High school athletes at higher elevations experience 31% fewer concussions than athletes closer to sea level, and the difference may have something to do with the "tight fit" created inside the skull when altitude increases intracranial pressure.
A recent study published in the Orthopaedic Journal of Sports Medicine looked at nearly 6,000 high school athlete concussions from across the US by examining data collected between 2005–2006 and 2011–2012 through the National High School Sports-Related Injury Surveillance System. After dividing incidents by the altitude at which they occurred, researchers found a strong correlation between lower concussion rates and higher elevations, with athletes playing at over 600 feet experiencing fewer concussions in both competition and practice settings.
Researchers pointed to several factors that could contribute to the differences, but stated that what seems to happen is that higher altitudes reduce intracranial compliance—essentially, the amount of give that allows the slosh effect associated with concussions—and create a situation "similar to having an airbag deploy or 'bubble wrap' inflate and thus prevent damage to structures within a container."
The study's authors call for more research in the relationship between altitude, intracranial pressure, and concussion, and point to recent studies that reduced brain injury in rats by as much as 83% through altering brain fluid dynamics. They wrote that "future research is warranted to test the hypothesis that mitigating slosh in the human cranium via mild jugular vein compression will reduce or diminish severity of concussion."
APTA believes that concussion should be managed and evaluated by a multidisciplinary team of licensed health care providers that includes a PT. The association has developed policy resources at both state and federal levels, while practice-focused online concussion resources include a series of podcasts, a PT's guide to concussions, and online learning opportunities on when to return to sport and managing concussions with an interprofessional team. Members can also access evidence-based practice research through the PTNow webpage.
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