On days when her symptoms are bad, Souder avoids driving and working on a computer, and wears sunglasses even indoors to deal with bright light. About 40 percent of her days are like this, she estimates. “I’ll usually know by about 10 or 10:30 a.m. what kind of day it will be.” While her initial asthma-related concussion may have been a rare event, the concussions that followed weren’t. Recent studies of concussion rates in high school and college sports have found that female soccer was second only to male football in the frequency of concussions, and players in many other sports sustain head injuries as well. “Concussions can even occur in non-contact sports like swimming and diving,” says Zachary Kerr, PhD, MPH, an assistant professor of exercise and sport science at the University of North Carolina in Chapel Hill. “Every sport needs to be responsible for the health and safety of its athletes,” he says, adding that the focus should be on preventing these injuries in the first place.

The Data on Concussions in College and High School Sports

At both the college and high school level, sports concussions are tracked using national reporting systems. The National Collegiate Athletic Association (NCAA) began its Injury Surveillance Program (ISP) in 1982; based on this model, the National High School Sports-Related Injury Surveillance System Study (High School RIO) began tracking high school injuries in 2005. Information is entered into both systems by certified athletic trainers. Using High School RIO, a study published in December 2017 in the American Journal of Public Health looked at the number of reported concussions for male and female high school athletes in nine sports. Of the 8,043 reported concussions from 2005 to 2016, the sports accounting for the most concussions (as a percentage of the total) were: At the college level, a study published in November 2015 in the American Journal of Sports Medicine looked at reported concussion data in the NCAA ISP from 2009 to 2014. Researchers used the reported injury data to estimate a total of 10,560 national concussions annually, with the following sports accounting for the highest percentages: Although cheerleading wasn’t included in these multisport studies, it was the subject of a paper published in December 2015 in the journal Pediatrics looking at injuries to high school cheerleaders from 2009 to 2014, as reported through RIO. Concussions were the most commonly diagnosed injury for female high school cheerleaders, and were most likely to happen during stunts and as a result of athletes colliding with each other (rather than from hitting the ground). Even so, the study found that concussion rates in cheerleading were much lower than in all the other sports tracked by RIO combined.

Concussion Prevention and Recovery

While concussion reporting laws have been credited with reducing youth-sport concussions, experts recommend that players and parents educate themselves about best practices for their sport. “It starts with an understanding of the sport you’re playing, including both the benefits and the risks,” says Jeffrey Kutcher, MD, a sports neurologist and the national director of the Sports Neurology Clinic in Brighton, Michigan. “Make sure you’re focusing on technique and playing by the rules, and get to know your coaches. Are they up-to-date on the best coaching techniques? What happens if there’s a suspected injury — is there an action plan in place?” Dr. Kutcher, an advisory board member for the Headway Foundation, notes that this should include clear expectations about removing players from practice or a game if a concussion is suspected, as well as appropriate triage to assess the player. Kutcher also recommends that athletes consider having a brain-health baseline evaluation, especially if they play contact sports, have a history of concussions, or have a family history that includes related factors such as migraines or cognitive or mood disorders. The player’s overall exposure is also a factor (for example, if he or she plays several contact sports). “I also stress that parents should think about what their concussion plan would be ahead of time,” Kutcher says. Do some research to find concussion resources in the community, he advises, so you’ll know what’s available. For players who do end up getting concussions, symptoms and recovery vary. “Every brain is different,” Kutcher explains, noting that people also have different thresholds for recognizing and reporting symptoms. Information on recovering from concussions can be found on the Headway Foundation’s site. Still, it’s important to note that with adequate recovery time, many athletes are able to return to play. Kutcher, who co-authored Back in the Game: Why Concussion Doesn’t Have to End Your Athletic Career, notes that sustaining one concussion doesn’t mean you’re more likely to get another. But he cautions players not to return to play before they’re fully healed. “A single concussion isn’t the issue,” Kutcher notes. “The bigger issue is long-term brain health.” RELATED: What to Do if You Suspect You or Your Child Has a Concussion