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As research continues to explore the relationship between collision sports and brain injury, a new study suggests college football players suffer more concussions during practices than in actual games. 

Published in the Journal JAMA Neurology, the study reviewed data from collegiate football programs enrolled in the Concussion Assessment, Research, and Education (CARE) Consortium. Data was collected from 658 football players during the years 2015 to 2019. 

Collision sports are those like football, hockey, soccer, baseball and other sports whereby players may experience concussive force during the course of play. Traumatic brain injury (TBI) occurs when the brain suffers insult from blunt force trauma or forces that act on the brain—such as the movement and sudden stop of a car accident—or a player who is tackled to the ground. Concussion is a common brain injury, sometimes difficult to detect and even harder to treat. 

In the recent JAMA study, researchers sought to understand head impact exposure (HIE). HIE studies of professional players in the National Football League (NFL), suggest less than seven percent of concussions suffered by players occur during practice sessions. In contrast, the JAMA research found that 72 percent of concussions suffered over five football seasons occurred during practice sessions. 

An editorial to the JAMA study written by researchers unaffiliated with the study notes “Concussions in games are inevitable, but concussions in practice are preventable. Practices are controlled situations where coaches have almost complete authority over the H.I.E. risks taken by players.”

The research suggests action is needed to protect the brains of collegiate-level football players. By extension, the study suggests higher concussion rates could have long-term physical impacts for patients down the line. Recently, a panel of experts endorsed a set of diagnostic criteria for traumatic encephalopathy syndrome (TES), the disorder that underpins chronic traumatic encephalopathy (CTE). 

The research also revealed differences in the head impact exposure among teammates, including those who play the same positions. An earlier study from the American Academy of Neurology, published in the journal Neurology, looked at positions played in football and hockey and was unable to find an association between the position played and risk for developing a neurodegenerative disorder like CTE. 

While the NFL continues to try and manage compensation to football players left with disabilities linked to their time on the field, the NCAA has not yet created or enforced rules that could keep the brains of young players from less trauma during practice sessions. With rule-making or the outcome of concussive impacts on the brain, time will tell. 

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