New laws that require better reporting and monitoring of concussions for high school athletes appear to be working to reduce the number of traumatic brain injuries that young players suffer, according to a study co-authored by a University of Colorado researcher.

The study found that the rates at which young athletes suffered a second concussion soon after their first declined dramatically after states passed the laws. Preventing such "recurrent concussions" is vital because the damage caused by concussions can increase exponentially if the head injuries occur close together in time.

Most of the new laws approved in the past decade — including in Colorado — require youth-sports coaches to remove athletes from play if they show signs of a concussion and to prevent the athletes from returning to play until they are cleared by a doctor. Dawn Comstock, a researcher at the CU School of Public Health and a co-author on the paper, said the study suggests that athletes who sit out until they fully recover from a concussion are less likely to suffer a new concussion when they return to competition.

"The take-home is that it does appear that these state-level concussion laws were effective at improving the recognition of concussions," Comstock said.


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The study was published online this month by the American Journal of Public Health.

Comstock oversees a national database called High School RIO, or Reporting Information Online. The database is part of a broader nationwide effort to track and study high school sports injuries.

Athletic trainers from across the country submit detailed reports on every type of injury their athletes suffer — noting not just the injury, but other factors such as the time of day it occurred, the position that athlete was playing, the playing surface and the weather conditions. It is from this treasure chest of injury data that Comstock and her co-authors pulled the numbers for their concussion study.

The first result they found was encouraging, if counterintuitive, Comstock said. The researchers found that reported concussions increased after states passed their traumatic brain injury laws. But Comstock said that increase is probably the result of better awareness about concussion symptoms and better reporting, not an actual increase in head-injury risk.

"Passing these laws meant fewer kids were missed," she said.

In subsequent years, Comstock said the rates for first-time concussions stabilized, while rates for recurrent concussions dropped.

Concussions were most common in football players, the study found. And, across all sports, boys suffered concussions more frequently.

But in sports that both boys and girls play — such as soccer or basketball — girls had concussion rates almost twice that of boys. Comstock said biological factors, such as neck strength, may play a role. But she said it is also possible that girls are more comfortable speaking up when they suffer a head injury or that coaches are more sensitive to possible injuries with female athletes compared to male athletes.

Overall, the study documented 8,043 concussions between 2005 and 2016, which, given their sample size, caused the researchers to estimate that there were 2.7 million concussions suffered by high school athletes in those years.

Despite the risk, Comstock said parents shouldn't be discouraged from letting their kids play sports.

"The long-term impact of inactivity," she said, "is worse than the smaller risk of serious injury."