Table 1 Days missed from concussion injuries per sport team
Source: Debellis et al., “Concussions Occur at Practice and on Average Require a Month to Return-to-sport–Epidemiology of Concussion Injuries in NCAA Division I Athletes: 17-year Data from a Single Institution.”


Published 9/2/2021
Ariel DeMaio

Football, Women’s Volleyball Lead Team Sports in Concussion Injuries

Study of NCAA Division I sports program also finds that concussions occur more often during practice than games

In an analysis of 17 years of data from the University of Southern California, researchers described the timing, frequency, and recovery patterns of concussion among NCAA Division 1 athletes. The findings were shared as a poster on display during the Tuesday–Wednesday poster session. Overall, concussion injuries occurred most commonly during practice as opposed to games, and full return to sport required approximately one month.

Nicholas Debellis, MD, an orthopaedic surgery resident at Mount Sinai West Hospital in New York, N.Y., who completed his fellowship at University of Southern California, was the lead author. “Based on our analysis of more than 500 concussions at our institution, identifying and preventing the causes of concussions during practice represent the best opportunity for improving concussion rates in NCAA athletics,” the authors wrote.

In this study, Dr. Debellis and researchers compared the number of concussion events and time of participation missed due to concussion injury among the different sport teams: baseball, football, golf, lacrosse, women’s basketball, men’s basketball, men’s track and field, women’s track and field, men’s volleyball, women’s volleyball, men’s water polo, women’s water polo, rowing, soccer, swimming, and tennis. Data were collected from the medical records of all athletes who sustained concussion injury during a period of 17 years, from 2003 to 2020.

Relevant information included patient age, gender, sport team, time missed from participation due to concussion injury in days, and whether the injury occurred during a practice or a game. The researchers categorized data by sport and compared findings using descriptive statistics.

During the study period, 452 NCAA Division I athletes sustained at least one concussion injury, equaling a total of 547 concussion events. Concussions resulted in an average of 33.8 ± 22.8 days of missed time from sport participation (Table 1).

According to the medical records, concussion injuries occurred more commonly during practice compared to games (66.7 percent versus 24.9 percent; P <0.001). the only sports for which concussion occurred more often during games than practice were soccer (52.9 percent versus 47.1 percent) and lacrosse (90.0 percent versus 10.0 percent).>

“Football was by far the sport with the highest number of concussion events,” the authors reported, with 220 events in 167 athletes. Women’s volleyball had the next highest number, with 60 events in 24 players.

Notably, tennis players had the longest period of time missed from sport participation due to concussion, at nearly three months, followed by men’s track and field, soccer, and women’s track and field.

Summarizing their findings, the authors noted that concussion injuries in NCAA Division I athletes more commonly occur during practice and required approximately one month for a full return to sport. “While men’s basketball athletes seemed to return to sport at a faster rate, tennis players took the longest to return to sport,” they concluded. “However, the low rate of concussion in tennis might have resulted in overestimation of the recovery period in these athletes.”

Dr. Debellis’ coauthors of “Concussions Occur at Practice and on Average Require a Month to Return-to-sport–Epidemiology of Concussion Injuries in NCAA Division I Athletes: 17-year Data from a Single Institution” are Alexander Weber, MD; Ioanna Bolia, MD, MS, PhD; Russell Romano; Reza Omid, MD; George Frederick Hatch III, MD; Frank Petrigliano, MD; James E Tibone, MD; and Seth C. Gamradt, MD.

Ariel DeMaio is the managing editor of AAOS Now. She can be reached at