Rates of Concussion in Various Sports

What would you say is the most important ability in sports? Regardless of which sport comes to mind the answer is the same.

And this ability is availability. Because unless you are healthy and able to play nothing else matters much. And that’s why our number one goal for our athletes is to make them resilient to injury. All of their athletic gifts and hard work are wasted if an athlete is on the sidelines.

Until recently we looked at the injury status of an athlete in terms of their physical abilities. Did they have an ankle spain? Shoulder impingement? Back spasms? Or something else related to the moving parts of the body. I know when I was young no one was talking about concussions. That’s not entirely true. My mom is an OT (occupational therapist) and told me repeatedly how dangerous a motorcycle could be due to the head injuries that could happen.

In adult sports concussions happen at higher rates in some sports compared with others. The highest rates for a concussion in competition are in:

  1. Men’s rugby match play (3.00/1,000 AE)
  2. Men’s American football (2.5/1,000 AE)
  3. Women’s ice hockey (2.27/1,000 AE)
  4. Men’s Ice hockey (1.63/1,000 AE)
  5. Women’s soccer (1.48/1,000 AE)
  6. Men’s football (or soccer) (1.07/1,000 AE)

For younger athletes (under 18) here’s what the numbers look like:

  1. Rugby (4.18/1,000 AE)
  2. Ice hockey (1.20/1,000 AE)
  3. American football (0.53/1,000 AE)
  4. Lacrosse (0.24/1,000 AE)
  5. Football (or soccer) (0.23/1,000 AE)
  6. Wrestling (0.17/1,000 AE)

AE stands for Athlete Exposures and means one athlete playing in one game or practice. So if 20 soccer players play another team of 20 players in a game there would be 40 Athlete Exposures. Or if a football team of 50 players goes through one practice than there are 50 AE.

As sports can be divided up into collision, contact and non-contact sports so it makes sense that we see these sports listed. Rugby, football and hockey (men’s) involve hitting and explain why they are at the top of the list.

But there are a number of things I find interesting about this list.

1. Rugby has the highest rate of concussions.

Fans of the game of rugby will tell you it is a safer game than football. They will tell you it is a ‘gentleman’s game’ and proof of this is gathering for a pint after the match. They will point out the fact that when compared to American football for example, players don’t wear the same protective equipment or armour. And because of the lack of helmets and pads, rugby players are better tacklers. And they learn the safer way to bring down an opponent.

This may be true when it comes to joint related injuries but in terms of concussions it is the worst. Maybe it’s the head contacting the ground after being tackled?

The other interesting thing about rugby, imo, is that it is the only sport listed where younger players have a higher rate of concussions than adult participants. An adult rugby player will suffer a concussion 3 out of every 1000 Athlete Exposures. For a young rugby player this number increases by almost 40% to 4.18 concussions per 1000.

With every other sport listed the rate of concussions increases as you move from youth to adult leagues. Rugby is the only one listed where the risk is not only greatest for youth but it decreases as you play as an adult.

2. For adult sports the rate of concussion for women is higher than it is for men playing the same sport.

When you consider a sport like hockey this becomes even more interesting.

First of all, women’s hockey is a non-collision game. There is definitely contact involving battles along the boards, on face-offs and in front of the net. But hitting is not allowed. If Scott Stevens had a twin sister playing hockey I’m sure it would been difficult to resist lining opposing forwards up at the blue line to deliver a big hip check.

 

Scott Stevens hitting Paul Kariya. You can't hit an opponent like this in the women's game.

Scott Stevens hitting Paul Kariya. You can’t hit an opponent like this in the women’s game.

The women’s game is not as fast.

Although the women’s game is quick as evidenced by the most recent skills competition at the NHL All Star Game it is still a step behind the men’s game. Men are generally faster skaters and tend to shoot the puck harder as well. Both of these features of the men’s game make it surprising that women suffer concussions at a higher rate than men in hockey.

Men are taller and more massive than women.

Below are the Canadian Men’s and Women’s 2018 Olympic Hockey Rosters. The men’s heights range from 5’8″ to 6’3″ with an average weight of 194.16 lbs. The women’s heights ranged from 5’4″ to 5’10” with an average weight of 14.78 lbs.

So the men outweighed the women by almost 40 lbs and the ranges in heights were 4-5 inches greater. When you consider momentum is a function of mass times velocity, and the men are more massive and moving more quickly, then the momentum produced would be much larger.

I’m not sure what accounts for the higher concussion rates of female versus male athletes. It is interesting to see how women are concussed at a higher rate than men in the same sport. Especially considering the male version of the game is collision hockey, for hockey anyway, and involves bigger faster players.

Table showing the 2018 Canadian Men’s Olympic Hockey Roster

No. Pos. Name Height Weight Birthdate Birthplace 2017–18 team
3 D Karl Stollery 5 ft 11 in (1.80 m) 181 lb (82 kg) November 21, 1987 Camrose, Alberta Latvia Dinamo Riga (KHL)
4 D Chris Lee – A 6 ft 0 in (1.83 m) 185 lb (84 kg) October 3, 1980 MacTier, Ontario Russia Metallurg Magnitogorsk (KHL)
5 D Chay Genoway 5 ft 9 in (1.75 m) 176 lb (80 kg) December 20, 1986 Morden, Manitoba Russia HC Lada Togliatti (KHL)
7 F Gilbert Brulé 5 ft 10 in (1.78 m) 190 lb (86 kg) January 1, 1987 Edmonton, Alberta China Kunlun Red Star (KHL)
8 F Wojtek Wolski 6 ft 3 in (1.91 m) 220 lb (100 kg) February 24, 1986 Zabrze, Poland Russia Metallurg Magnitogorsk (KHL)
9 F Derek Roy – A 5 ft 9 in (1.75 m) 187 lb (85 kg) May 4, 1983 Rockland, Ontario Sweden Linköpings HC (SHL)
11 F Chris Kelly – C 6 ft 0 in (1.83 m) 194 lb (88 kg) November 11, 1980 Toronto, Ontario Canada Belleville Senators (AHL)
12 F Rob Klinkhammer 6 ft 2 in (1.88 m) 216 lb (98 kg) August 12, 1986 Lethbridge, Alberta Russia Ak Bars Kazan (KHL)
15 F Brandon Kozun 5 ft 8 in (1.73 m) 172 lb (78 kg) March 8, 1990 Los Angeles, CaliforniaUnited States Russia Lokomotiv Yaroslavl (KHL)
16 F Quinton Howden 6 ft 2 in (1.88 m) 190 lb (86 kg) January 21, 1992 Oakbank, Manitoba Belarus HC Dinamo Minsk (KHL)
17 F Rene Bourque – A 6 ft 2 in (1.88 m) 216 lb (98 kg) December 10, 1981 Lac La Biche, Alberta Sweden Djurgårdens IF (SHL)
18 D Marc-André Gragnani 6 ft 3 in (1.91 m) 205 lb (93 kg) March 11, 1987 L’Île-Bizard, Quebec Belarus HC Dinamo Minsk (KHL)
19 F Andrew Ebbett – A 5 ft 9 in (1.75 m) 176 lb (80 kg) January 2, 1983 Vernon, British Columbia Switzerland SC Bern (NL)
21 F Mason Raymond 6 ft 1 in (1.85 m) 179 lb (81 kg) September 17, 1985 Cochrane, Alberta Switzerland SC Bern (NL)
22 F Eric O’Dell 6 ft 1 in (1.85 m) 201 lb (91 kg) June 21, 1990 Ottawa, Ontario Russia HC Sochi (KHL)
24 D Stefan Elliott 6 ft 1 in (1.85 m) 190 lb (86 kg) January 30, 1991 Vancouver, British Columbia Sweden HV71 (SHL)
27 D Cody Goloubef 6 ft 1 in (1.85 m) 201 lb (91 kg) November 30, 1989 Oakville, Ontario United States Stockton Heat (AHL)
30 G Ben Scrivens 6 ft 2 in (1.88 m) 198 lb (90 kg) September 11, 1986 Spruce Grove, Alberta Russia Salavat Yulaev Ufa (KHL)
31 G Kevin Poulin 6 ft 2 in (1.88 m) 205 lb (93 kg) April 12, 1990 Montreal, Quebec Switzerland EHC Kloten (NL)
35 G Justin Peters 6 ft 1 in (1.85 m) 209 lb (95 kg) August 30, 1986 Blyth, Ontario Germany Kölner Haie (DEL)
37 D Mat Robinson 5 ft 9 in (1.75 m) 185 lb (84 kg) June 20, 1986 Calgary, Alberta Russia CSKA Moscow (KHL)
40 F Maxim Lapierre 6 ft 0 in (1.83 m) 216 lb (98 kg) March 29, 1985 Saint-Leonard, Quebec Switzerland HC Lugano (NL)
56 D Maxim Noreau – A 6 ft 0 in (1.83 m) 198 lb (90 kg) May 24, 1987 Montreal, Quebec Switzerland SC Bern (NL)
91 F Linden Vey 6 ft 0 in (1.83 m) 190 lb (86 kg) July 17, 1991 Wakaw, Saskatchewan Switzerland ZSC Lions (NL)
92 F Christian Thomas 5 ft 9 in (1.75 m) 174 lb (79 kg)

Table showing the 2018 Canadian Olympic Women’s Hockey Roster

No. Pos. Name Height Weight Birthdate Birthplace 2017–18 team
1 G Shannon Szabados 5 ft 8 in (1.73 m) 141 lb (64 kg) August 6, 1986 Edmonton, Alberta Canada National Women’s Team
2 F Meghan Agosta – A 5 ft 7 in (1.70 m) 148 lb (67 kg) February 12, 1987 Windsor, Ontario Canada National Women’s Team
3 D Jocelyne Larocque – A 5 ft 6 in (1.68 m) 146 lb (66 kg) May 19, 1988 Ste. Anne, Manitoba Canada Markham Thunder (CWHL)
4 D Brigette Lacquette 5 ft 6 in (1.68 m) 181 lb (82 kg) November 10, 1992 Dauphin, Manitoba Canada Calgary Inferno (CWHL)
5 D Lauriane Rougeau 5 ft 8 in (1.73 m) 168 lb (76 kg) April 12, 1990 Pointe-Claire, Quebec Canada Les Canadiennes (CWHL)
6 F Rebecca Johnston 5 ft 9 in (1.75 m) 148 lb (67 kg) September 24, 1989 Sudbury, Ontario Canada Calgary Inferno (CWHL)
7 F Laura Stacey 5 ft 10 in (1.78 m) 157 lb (71 kg) May 5, 1994 Mississauga, Ontario Canada Markham Thunder (CWHL)
8 D Laura Fortino 5 ft 4 in (1.63 m) 137 lb (62 kg) January 30, 1991 Hamilton, Ontario Canada Markham Thunder (CWHL)
9 F Jenn Wakefield 5 ft 10 in (1.78 m) 176 lb (80 kg) June 15, 1989 Scarborough, Ontario Canada National Women’s Team
11 F Jillian Saulnier 5 ft 5 in (1.65 m) 146 lb (66 kg) March 7, 1992 Halifax, Nova Scotia Canada Calgary Inferno (CWHL)
12 D Meaghan Mikkelson 5 ft 9 in (1.75 m) 150 lb (68 kg) January 4, 1985 Regina, Saskatchewan Canada Calgary Inferno (CWHL)
14 D Renata Fast 5 ft 6 in (1.68 m) 143 lb (65 kg) October 6, 1994 Hamilton, Ontario Canada Toronto Furies (CWHL)
15 F Mélodie Daoust 5 ft 4 in (1.63 m) 157 lb (71 kg) January 7, 1992 Valleyfield, Quebec Canada Les Canadiennes (CWHL)
17 F Bailey Bram 5 ft 8 in (1.73 m) 139 lb (63 kg) September 5, 1990 Winnipeg, Manitoba Canada Calgary Inferno (CWHL)
19 F Brianne Jenner – A 5 ft 9 in (1.75 m) 157 lb (71 kg) May 4, 1991 Oakville, Ontario Canada Calgary Inferno (CWHL)
20 F Sarah Nurse 5 ft 9 in (1.75 m) 148 lb (67 kg) January 4, 1995 Hamilton, Ontario United States University of Wisconsin (WCHA)
21 F Haley Irwin 5 ft 7 in (1.70 m) 170 lb (77 kg) June 6, 1988 Thunder Bay, Ontario Canada Calgary Inferno (CWHL)
24 F Natalie Spooner 5 ft 10 in (1.78 m) 181 lb (82 kg) October 17, 1990 Scarborough, Ontario Canada Toronto Furies (CWHL)
26 F Emily Clark 5 ft 7 in (1.70 m) 134 lb (61 kg) November 28, 1995 Saskatoon, Saskatchewan United States University of Wisconsin (WCHA)
29 F Marie-Philip Poulin – C 5 ft 7 in (1.70 m) 161 lb (73 kg) March 28, 1991 Quebec City, Quebec Canada Les Canadiennes (CWHL)
31 G Geneviève Lacasse 5 ft 8 in (1.73 m) 152 lb (69 kg) May 5, 1989 Montreal, Quebec Canada Calgary Inferno (CWHL)
35 G Ann-Renée Desbiens 5 ft 9 in (1.75 m) 161 lb (73 kg) April 10, 1994 La Malbaie, Quebec Canada National Women’s Team
40 F Blayre Turnbull 5 ft 7 in (1.70 m) 159 lb (72 kg) July 15, 1993 New Glasgow, Nova Scotia Canada Calgary Inferno (CWHL)

 

3. The chance of a concussion is 10x in competition versus practice

I haven’t included the stats for concussions that occur in practice versus competition but it is roughly ten times greater in a game. It makes sense that a game would be riskier than a practice. Practices are structured and controlled. A coach can whistle a play dead at any time for a teaching opportunity, for safety or any other reason. In a game the play continues until there is a goal, a penalty or the puck leaves the ice. Players aren’t looking to hit each other with full effect as they would in a game. And although practices may be uptempo they are no substitute for the speed of competition.

In the NFL training camps for example, quarterbacks will wear bright colours different from every other player on the field. This is so this player will stand out and make it easy to know not to hit the quarterback. If you are a rookie looking to crack an NFL roster hitting your own quarterback would almost surely lead to being cut immediately.

Lastly, since the chance of a concussion is related by the frequency, recency and intensity of previous concussions it becomes more urgent to be patient when waiting to return to competition. A practice is not substitute for the risk of a concussion compared to a game. Be patient with the recovery and err on the side of caution. Don’t rush back.

The take home message here is to take care of your head. If you play some of the sports listed exercise an extra dose of caution. With rugby this might be a sport to save until you’re older as the risk is greater when you’re young. And if you’re a female athlete playing hockey or soccer educate yourself as to the best ways to minimize your risk in these sports.

 

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