Younger Kids More Likely To Quickly Return to Sports After Concussion Interview with:

Zachary Y. Kerr, PhD, MPH Sports Injury Epidemiologist Director, NCAA Injury Surveillance Program Datalys Center for Sports Injury Research and Prevention Indianapolis, IN 46202

Dr. Zachary Keff

Zachary Y. Kerr, PhD, MPH
Sports Injury Epidemiologist
Director, NCAA Injury Surveillance Program
Datalys Center for Sports Injury Research and Prevention
Indianapolis, IN 46202 What is the background for this study? What are the main findings?

Dr. Kerr: A 2013 Institutes of Medicine report called for more research on concussion in athletes aged 5-21 years.  Although there is much research on the incidence of concussion across this age span, there is less related to outcomes such as symptoms and return to play time, let along comparisons by age.

In examining sport-related concussions that occurred in youth, high school, and college football, we found differences in the symptomatology and return to play time of concussed players.  For example, the odds of return to play time being under 24 hours was higher in youth than in college.  Also, over 40% of all concussions were returned to play in 2 weeks or more. What should clinicians and patients take away from your report?

Dr. Kerr: The finding related to return to play under 24 hours being the highest in the youth level is surprising, but may be the result of young football players struggling to identify concussion symptoms and express how they feel to onsite athletic trainers.  Thus, it is imperative to educate not only the young football players about concussions, but also all adults present as well, including parents, coaches, medical staff, and officials on recognition and management of concussions.   Still, we also should highlight that appropriate medical care includes managing and returning concussions at the appropriate time.  With over 40% of concussions being returned to play in 2 weeks or longer, we believe that athletic trainers are ensuring that concussed players go through an appropriate return-to-play timeline. What recommendations do you have for future research as a result of this study?

Dr. Kerr: Overall, having athletic trainers on-site at any level of play is important to detect, diagnose, and manage concussion.  All colleges should have an athletic trainer on-site during football games and practices.  However, a number of high schools do not have access to a full-time athletic trainer, and many youth football leagues do not have any access.  An investment in an athletic trainer at these games and practices is an investment in the health and safety of our adolescent and children athletes.  More related to the study itself, our study is the first to examine concussion-related symptomatology and return-to-play time in youth, high school, and collegiate athletes, finding differences among the groups.  Nevertheless, we advocate further research;  we particularly hope such future research will specifically examine the many level-specific organizational, social environmental, and policy-related factors that may drive such variations in outcomes. Is there anything else you would like to add?

Dr. Kerr: Injury surveillance is essential in driving the development of evidence-based concussion prevention and policies.  We hope other researchers are motivated to further examine the strengths of using injury surveillance data, while learning more about the limitations of surveillance data, and examining ways to improve data collection efforts. Thank you for your contribution to the community.


Zachary Y. Kerr, Scott L. Zuckerman, Erin B. Wasserman, Tracey Covassin, Aristarque Djoko, Thomas P. Dompier. Concussion Symptoms and Return to Play Time in Youth, High School, and College American Football Athletes. JAMA Pediatrics, 2016;

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on May 2, 2016 by Marie Benz MD FAAD