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Sex Differences in Concussion Rates among Middle School Sex-comparable Sports.

Samantha L Hacherl1,2, Daniel C Herman2,3, Joel R Martin2,4,5

  • 1Graduate Health Sciences, Franklin College, Franklin, IN.

Journal of Pediatrics. Clinical Practice
|March 9, 2026
PubMed
Summary
This summary is machine-generated.

Girls in middle school sports are more than twice as likely to sustain sports-related concussions (SRCs) than boys. These findings highlight the need for female-specific concussion prevention and care strategies for young athletes.

Keywords:
concussionearly adolescentepidemiologypreventionyouth sports

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Area of Science:

  • Sports Medicine
  • Adolescent Health
  • Epidemiology

Background:

  • Sports-related concussions (SRCs) are a significant concern in adolescent athletics.
  • Understanding sex-based differences in SRC rates is crucial for targeted prevention strategies.
  • Previous research has indicated differences in SRC rates between sexes, but data in early adolescence is less defined.

Purpose of the Study:

  • To investigate and compare the rates of sports-related concussions (SRCs) between early adolescent girls and boys participating in sex-comparable middle school sports.
  • To analyze sex differences in SRC rates across different sports and game contexts (competition vs. practice).

Main Methods:

  • A prospective epidemiological study was conducted from 2015 to 2022 in Virginia.
  • Athletic trainers collected injury and athlete exposure (AE) data from middle school athletes in sex-comparable sports.
  • Outcomes included SRC injury rates (IR) per 1000 AE, injury rate ratios (IRRs) for sex and event-type differences, and injury mechanism proportions.

Main Results:

  • A total of 11,213 athletes contributed 329,269 AEs, with 97 SRCs diagnosed.
  • Girls exhibited over twice the overall SRC rate compared to boys (IRR, 2.26).
  • Higher SRC rates in girls were observed in softball/baseball, basketball, and soccer during both competition and practice, with no sex differences noted in track and field.

Conclusions:

  • Early adolescent girls participating in sex-comparable middle school sports have a significantly higher risk of SRCs compared to boys.
  • The observed sex difference in SRC rates among middle school athletes is greater than that reported in older populations.
  • These findings underscore the necessity for sex-specific, developmentally appropriate concussion prevention and clinical management strategies for young female athletes.