Nearly half of all traumatic brain injuries among children in Canada who needed to be taken to an emergency department are caused by ice hockey, researchers from St. Michael’s Hospital, Toronto, reported in the journal PLOS ONE.

Dr. Michael Cusimano and team, who claim that their study is the first-of-its-kind, gathered and examined data on the causes of sports-related brain injuries among Canadian children. They also identified which preventive measures could be implemented straight away to make children’s sports safer.

Lead author, Dr. Cusimano, a neurosurgeon, said:

“Unless we understand how children are getting hurt in sport, we can’t develop ways to prevent these serious injuries from happening. One would think that we know the reasons why kids are having brain injuries in sports, but until know, it was based mainly on anecdotes.”

Sports-related head injuries can have lingering effects on children. Researchers from the University of Oregon found that high school athletes who suffered concussion continued having problems focusing and switching tasks readily amid distractions two months after their injury.

In this latest study, the team looked at the records from The Canadian Hospitals Injury Reporting and Prevention Program, which included information on 13,000 children and teenagers who had sustained a sports-related brain injury between 1990 and 2009.

The authors categorized the young sportspeople’s injuries according to their ages, the type of sport they were practicing, when the injury occurred, and what caused it (a blow by another player, an object, etc.).

Below is a breakdown of the main sports that cause the majority of sports-related head injuries among Canadian children and teenagers:

Ice Hockey caused 44.3% of all sports-related injuries among Canadian children and teenagers. Most of the injuries (nearly 70%) affected children aged over ten years as a result of being hit into boards or player-to-player contact. It is not surprising that hockey – Canada’s national sport – causes so many head injuries, Dr. Cusimano added. “This shows that body contact is still an area where we need to make major inroads to preventing brain injuries. For example, enforcing existing rules and making more effective incentives and disincentives about checking from behind could make huge improvements.”

caused 44.3% of all sports-related injuries among Canadian children and teenagers. Most of the injuries (nearly 70%) affected children aged over ten years as a result of being hit into boards or player-to-player contact. Soccer accounted for 19% of all sports-related brain injuries. Most injuries affected children in the 10-14 and 15-19 age groups. In these two age groups, the most common cause of injury was being hit by another player, being kicked in the head, and head-to-head collisions. Among kids aged 5 to 9 years, traumatic brain injuries were more likely to be caused by striking a goal post or a surface, the researchers found. Dr. Cusimano said “There’s a really straightforward solution here. Padding the goal posts could have potentially prevented a large number of these brain injuries in young children.”

accounted for 19% of all sports-related brain injuries. Most injuries affected children in the 10-14 and 15-19 age groups. In these two age groups, the most common cause of injury was being hit by another player, being kicked in the head, and head-to-head collisions. Among kids aged 5 to 9 years, traumatic brain injuries were more likely to be caused by striking a goal post or a surface, the researchers found. Baseball , which caused 15.3% of all sports-related head injuries, was also found to affect a higher percentage of younger children. Forty-five percent of all serious head injuries in baseball affected children aged under nine years. Not being supervised by an adult, or standing too close to the batter or bat were the most common causes of injuries among childhood baseball players. Dr. Cusimano said “These results give us a very specific prevention message for kids under nine who play baseball: make helmets and supervision a mandatory. The younger the child, the more supervision they need when using things like bats and balls. Simple rules around not being close to the batter can be taught to children and adults.”

, which caused 15.3% of all sports-related head injuries, was also found to affect a higher percentage of younger children. Forty-five percent of all serious head injuries in baseball affected children aged under nine years. Football accounted for 12.9% of all injuries, most of which were caused by tackling. Tackling was the main cause of all rugby injuries. Rugby caused 5.6% of all sports-related head injuries.

accounted for 12.9% of all injuries, most of which were caused by tackling. Tackling was the main cause of all injuries. Rugby caused 5.6% of all sports-related head injuries. Basketball – accounted for 11.6% of all injuries, most of them caused by players elbowing each other. The risk of injuries grew as the players got older.

Dr. Cusimano concluded:

“There is a real opportunity for prevention here. Having educational programs, proper equipment, rules and other incentives that support a culture of safety in sports should be a mandate of parents, coaches, players, sports organizations, schools, sports sponsors, and other groups like governments.”

The study was funded by the Ontario Neurotrauma Foundation and the Canadian Institutes of Health Research.

The American Academy of Neurology, which released its first updated guidelines on evaluating and managing athletes with concussion in 15 years, informed that over one million Americans experience sports-related head injuries (concussions) annually.

Written by Christian Nordqvist