Epidemiological Characteristics of Sport-Related Concussions in Elite Winter Sport Athletes: A Cross-sectional Study From the Japan Institute of Sports Sciences
Kazumi Goto, Mika Hangai, Yusuke Nishida, Rika Shigemoto, Kohei NakajimaBackground:
Sports-related concussions represent a major concern in winter sports because of the high-speed environment and sport-specific injury mechanisms. Previous studies have relied on competition-based injury surveillance data, whereas the information on individual-level concussion history among elite winter sport athletes remains limited.
Purpose/Hypothesis:
To evaluate individual-level concussion history, including age at first concussion, across winter sport disciplines, hypothesizing a higher proportion and greater cumulative burden in freestyle skiing and snowboarding.
Study Design:
Cross-sectional study; Level of evidence, 2.
Methods:
This retrospective cross-sectional analysis included elite winter sport athletes aged ≥12 years who underwent periodic health evaluations at the Japan Institute of Sports Sciences between 2021 and 2024. Standardized periodic health evaluation questionnaires were used to assess physician-diagnosed concussion, self-reported concussion-like episodes without medical evaluation (concussion-like episodes), age at first concussion, number of concussions, and persistent symptoms. Descriptive statistics were calculated, and Spearman rank correlation coefficient was used to assess the association between the age at first concussion and number of concussions.
Results:
This study included a total of 735 athletes (mean ± SD age, 22.4 ± 5.1 years; 367 females), among which 277 athletes (37.7%) had a concussion-related history, including 222 with a diagnosed concussion (30.2%) and 112 with a concussion-like episode (15.2%). Diagnosed concussion history was most common in snowboarding (75.0%), particularly in halfpipe (85.7%), slopestyle/big air (76.9%), and snowboard cross (73.7%). Freestyle skiing disciplines also demonstrated a high concussion proportion, including halfpipe (80.0%), moguls (70.0%), and freeski slopestyle (66.7%). Age at the first concussion was negatively correlated with the number of concussions (rho = −0.42;
Conclusion:
Elite winter sport athletes, particularly those in snowboard and freestyle skiing disciplines, had frequent concussion histories and substantial cumulative concussion burden. Younger age at the first concussion was associated with a greater number of concussions. Monitoring cumulative concussion history among elite winter sport athletes is crucial in developing targeted prevention strategies.