Requested DocAlert: Football Players’ Concussion Symptoms and Time to Return to Play Vary by Age

Information sourced from NEJM Journal Watch:

Football Players’ Concussion Symptoms and Time to Return to Play Vary by Age

Football players aged 5 to 14 years suffer concussions as frequently as high school players, but have fewer symptoms.

Concussions in high school and college athletes have been studied extensively, but their incidence and characteristics in younger athletes are less understood. Researchers analyzed data from injury-reporting systems for 118 youth (age 5–14 years) football teams, 96 high school teams, and 34 college teams. Postconcussion symptoms and time until returning to play were reported by athletic trainers attending all practices and games from 2012 to [2014].

College athletes had the highest rate of concussions per 1000 athlete exposures (3.52 in games, 0.47 in practices), followed by youth (2.13, 0.53), and high school athletes (1.61, 0.47). High school athletes with concussions had the highest mean number of symptoms (5.60), similar to college athletes (5.56), and significantly higher than youth athletes (4.76). Compared with college athletes, the odds of returning to play at least 30 days after a concussion were higher in youth (odds ratio, 2.75) and high school (OR, 2.89) athletes. The most common symptoms were headache (94%), dizziness (75%), and difficulty concentrating (61%). Loss of consciousness was rare (3.8%).


As parents consider the risks of youth and high school football, pediatricians can advise them based on available concussion data. Despite the difficulty in detecting and characterizing concussions in young athletes (who may recognize and describe symptoms differently than older athletes), these findings suggest that concussions are as common in youth football as in high school football, and cause similar symptoms. Knowing that headache, dizziness, and poor concentration are the most common symptoms across age groups, while loss of consciousness is rare, helps us counsel parents and assess athletes in the clinical setting.

John D. Cowden, MD, MPH reviewing Kerr ZY et al. JAMA Pediatr 2016 May 2.


Kerr ZY et al. Concussion symptoms and return to play time in youth, high school, and college American football athletes. JAMA Pediatr 2016 May 2; [e-pub].
[PubMed® abstract]

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