Severe concussion in a child is six times more likely to happen during organised sport than in the course of other physical leisure activities. That’s the worrying conclusion of a new study on sports injury in children from Australia.

Injuries from sports and other physical leisure activities are often grouped together by researchers. But this research team was keen to tease out the differences between the two situations.

They reviewed the medical records of all children aged 6-16 who presented at the emergency department of a children’s hospital in Sydney, between 2000 and 2003, with a concussive head injury related to sport or other physical activity.
Their underlying aim was to compare the characteristics of patients injured in organised sports and other physical leisure activities.

Of the total of 592 children and adolescents studied:

• About a quarter sustained their injury during organised sport and three quarters during other physical leisure activity;
• Falls caused just over half of the injuries, with the rest caused by collision with a person or object;
• In terms of sport, the various types of football accounted for the highest proportion of injuries (nearly 20%);
• Most cases (71.2%) were mild, a quarter were moderate and 3.2% were severe. A total of 143 children (24.2%) were admitted to hospital;
• All eventually made a good recovery.

However, the most worrying finding was that children and adolescents involved in organised sport were nearly six times more likely to suffer a severe concussion than those involved in other physical activities.

‘The results… suggest,’ say the researchers, ‘that severe concussion is associated with collision rather than a fall. Collisions occur more often in organised sports than leisure physical activity.’

They believe that low compliance with the use of protective equipment is to blame for the effects of such collisions.

‘Rules and regulations need to be enforced by parents and coaches if we are to see the benefits of such protective equipment in reducing [concussive head injury],’ they conclude.

Br J Sports Med 2006;40:163-168