Archbold (2017)[77] | Ireland | Rugby Union | Male | 825 (825/0) | Age range (SD) = 16.8 (0.8) | 1,000 PH | Sprain, concussion, and muscle injury were the most common diagnoses and concussion carried the most significant time out from play. |
Barden (2021)[78] | England | American Football, Basketball, Soccer, Rugby Union, and Rugby League | Male, Female | 843 (NR/NR) | Mean age (SD) = 17.7 (1), Age range (16–20) | 1,000 PH | Concussion was the most common injury and female rugby union had the highest concussion incidence (50%). |
Baron (2020)[79] | USA | Lacrosse | Female | NR (0/NR) | NR | 1,000 AE | The player wearing headgear demonstrated significant decreases in game concussion when compared to players not wearing headgear. |
Beis (2007)[80] | Greece | Taekwondo | Male, Female | 1,990 (1,223/767) | Age range (11–17) | 1,000 AE | Junior boys and girls (aged 11 to 13 years) sustained more concussions than older age groups. |
Black (2016)[81] | Canada | Ice Hockey | Male, Female | 1,331 (1,273/43)a | Age range (11–12) | 1,000 PH | Pee Wee hockey players that played in a body checking permitting league had a threefold greater rate of concussion compared with a league where body checking was prohibited due to policy change. |
Blake (2018)[82] | Canada | Ice Hockey | Male | 1,208 (1,208/0) | Age range (11–17) | 1,000 PH | There was a higher concussion rate in ice-hockey players who did not meet the Physical Activity recommendation guidelines in comparison to players that did meet these recommendations |
Clifton (2018a)[83] | USA | Basketball | Female | NR (0/NR) | NR | 1,000 AE | The most common injuries for basketball female athletes were ligament sprains, concussions, and muscle/tendon strains. |
Clifton (2018b)[84] | USA | Basketball | Male | NR (NR/0) | NR | 1,000 AE | The most common injuries for basketball male athletes were ligament sprains, concussions, and muscle/tendon strains. |
Collins (2016)[85] | USA | American Football | Male | NR (NR/0) | NR | 10,000 AE | Concussion rates significantly increased from 2008–2009 through 2012–2013. |
DiStefano (2018)[86] | USA | Soccer | Female | NR (0/NR) | NR | 1,000 AE | Concussions accounted for 24.5% of competition injuries in high school soccer. |
Dompier (2015)[87] | USA | American Football | NR | NR (NR/NR) | Age range (5–23) | 1,000 AE | Game concussion IR was higher than practice IR across youth, high school, and college American football athletes. |
Echlin (2010)[88] | Canada | Ice Hockey | Male | 67 (67/0) | Mean age (SD) = 18.2 (1.2), Age range (16–21) | 1,000 AE | The IR of concussions during junior ice hockey games was seven times higher than the highest rate reported in previous studies. |
Eliason (2022a)[89] | Canada | Ice Hockey | Male, Female | 1,647 (NR/NR) | Age range (13–14) | 1,000 PH | Among ice hockey players aged 12–14 years in leagues permitting body checking, there was no significant difference in concussion IR between athletes with and without prior body checking experience. |
Eliason (2022b)[90] | Canada | Ice Hockey | Male, Female | 941 (NR/NR) | Age range (15–17) | 1,000 PH | Players with three or more years of body checking experience had higher concussion rates when compared to players with two years or less experience. |
Emery (2011)[91] | Canada | Ice Hockey | Male, Female | 1,971 (1,956/15) | Age range (11–14) | 1,000 PH | The risk of concussion was reduced for ice hockey players (aged 13–14 years) who had two years of bodychecking experience previously compared with players introduced to bodychecking for the first time at age 13. |
Emery (2020)[92] | Canada | Ice Hockey | Male, Female | 1,004 (987/17) | Age range (13–14) | 1,000 PH | Whilst there was a lower IR of concussion within ice hockey leagues prohibiting body checking compared to leagues permitting, it was not statistically significant. |
Emery (2022)[93] | Canada | Ice Hockey | Male, Female | 1,127 (1,118/8)a | Age range (15–17) | 1,000 PH | The rate of concussion injury was 51% lower in ice hockey leagues not permitting body checking in for non-elite 15–17-year-olds. |
Emery (2010)[94] | Canada | Ice Hockey | Male, Female | 2,154 (2,117/33)a | Age range (11–12) | 1,000 PH | In ice hockey teams where body checking was permitted, there was a threefold increase in concussions, compared to leagues that prohibited body checking. |
Emery (2006)[95] | Canada | Ice Hockey | Male, Female | 986 (962/24) | Age range (8–17) | 1,000 PH | Concussions were the most common specific injury type for ice hockey players, followed by shoulder sprains/dislocation and knee sprains. |
Fremont (2022)[96] | Canada | Canadian Footballb | Male | 672 (672/0) | Age range (11–17) | 1,000 AE | The concussion IR was over six times higher than the highest incidence rate reported for high school football between 1999 and 2012. |
Gessel (2007)[97] | USA | American Football, Basketball, Volleyball, Soccer/Football, Wrestling, Baseball, and Softball | Male, Female | NR (NR/NR) | NR | 1,000 AE | Rates of concussion were highest in football and soccer, and high school girls sustained a higher rate of concussions than boys. |
Gomez (1996)[98] | USA | Basketball | Female | 890 (0/890) | Age range (14–18) | 1,000 PH | Of the injuries that occurred in basketball, concussion accounted for 2%. |
Guillaume (2021)[99] | USA | Lacrosse | Male | NR (NR/0) | NR | 1,000 AE | When there were penalty rule modifications enacted together for reducing XXX for lacrosse players. |
Guskiewicz (2000)[100] | USA | American Football | NR | 17,549 (NR/NR) | NR | 1,000 AE | The greatest incidence of concussion occurred at the high school level and collegiate division III level for American football athletes, suggesting that there was no association between levels of play and the proportion of injury. |
Haseler (2010)[101] | England | Rugby Union | Male | 210 (210/0) | Age maximum (< 17) | 1,000 PH | Concussion affected half of the total head injuries that occurred for the rugby union players. |
Hecimovich (2017)[102] | Australia | Australian Rules Football | Male | 976 (976/0) | Age range (9–17) | 1,000 AE | Australian rules football players aged 14–17 had the highest rates of concussion in comparison to younger players. |
Herman (2022)[103] | USA | Lacrosse | Female | NR (0/NR) | NR | 1,000 AE | The concussion injury rate was higher in the no headgear mandate in comparison to the headgear mandated lacrosse athletes. |
Hinton (2005)[104] | USA | Lacrosse | Male, Female | NR (NR/NR) | Age range (15–18) | 1,000 AE | Male lacrosse players had higher rates of concussion from player-to-player contact in comparison to females. |
Junge (2004)[105] | New Zealand | Soccer and Rugby Union | Male | 268 (268/0) | Mean age (SD) = 16.7 (.97), Age range (14–18) | 1,000 PH | More concussions occurred in the rugby union players in comparison to the soccer players. |
Kerr (2016a)[106] | USA | Lacrosse | Male | 550 (550/0) | Mean age (SD) = 12 (2), Age range (9–15) | 1,000 AE | Concussion injuries for these lacrosse players were higher in games than practices overall. |
Kerr (2019a)[107] | USA | American Football, Ice Hockey, Lacrosse, Wrestling, Soccer, Basketball, Baseball Swimming, Track and Field, Cross Country, Volleyball, Field Hockey, and Softball | Male, Female | NR (NR/NR) | NR | 10,000 AE | Competition had a higher concussion compared to practice, and boys’ football had the highest concussion rate, followed by girls’ soccer and boys’ ice hockey. |
Kerr (2019b)[108] | USA | American Football | Male | 664 (664/0) | Mean age (SD) = 12 (1), Age range (10–14) | 1,000 AE | The proportion of injuries diagnosed as concussions was higher in competition than practice for these American football youth athletes. |
Kerr (2017a)[109] | USA | Baseball, Basketball, American Football, Soccer, Track, Wrestling, Cheerleading, Softball, and Volleyball | Male, Female | NR (NR/NR) | NR | 1,000 AE | Football had the highest concussion rate and concussion rates were higher in games versus practices. |
Kerr (2016b)[110] | USA | American Football | NR | 390 (NR/NR) | NR | 1,000 AE | The concussion rate was lower in high schools where player safety coach intervention had been implemented, in comparison to players that received education only. |
Kerr (2018a)[111] | USA | Volleyball | Female | NR (0/NR) | NR | 1,000 AE | Volleyball players playing in the libero position had a high incidence of concussion. |
Kerr (2015a)[112] | USA | American Football | NR | NR (NR/NR) | Mean age (SD) = 10.7 (1.9), Age range (5–14.9) | 1,000 AE | The most common injuries included contusions, ligament sprains, concussions, and muscle strains for these American football youth athletes. |
Kerr (2021)[113] | USA | Ice Hockey | Male | NR (NR/0) | Age range (14–18) | 1,000 AE | The concussion rate was higher in competition in comparison to practice, and most concussions occurred after the first period of ice hockey games. |
Kerr (2018b)[114] | USA | Soccer | Male | NR (NR/0) | NR | 1,000 AE | Concussions accounted for more than one fifth of injuries in high school soccer games. |
Kerr (2019c)[115] | USA | Lacrosse | Male | NR (NR/0) | NR | 1,000 AE | The concussion rate in youth lacrosse players was higher than those in high school and college. |
Kerr (2018c)[116] | USA | American Football | Male | NR (NR/0) | NR | 1,000 AE | Concussions were a common injury during competitions amongst most positions for American football youth athletes. |
Kerr (2015b)[117] | USA | American Football | NR | 2108 (NR/NR) | Mean age (SD) = 10.88 (1.92), Age range (5.2–15.64) | 1,000 AE | Most concussions were reported in the group of American football youth athletes that received no Heads-Up Football Program compared to those that did receive this education program. However, no statistical difference in concussion rates were found between groups. |
Kerr (2017b)[118] | USA | American Football | NR | 2,098 (NR/NR) | Age range (5–15) | 1,000 AE | Concussion injury rates were greater in American football players aged 11 to 15 years old in comparison to five to 10 years old. |
Kerr (2016c)[119] | USA | American Football | NR | NR (NR/NR) | Youth age range (5–14) | 1,000 AE | Concussions in high school football had the highest mean number of reported symptoms, followed by college and youth. |
Koh (2004)[120] | South Korea | Taekwondo | Male, Female | 2,328 (1,652/676) | Mean age (SD) = 15 (1.62), Age range (11–19) | 1,000 AE | The incidence of concussions was high in competition taekwondo. |
Kolstad (2023)[121] | Canada | Ice Hockey | Male, Female | 3,330 (NR/NR) | Age range (11–18) | 1,000 PH | Wearing a mouthguard was associated with a lower concussion rate for youth ice hockey players. |
Kontos (2013)[122] | USA | American Football | Male | 468 (468/0) | Mean age (SD) = 10.12 (1.31), Age range (8–12) | 1,000 AE | Participation in American football games was associated with an increased concussion risk compared to practices, and players aged 11–12 years were nearly three times more likely to suffer a concussion compared to younger players. |
Kontos (2016)[123] | USA | Ice Hockey | Male, Female | 397 (330/67) | Mean age (SD) = 14.73 (1.99), Age range (12–18) | 1,000 AE | The concussion incidence rate was higher during ice hockey games compared to practices. |
Kroshus (2018)[124] | USA | Wrestling | Male | NR (NR/0) | NR | 1,000 AE | For high school male wrestlers, the most common occurring injuries during competitions were concussions, followed by knee and ankle sprains. |
Leahy (2023)[125] | Ireland | Rugby Union | Male | NR (NR/0) | Age range (16–19) | 1,000 PH | Concussions carried the highest injury burden for rugby union forward position players, compared to other positions. |
Leung (2017a)[126] | Australia | Rugby Union | Male | 3,585 (3,585/0) | Age range (9–18) | 1,000 PH | The incidence of suspected concussion injuries was 4.3/1,000 PH, and injuries differed across age groups. |
Leung (2017b)[127] | Australia | Rugby Union | Male | 480 (480/0) | Age range (10–18) | 1,000 PH | Concussions accounted for 19% of all injuries reported for these rugby union youth athletes. |
Lincoln (2011)[128] | USA | American Football, Lacrosse, Soccer, Wrestling, Basketball, Baseball, Softball, Field Hockey, and Cheerleading | Male, Female | 158,430 (NR/NR) | NR | 1,000 AE | American football had the highest incidence rates, whilst girls’ soccer had the most concussions amongst the sports participated by girls. |
Lincoln (2007)[129] | USA | Lacrosse | Male, Female | 8,638 (5,072/3,566) | NR | 1,000 AE | Concussion was the most common injury and male lacrosse players had a higher percentage of concussions in comparison to females. |
Lincoln (2014)[130] | USA | Lacrosse | Male, Female | NR (NR/NR) | Age range (9–15) | 1,000 AE | Whilst there were four concussions amongst the male lacrosse players, no concussions were reported amongst the females. |
Lopez (2020)[131] | USA | Rugby 7s | Male, Female | 3,804 (3,072/732) | Age maximum (< 19) | 1,000 PH | The most common overall injury types were ligament sprains, concussions, and contusions. |
Lynall (2018b)[132] | USA | Field Hockey | Female | NR (0/NR) | NR | 1,000 AE | Concussions accounted for almost 25% of all competition injuries among high school field hockey players. |
Lynall (2018a)[133] | USA | Ice Hockey | Male | NR (NR/0) | NR | 1,000 AE | In both practice and competition, the majority of injuries occurred in the head/face and shoulder/clavicle and resulted in concussions, contusions, or ligament sprains. |
Makovec Knight (2022)[134] | Australia | Australian Rules Football | Male, Female | 400 (230/170) | Mean age (SD) = 10.6 (1.2), Age range (7–13) | 1,000 PH | Head gear use in Australian Rules Football youth players was not found to be associated with suspected concussions. |
Marshall (2015)[135] | USA | American Football, Soccer, and Lacrosse | Male, Female | 7,513 (NR NR) | NR | 100,000 AE | Football had the highest concussion IR, followed by women’s lacrosse, men’s lacrosse, men’s soccer, and women’s soccer. |
Marshall (2001)[136] | USA | Rugby Union | NR | NR (NR/NR) | NR | 1,000 AE | Games had a higher concussion rate than practices and concussions were responsible for 25% of all days lost in rugby participation due to injury. |
McFie (2016)[137] | South Africa | Rugby Union | NR | 7,216 (NR/NR) | Under 13 Median age = 13.3, Under 16 Median Age = 16.3, Under 18 Median Age = 17.8, Age maximum (< 18) | 1,000 PH | Under 13 players and Under 16 players had higher concussion incidence rates than Under 18 players. |
McGinnis (2020)[138] | USA | Lacrosse | Male | NR (NR/0) | Mean age (SD) = 14.8 (2.12), Age range (8–18) | 1,000 AE | The most common injury diagnoses for male lacrosse players included contusions, concussions, fractures and sprains. |
McGuine (2014)[139] | USA | American Football | NR | 2,081 (NR/NR) | Mean age (SD) = 15.9 (1.2) | 1,000 AE | The SRC rate in competition was significantly higher than in practice for these American football youth athletes. |
McIntosh (2001)[140] | Australia | Rugby Union | Male | 294 (294/0) | Age maximum (< 15) | 1,000 AE | The was no significant difference in injury rates (including concussion) between rugby union players with and without headgear. |
McIntosh (2009)[141] | Australia | Rugby Union | Male | 4,095 (4,095/0) | Age range (12–21) | 1,000 PH | The results of this study suggested that padded headgear does not reduce the rate of head injury or concussion for these rugby union players as no differences were found in the concussion rate between control groups and headgear groups. |
McMahon (1993)[142] | Australia | Australian Rules Football | Male, Female | 1,253 (1,236/17) | Age maximum (< 15) | 1,000 PH | Three out 15 cases of concussions resulted in a loss of consciousness and there were more concussions recorded in the older age group (Under 15) in comparison to the younger age groups. |
Messina (1999)[143] | USA | Basketball | Male, Female | 1,863 (973/890) | Age range (14–18) | 1,000 PH | There was a reported higher number of concussions in boy compared to girl basketball players. |
Murray-Smith (2022)[144] | Australia | Rugby Union | Male | 979 (979/0) | Age maximum (< 17) | 1,000 PH | Concussion accounted for the greatest injury burden out of all injuries diagnosed for these rugby union players. |
O’Connor (2017)[145] | USA | American Football, Wrestling, Field Hockey, Gymnastics, Volleyball, Baseball, Softball, Basketball, Crew/Rowing, Cross Country, Golf, Lacrosse, Soccer, Indoor Track and Field, Outdoor Track and Field, Swimming and Diving, and Tennis | Male, Female | NR (NR/NR) | NR | 10,000 AE | Football has the highest SRC rate, followed by boys’ lacrosse and girls’ soccer. The SRC rate was higher in competition in comparison to practice. |
O’Kane (2014)[146] | USA | Soccer | Female | 351 (0/351) | Age range (11–14) | 1,000 AE | The concussion rate in games was greater than that in practices, the Under 15 female soccer players had the highest rate of concussion, and the Under 14 players had the lowest rate of concussion. |
Peterson (2017)[147] | USA | American Football | Male, Female | 3,794 (NR/NR) | Age range (8–13) | 1,000 AE | Concussions were more frequent during game than practice for the American football youth players. Players in the sixth or seventh grade had a higher likelihood of experiencing concussions in comparison to younger players. |
Pfaller (2019)[148] | USA | American Football | NR | NR (NR/NR) | Mean age (SD) = 15.9 (1.2) | 1,000 AE | The concussion rate overall in American football practice was significantly lower after the rule change in 2014 that limited the amount and duration of full contact. |
Pierpoint (2019a)[149] | USA | Lacrosse | Female | NR (0/NR) | NR | 1,000 AE | Concussion was the most common diagnosis among all high school female lacrosse player positions. |
Pierpoint (2019b)[150] | USA | Lacrosse | Male | NR (NR/0) | NR | 1,000 AE | Concussion was the most frequent competition diagnosis for all high school male lacrosse player positions. |
Pieter (1999)[151] | USA | Taekwondo | Male, Female | 4,258 (3,341/917) | Age range (6–16) | 1,000 AE | Contusions were the most common injury occurring for boys and girls, followed by concussion. |
Powell (1999)[152] | USA | Baseball, Basketball, American Football, Soccer, Wrestling, Field Hockey, Softball, and Volleyball | Male, Female | NR (NR/NR) | NR | 1,000 AE | Of the mild traumatic brain injuries, American football accounted for 63.4% of them, followed by wrestling (10.5%) and girls’ soccer (6.2%). |
Rivara (2014)[153] | USA | American Football, Soccer | Male, Female | 778 (490/288) | Age range (14–19) | 1,000 AE | The cumulative incidence of concussions was more than 10% for both high school football and girls’ soccer players. |
Roberts (1999)[55] | USA | Ice Hockey | Male, Female | 807 (695/112) | Age range (11–19) | 1,000 PH | Male ice hockey players had a higher rate of concussion at all age levels in comparison to female players. |
Schneider (2021)[154] | Canada | Ice Hockey | Male, Female | 778 (659/119) | Age range (13–17) | 1,000 PH | The rate of concussion in this ice hockey study was found to be higher than previously reported from the same league and the rate of concussion in males and females were not significantly different. |
Schulz (2004)[155] | USA | American Football, Soccer, Wrestling, Basketball, Softball, Baseball, Track, and Cheerleading. | Male, Female | 15,802 (NR/NR) | NR | 100,000 AE | Concussion rates were elevated for athletes with a history of concussion, and they increased with the increasing level of body contact allowed in the sport. American football had the overall highest concussion rate. |
Sewry (2018)[156] | South Africa | Rugby Union | NR | NR (NR/NR) | NR | 1,000 PH | The trend in concussions for rugby union players decreased until 2013 and increased in 2014–2016, consistent with the overall injury rate trend. |
Shill (2022)[157] | Canada | Rugby Union | Female | 421 (0/421) | Age range (15–18) | 1,000 PH | The concussion rate decreased from 2018 and 2019 for rugby union female players and tackling was the most frequent mechanism of concussion in matches. |
Smith (2013)[158] | USA | American Football, Soccer, Basketball, Wrestling, Baseball, Volleyball, Softball, Ice Hockey, Lacrosse, Swimming and Diving, Cheerleading, and Track and Field. | Male, Female | NR (NR/NR) | NR | 10,000 AE | High school sports players located in an environment with a higher altitude demonstrated a 31% reduction in the incidence of total reported concussions. |
Tee (2019)[159] | England | Rugby League | NR | 81 (NR/NR) | Mean age (SD) = 17.8 (0.7) | 1,000 PH | Concussion and ankle sprains were the most common injuries for these rugby league players. |
Tuominen (2017)[160] | NR | Ice Hockey | Male | NR (NR/0) | Age maximum (< 18) | 1,000 PH | Concussion was the most common head and face injury in the Ice Hockey World Championship Under-18 tournament. |
Vaandering (2022)[161] | Canada | Volleyball | Male, Female | 1,876 (466/1,391)a | Mean age (SD) = 16.2 (1.26), Age maximum (< 18) | 1,000 AE | Joint sprains and concussions were the most common injuries for these volleyball athletes. |
Valier (2020)[162] | USA | Softball | Female | NR (0/NR) | NR | 1,000 AE | The most frequent time loss injuries for female softball players were concussions, strains and sprains. |
Warner (2018)[60] | USA | Lacrosse | Male, Female | NR (NR/NR) | Male mean age (SD) = 16.2 (1.3), Female mean age (SD) = 16 (1.2) | 10,000 AE | The most frequently diagnosed injury for both male and female lacrosse players were concussions. |
Wasserman (2019)[163] | USA | Softball | Female | NR (0/NR) | NR | 1,000 AE | Softball players sustained a variety of injuries, with the most being ankle sprains and concussions. |
West (2023)[164] | Canada | Rugby Union | Male | 429 (429/0) | NR | 1,000 PH | The rate of injury and concussion in Canadian youth high school male rugby was high, with tackle-related injuries and concussion being the most common. |
Williams (2022)[165] | USA | Volleyball | Female | NR (0/NR) | NR | 1,000 AE | The most diagnoses reported for these female volleyball players included sprains, concussions and contusions. |
Yard (2009)[166] | USA | American Football, Soccer, Basketball, Wrestling, Baseball, Volleyball, and Softball | Male, Female | NR (NR/NR) | NR | 100,000 AE | Concussion rates were highest in football, girls’ soccer, boys’ soccer, girls’ basketball and wrestling. Concussion rates were higher in competition in comparison to practice. |
Zemper (2003)[167] | USA | American Football | Male | NR (NR/0) | NR | 1,000 AE | American football youth athletes with a history of concussion were six times more likely to sustain a concussion compared to athletes with no history of concussion. |