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Contact sports such as football, hockey, soccer and wrestling are far more dangerous than other activities.

Nobody would be foolish enough to argue that point.

Except, perhaps, your reporter.

The most dreaded injuries in sport today are concussion and ACL tear.

As far as concussions among children are concerned, though — contrary to generally accepted opinion — the majority occur outside contact sports. This is the conclusion offered by a comprehensive study published earlier this month in the Journal of Pediatrics.

According to the research, only 40 percent of concussions happen during contact sports. The remainder take place in limited- or non-contact sports, recreational activities, motor vehicle accidents, activities of daily living and violent incidents.

Physicians and scientists at Children’s Hospital of Philadelphia and the Centers for Disease Control in Atlanta analyzed data gathered between 2012 and 2014 at CHOP. They were particularly concerned after determining a similar majority (58 percent) of victims did not receive medical care for their injuries until two days or more after the injury.

"It's important to remember that life concussions can also have a big impact on return to activities, similar to sports concussion, and should receive as much attention and active management as sports concussion," said lead study author Christina Master, MD in Medscape Medical News. Master is a pediatrician at CHOP, specializing in sports medicine.

“Lessons learned from treating sports-related concussions are easily applicable to children who have suffered concussions outside sports, especially in terms of managing a return to school, ” said athletic trainer Mary Spina, the supervisor of the Concussion Clinic at Community Hospital in Munster.

As reported in this space recently, concussion has been implicated as a risk factor for ACL injuries.

Contact sports again would seem to be the most likely culprit and, for this injury, such an assumption is more accurate than the one made regarding concussions.

Nonetheless, keep in mind the fact that in those contact sports, only 30 percent of ACL tears are the result of contact. The other 70 percent, are “self-inflicted,” caused by an awkward landing, sudden stop, or sudden change in direction. The foot catches, balance is lost, and the knee shifts and/or bends in an unnatural direction.

As for the most dangerous sports, the one with the highest risk of ACL injury is women’s soccer, not football. Football isn’t even second, also being surpassed by women’s basketball.

So says data gathered at CHOP by Theodore Ganley, MD, the director of the Center for Sports Medicine and Performance there.

Ganley is particularly concerned about what he has found among teenage girls playing soccer, advising that parents should consider other sports for their daughters at least part of the year.

“Basically, there are two ways we can ensure a child will not sustain an ACL injury,” said Ganley in an interview published online by Medscape last week. “One is to let them watch television and never leave the house, but that's not a good idea. The other is to steer kids toward such sports as crew, golf, swimming, and biking, in which risk for these injuries is quite low. That is obviously not going to work for everyone.“

What does work for most everyone is an ACL injury prevention program. Followed religiously, for 20 minutes, two-three times per week, such programs bring the injury rate among girls down to the much lower rate experienced by boys.

John Doherty is a licensed athletic trainer and physical therapist. This column reflects solely his opinion. Reach him at jdoherty@comhs.org. Follow him on Twitter @JDohertyATCPT.

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