but suspected … group of athletes exhibiting neurocognitive deficits that persist over time, but which does not present observable symptoms.” The study’s authors say the findings indicate current on-field tests for concussions may not be sufficient in determining full risks to the brain.

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