Although the collision sports of football and boys' lacrosse had the highest number of concussions and football the highest concussion rate, concussion occurred in all other sports and was observed in girls' sports at rates similar to or higher than those of boys' sports. The increase over time in all sports may reflect actual increased occurrence or greater coding sensitivity with widely disseminated guidance on concussion detection and treatment. The high-participation collision sports of football and boys' lacrosse warrant continued vigilance, but the findings suggest that focus on concussion detection, treatment, and prevention should not be limited to those sports traditionally associated with concussion risk.

Background Muscle strains are one of the most common injuries treated by physicians. Standard conservative therapy for acute muscle strains usually involves short-term rest, ice, and non-steroidal anti-inflammatory medications, but there is no clear consensus on how to accelerate recovery. Hypothesis Local delivery of platelet-rich plasma (PRP) to injured muscles hastens recovery of function. Study Design Controlled laboratory study. We used an established animal model of injury to test the effects of autologous platelet-rich plasma PRP on recovery of contractile function. Methods In vivo, the tibialis anterior muscles (TA) of anesthetized Sprague-Dawley rats were injured by a single (large strain) lengthening contraction or multiple (small strain) lengthening contractions, both of which result in a significant injury. The TA was injected with either PRP, PPP (platelet-poor plasma, as a sham treatment), or received no treatment. Results Both injury protocols yield a similar loss of force. The PRP only had a beneficial effect at one time point after the single contraction injury protocol. However, PRP had a beneficial effect at several time points after the multiple contraction injury protocol, and resulted in a faster recovery time to full contractile function. The sham injections had no effect compared to no treatment. Conclusion Local delivery of PRP can shorten recovery time after a muscle strain injury. Recovery of muscle from the high repetition protocol has already been shown to require myogenesis, whereas recovery from a single strain does not. This difference in mechanism of recovery may explain why PRP was more effective in the high repetition protocol, as PRP is rich in growth factors that can stimulate myogenesis. Since autologous blood products are safe, PRP may be a useful product to use in clinical treatment of muscle injuries.

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The overall injury rates for boys' and girls' high school lacrosse were significantly lower than those for collegiate play. Significant differences existed between adolescent boys and girls with respect to injury mechanisms, body parts injured, and player and team activity at the time of injury.