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The sport with the most concussions (hint: it's not football)
Although football gets all the bad press, it's only one way to get a concussion. Here are other sports with high rates of concussion and the reason a helmet may be your most important sports gear. - photo by Jennifer Graham
Although football gets all the bad press, it's not the cause of most concussions in the United States. Horseback riding is.

In its April edition, the journal Neurosurgical Focus reported that horseback-riding accidents were the chief cause of emergency-room visits for sports-related traumatic brain injuries.

Researchers analyzed ER visits between 2003 and 2012 in six categories: contact sports (such as football or soccer), roller sports, skiing/snowboarding, equestrian sports and aquatic sports.

While traumatic-brain injury was deemed mild in 86 percent of all cases, equestrians accounted for 45.2 percent of cases.

Next was interpersonal contact sports, with 20.3 percent; roller sports, 19 percent; skiing and snowboarding, 12 percent; and aquatic sports, 3.5 percent.

Traumatic-brain injury, or TBI, is a change in brain function because of a blow to the head. Its mildest form, which occurs in 70 to 90 percent of cases, is called a concussion.

Research has found that repeat concussions can be dangerous and even deadly, and may over time lead to chronic traumatic encephalopathy, or CTE. The story of how CTE was discovered among National Football League players was the subject of the 2015 film "Concussion" starring Will Smith.

"Brain injuries in professional athletes, however, represent only a small fraction of the overall incidence of TBI annually; the vast majority of these injuries occur in recreational athletes," the researchers said.

Young adults, in particular, appear to be especially at risk. People between the ages of 18 and 29 contributed disproportionately to the total of sports-related TBIs, accounting for 44 percent of all injuries, the report said.

Ironically, although aquatic sports caused the fewest injuries in the study, they accounted for the most complications and fatalities, most from jumping or diving into a pool.

Among cases that ended in death, roller sports were the second most deadly.

The researchers said the findings make clear the importance of educating recreational athletes about traumatic-brain injury and how helmets can help prevent it, especially in equestrian activities.

"One report found that, when normalized for hours of activity, horseback riding results in a higher rate of hospital admission than other high-risk activities such as motorcycle riding," the researchers said.

But they noted, "Rates of helmet use are 25 percent or lower across equestrian sports, despite the fact that helmets have been associated with as much as a 40-50 percent reduction in absolute risk for TBI."

The growing body of research on concussions has also shown the importance of rest after even a mild head injury. A study published in February showed that the brains of mice regrew damaged synapses after a week's rest, but not if they were injured every day, Ike Swetlitz reported in STAT.
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