High Contact Sports Research Articles

Relation Between Repetitive Head Traumas and Academic Performance of Non-Concussed High School Athletes: A Comparison of High And Low Contact Sports

To assess the relation of repeated subconcussive head traumas and the academic performance and neuropsychological functioning of non-concussed high school athletes participating in high and low levels of contact sports.

379. Abstract For Comparison of Mandatory vs Non-Mandatory Compliance Rates For SARS-CoV-2 Testing in Grades K-12

BackgroundRapid testing to identify asymptomatically infected students with SARS-CoV-2 in elementary schools has been suggested as a possible method to reduce risk for in person instruction. As of August 3, 2020 (updated on January 25, 2021), California schools who obtained a waiver to conduct in-person instruction are not required to have mandatory testing for asymptomatic students, except for high contact sports which are required to undergo weekly testing. We explored the uptake of voluntary vs mandatory testing in a private waivered school. MethodsBetween the dates January 25, 2021 to April 16, 2021, the K-12 school superintendent sent an email to all parents outlining the voluntary testing program with a link to the on-line sign up and consent form. All students were offered weekly self-collected anterior nares BinaxNOW Rapid Antigen Test. Signed parental consent was required and tests were performed at the school. Students participating in contact sports were required to undergo testing the week a varsity game was played as a condition of participation. Data was gathered from the school administration and de-identified.ResultsK-5 Lower school had a school population of 448 students. Testing was offered on 8 weeks during the period of 2/15-2/19 to 4/5-4/9. 2 students (0.45%) receive screening on the week of 3/22-3/26. The other seven weeks when screening was offered 0 students received screening. 6-12 Upper school had a school population of 360 enrolled students. Testing was offered 3/8-3/12 and 3/15-3/19. The upper school had 22 students (6.11%) receive testing on the week of 3/8-3/12 and 21 students (5.83%) on the week of 3/15-3/19. Contact sports teams had 67 students on their roster. Weekly testing was offered from 3/22-3/26 to 4/12-4/16. Contact sports teams had 10 students (14.93%) receive testing on the week of 3/22-3/26, 33 students (52.24%) on the week of 4/5-4/9, and 32 students (49.25%) on the week of 4/12-4/16.Figure 1. Percent of students from each campus and sports team screened per week offered. ConclusionVoluntary SARS-CoV-2 screening was not a feasible approach for detection of asymptomatically infected individuals due to low uptake, however in the same school, mandatory testing had high uptake and would be a feasible strategy. Disclosures All Authors: No reported disclosures

A Randomized Controlled Trial of A Theory-Based Concussion Education Video for NCAA Division I Athletes

ABSTRACT A large body of research demonstrates that concussions are exceedingly common and extremely difficult to detect. Despite medical efforts to develop sophisticated tools to detect concussions, research continues to demonstrate that proper detection relies on prompt and thorough symptom reporting from the injured athlete. In the context of sports, such reporting requirements are complicated by systems that reward athletic performance. This study seeks to provide student athletes who play NCAA Division I high-contact sports with a theoretically driven intervention to improve their attitudes and behavior toward concussion reporting. Division I student athletes (N = 345) viewed one of three conditions: an NCAA handout consistent with current practices, the experimental video, or a non-treatment control video, then responded to questions regarding attitudes and behaviors toward concussion reporting. Overall, results support the video’s effectiveness in changing perceptions of concussion injuries. Nuances of the findings lead to a discussion for practical implications to transform concussion-reporting attitudes and behaviors among athletes.

The Personal Food Systems of Pre-Season NCAA Division 1 High-Contact, Low-Contact, and Non-Contact College Athletes.

Previous research indicates that dietary habits may differ between athletes of different sports. In this cross-sectional study, we hypothesize meal frequency, food choices, and food preferences will significantly differ between contact types. The participants were athletes (n = 92; men: n = 57, body fat percent (BF%): 14.8 ± 8.4%, body mass index (BMI): 25.5 ± 5.5 kg·m−2; women: n = 36, BF%: 26.7 ± 7.3%, BMI: 22.3 ± 2.7 kg·m−2) from high-contact (HCS), low-contact (LCS), and non-contact (NCS) sports. Meal frequency, food preference, and food choice questionnaires assessed factors influencing dietary habits. Dual-energy X-ray absorptiometry (DXA) measured lean body mass, fat mass, and body fat. A GLM multivariate analysis was used with significance accepted at p < 0.05. Significant body composition differences were observed between genders (p < 0.001) and among sports (p < 0.001). Dinner (83.7%), lunch (67.4%), and breakfast (55.4%) were the most frequently eaten meals, followed by evening snack (17.8%), afternoon snack (15.2%), and morning snack (8.7%). Greater preferences for starches were observed for HCS (p = 0.04; η2 = 0.07) and for a greater preference for vegetables was found for NCS (p = 0.02; η2 = 0.09). Significant differences also existed in the importance of health (p = 0.04; η2 = 0.07), weight control (p = 0.05; η2 = 0.11), natural content (p = 0.04; η2 = 0.07), and price (p = 0.04; η2 = 0.07). These results support our hypothesis that food choices and food preferences differ between contact types. This may help sports dieticians create more individualized nutrition programs.

High School Sports-Related Concussion and the Effect of a Jugular Vein Compression Collar: A Prospective Longitudinal Investigation of Neuroimaging and Neurofunctional Outcomes.

Sports-related concussion (SRC) can exert serious acute and long-term consequences on brain microstructure, function, and behavioral outcomes. We aimed to quantify the alterations in white matter (WM) microstructure and global network organization, and the decrements in behavioral and cognitive outcomes from pre-season to post-concussion in youth athletes who experienced SRC. We also aimed to evaluate whether wearing a jugular compression neck collar, a device designed to mitigate brain "slosh" injury, would mitigate the pre-season to post-concussion alterations in neuroimaging, behavioral, and cognitive outcomes. A total of 488 high school football and soccer athletes (14-18 years old) were prospectively enrolled and assigned to the non-collar group (n = 237) or the collar group (n = 251). The outcomes of the study were the pre-season to post-concussion neuroimaging, behavioral, and cognitive alterations. Forty-six participants (non-collar: n = 24; collar: n = 22) were diagnosed with a SRC during the season. Forty of these 46 athletes (non-collar: n = 20; collar: n = 20) completed neuroimaging assessment. Significant pre-season to post-concussion alterations in WM microstructural integrity and brain network organization were found in these athletes (corrected p < 0.05). The alterations were significantly reduced in collar-wearing athletes compared to non-collar-wearing athletes (corrected p < 0.05). Concussion and collar main effects were identified for some of the behavioral and cognitive outcomes, but no collar by SRC interaction effects were observed in any outcomes. In summary, young athletes exhibited significant WM microstructural and network organizational, and cognitive alterations following SRC. The use of the jugular vein compression collar showed promising evidence to reduce these alterations in high school contact sport athletes.

Neuroradiologic Evaluation of MRI in High-Contact Sports.

Background and Purpose: Athletes participating in high-contact sports experience repeated head trauma. Anatomical findings, such as a cavum septum pellucidum, prominent CSF spaces, and hippocampal volume reductions, have been observed in cases of mild traumatic brain injury. The extent to which these neuroanatomical findings are associated with high-contact sports is unknown. The purpose of this study was to determine whether there are subtle neuroanatomic differences between athletes participating in high-contact sports compared to low-contact athletic controls.Materials and Methods: We performed longitudinal structural brain MRI scans in 63 football (high-contact) and 34 volleyball (low-contact control) male collegiate athletes with up to 4 years of follow-up, evaluating a total of 315 MRI scans. Board-certified neuroradiologists performed semi-quantitative visual analysis of neuroanatomic findings, including: cavum septum pellucidum type and size, extent of perivascular spaces, prominence of CSF spaces, white matter hyperintensities, arterial spin labeling perfusion asymmetries, fractional anisotropy holes, and hippocampal size.Results: At baseline, cavum septum pellucidum length was greater in football compared to volleyball controls (p = 0.02). All other comparisons were statistically equivalent after multiple comparison correction. Within football at baseline, the following trends that did not survive multiple comparison correction were observed: more years of prior football exposure exhibited a trend toward more perivascular spaces (p = 0.03 uncorrected), and lower baseline Standardized Concussion Assessment Tool scores toward more perivascular spaces (p = 0.02 uncorrected) and a smaller right hippocampal size (p = 0.02 uncorrected).Conclusion: Head impacts in high-contact sport (football) athletes may be associated with increased cavum septum pellucidum length compared to low-contact sport (volleyball) athletic controls. Other investigated neuroradiology metrics were generally equivalent between sports.

Severe Acute Respiratory Syndrome Coronavirus 2 Transmission in a Georgia School District—United States, December 2020–January 2021

BackgroundTo inform prevention strategies, we assessed the extent of SARS-CoV-2 transmission and settings in which transmission occurred in a Georgia public school district.MethodsDuring December 1, 2020–January 22, 2021, SARS-CoV-2–infected index cases and their close contacts in schools were identified by school and public health officials. For in-school contacts, we assessed symptoms and offered SARS-CoV-2 RT-PCR testing; performed epidemiologic investigations and whole-genome sequencing to identify in-school transmission; and calculated secondary attack rate (SAR) by school setting (e.g., sports, elementary school classroom), index case role (i.e., staff, student), and index case symptomatic status.ResultsWe identified 86 index cases and 1,119 contacts, 688 (63.1%) of whom received testing. Fifty-nine (8.7%) of 679 contacts tested positive; 15 (17.4%) of 86 index cases resulted in ≥2 positive contacts. Among 55 persons testing positive with available symptom data, 31 (56.4%) were asymptomatic. Highest SAR were in indoor, high-contact sports settings (23.8%, 95% confidence interval [CI] 12.7, 33.3), staff meetings/lunches (18.2%, CI 4.5–31.8), and elementary school classrooms (9.5%, CI 6.5–12.5). SAR was higher for staff (13.1%, CI 9.0–17.2) versus student index cases (5.8%, CI 3.6–8.0) and for symptomatic (10.9%, CI 8.1–13.9) versus asymptomatic index cases (3.0%, CI 1.0–5.5).ConclusionsIndoor sports may pose a risk to the safe operation of in-person learning. Preventing infection in staff members, through measures that include COVID-19 vaccination, is critical to reducing in-school transmission. Because many positive contacts were asymptomatic, contact tracing should be paired with testing, regardless of symptoms.

The role of salivary vesicles as a potential inflammatory biomarker to detect traumatic brain injury in mixed martial artists

Traumatic brain injury (TBI) is of significant concern in the realm of high impact contact sports, including mixed martial arts (MMA). Extracellular vesicles (EVs) travel between the brain and oral cavity and may be isolated from salivary samples as a noninvasive biomarker of TBI. Salivary EVs may highlight acute neurocognitive or neuropathological changes, which may be particularly useful as a biomarker in high impact sports. Pre and post-fight samples of saliva were isolated from 8 MMA fighters and 7 from controls. Real-time PCR of salivary EVs was done using the TaqMan Human Inflammatory array. Gene expression profiles were compared pre-fight to post-fight as well as pre-fight to controls. Largest signals were noted for fighters sustaining a loss by technical knockout (higher impact mechanism of injury) or a full match culminating in referee decision (longer length of fight), while smaller signals were noted for fighters winning by joint or choke submission (lower impact mechanism as well as less time). A correlation was observed between absolute gene information signals and fight related markers of head injury severity. Gene expression was also significantly different in MMA fighters pre-fight compared to controls. Our findings suggest that salivary EVs as a potential biomarker in the acute period following head injury to identify injury severity and can help elucidate pathophysiological processes involved in TBI.

Mood Responses and Regulation Strategies Used During COVID-19 Among Boxers and Coaches.

The COVID-19 pandemic brought unprecedented changes to daily life and in the first wave in the UK, it led to a societal shutdown including playing sport and concern was placed for the mental health of athletes. Identifying mood states experienced in lockdown and self-regulating strategies is useful for the development of interventions to help mood management. Whilst this can be done on a general level, examination of sport-specific effects and the experience of athletes and coaches can help develop interventions grounded in real world experiences. The present study investigated perceived differences in mood states of boxers before and during COVID-19 isolation in the first lockdown among boxers. Boxing is an individual and high-contact sport where training tends to form a key aspect of their identity. Boxers develop close relationships with their coach and boxing. Hence boxers were vulnerable to experiencing negative mood, and support via the coach was potentially unavailable. Participants were 58 experienced participants (44 boxers, male n = 33, female n = 11; 14 boxing coaches, male n = 11, female n = 3). Boxers completed the Brunel Mood Scale to assess mood before COVID-19 using a retrospective approach and during COVID-19 using a “right now” time frame. Boxers responded to open-ended questions to capture mood regulation strategies used. Coaches responded to open ended questions to capture how they helped regulate boxer’s mood. MANOVA results indicated a large significant increase in the intensity of unpleasant moods (anger, confusion, depression, fatigue, and tension) and reduction in vigor during COVID-19 (d = 0.93). Using Lane and Terry (2000) conceptual framework, results showed participants reporting depressed mood also reported an extremely negative mood profile as hypothesized. Qualitative data indicated that effective mood-regulation strategies used included maintaining close coach-athlete contact and helping create a sense of making progress in training. When seen collectively, findings illustrate that mood state responses to COVID-19 were severe. It is suggested that that active self-regulation and self-care should be a feature of training programmes to aid coaches and boxers in regulating mood when faced with severe situational changes.

Sensation-Seeking and Impulsivity in Athletes with Sport-Related Concussion.

Sport-related concussion (SRC) is a significant public health problem. Understanding the behavioral and personal factors that influence risk and incidence of SRC is critically important for appropriate care and management. Sensation-seeking and impulsivity have been posited to be two such factors that may be significantly associated with SRC. We performed a focused review of recent evidence of the relationships between sensation-seeking and impulsivity in athletes with SRC. While the research is relatively limited, extant findings demonstrate a significant relationship between sensation-seeking and contact sport participation and risk of prior and future SRC. Impulsivity appears to be common among athletes competing in high contact sports and may contribute to neural and functional brain changes following SRC; however, causal relationships between impulsivity, contact sport participation, and SRC have not been demonstrated. Both sensation-seeking and impulsivity are significantly associated with SRC in collegiate athletes. Interventions designed to ameliorate high levels of these constructs may prove to be beneficial avenues to reducing SRC risk and improving patient care and outcomes.

Individual Baseline Balance Assessments in a Large Sample of Incoming NCAA Division I Athletes Using a Force Plate System

BACKGROUNDIndividualized baseline testing is resource and time intensive. The use of normative data to approximate changes after a suspected concussion is thus an appealing alternative. Yet, few peer-reviewed, large-sample studies are available from which to develop accurate normative averages of balance using force-plate technology.PURPOSEThis study sought to validate a normative dataset from the force-plate manufacturer and examine the magnitude and nature of sample variability.STUDY DESIGNCross-sectional.METHODSBaseline balance and self-reported sex, sport, and concussion history were assessed in 533 prospective collegiate athletes (45% female) during pre-participation physical examinations. Balance was measured using four stances from the modified Clinical Test of Sensory Interaction and Balance and quantified as Sway Index Scores with the Biodex Biosway Portable Balance System. Group averages are contrasted to data from the force-plate manufacturer. Individual variability around these averages was visualized and analyzed by sex and sport.RESULTSMale student athletes showed significantly more sway in the eyes open, soft stance condition than female athletes. These differences were maintained when concussion history was included as a covariate. Athletes, particularly male athletes, in the high versus low contact sport group showed significantly more sway in the eyes open, soft surface and the eyes closed, hard and soft surface stances.CONCLUSIONThere was substantial individual variability that was partially explained by sex differences and sport differences. The development of normative averages for sway may benefit from consideration of sex and sport. Further studies should characterize other factors that influence baseline balance in collegiate athletes.LEVEL OF EVIDENCE2b

Severe Suicidality in Athletes with Chronic Traumatic Encephalopathy: A Case Series and Overview on Putative Ethiopathogenetic Mechanisms

Chronic traumatic encephalopathy (CTE) results from repetitive brain injuries and is a common neurotraumatic sequela in contact sports. CTE is often accompanied by neuropsychiatric symptoms, which could escalate to suicidal ideation (SI) and suicidal behaviour (SB). Nevertheless, fairly limited emphasis about the association between suicidality and CTE exists in medical literature. Here, we report two cases of retired professional athletes in high contact sports (boxing and ice hockey) who have developed similar clinical trajectories characterized by progressive neuropsychiatric symptoms compatible with a CTE diagnosis and subsequent SB in its severe forms (medical serious suicide attempt (SA) and completed suicide). In addition to the description of outlining clinical, neuropsychological, neuroimaging, and differential diagnosis elements related to these cases, we also hypothesized some mechanisms that might augment the suicide risk in CTE. They include those related to neurobiological (neuroanatomic/neuroinflammatory) dysfunctions as well as those pertaining to psychiatry and psychosocial maladaptation to neurotraumas and retirement from professional competitive activity. Findings described here can provide clinical pictures to improve the identification of patients with CTE and also potential mechanistic insights to refine the knowledge of eventual severe SB development, which might enable its earlier prevention.

Incidence of concussions and injuries among quidditch players

Purpose: To evaluate the rates of concussion and injury in quidditch, a high-contact sport growing in worldwide participation. Methods: A systematic review of the MEDLINE database was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for all studies reporting on concussion and/or injury rates in quidditch epidemiology. Results: Five studies were identified that had been published in the last 15 years on the concussion and injury rates among quidditch players worldwide. Each of these five studies included a concussion analysis and two included overall epidemiological rates. Conclusions: Injury rates seen in the two studies were found to be lower than those seen in other high-contact sports. There is a need to further study concussion symptoms among this understudied population.

Marketing the use of headgear in high contact sports

High contact sports have gained popularity among consumers, who often seek thrills and the feeling of invincibility by risking their well-being. One major health risk associated with these sports is head injuries, including trauma, concussion, and sleep disruption. In this research, we investigate the effect of consumers’ product choice difficulty on their health risk assessments. We illustrate a novel mediating route by documenting how and when choice maximization can help consumers make the optimal choice when faced with the many products available in the market. To aid their decisions, consumers require communication about the health benefits of the product (first-stage boundary condition) but not at the expense of reducing their game-playing enjoyment (second-stage boundary condition). The paper concludes with contributions to and implications for theory and practice and a research agenda to guide future inquiries in this under-researched area.

Concussion Symptom Characteristics and Resolution in 20 United States High School Sports, 2013/14-2017/18 Academic Years.

High school (HS) sport-related concussions (SRCs) remain a public health concern in the United States. To describe patterns in symptom prevalence, symptom resolution time (SRT), and return-to-play time (RTP) for SRCs sustained in 20 HS sports during the 2013/14-2017/18 academic years. A convenience sample of athletic trainers reported concussion information to the HS RIOTM surveillance system. Symptom prevalence, average number of symptoms, and SRT and RTP distributions were examined and compared by event type (practice, competition), injury mechanism (person contact, nonperson contact), sex, and contact level (collision, high contact, and low contact) with chi-square tests and Wilcoxon rank-sum tests. Among all SRCs (n=9542), headache (94.5%), dizziness (73.8%), and difficulty concentrating (56.0%) were commonly reported symptoms. On average, 4.7±2.4 symptoms were reported per SRC. Overall, 51.3% had symptoms resolve in<7 d, yet only 7.9% had RTP<7 d. Differential prevalence of amnesia was seen between practice and competition-related SRCs (8.8% vs 13.0%; P<.001); nonperson-contact and person-contact SRCs (9.3% vs 12.7%; P<.001); and female and male SRCs in low-contact sports (5.8% vs 17.5%; P<.001). Differential prevalence of loss of consciousness was seen between practice and game-related SRCs (1.3% vs 3.2%; P<.001); and female and male SRCs in high contact sports (1.2% vs 4.0%; P<.001). Differential longer SRT (>21 d) was seen between new and recurrent SRCs (9.4% vs 15.9%; P<.001). Headache was the most commonly reported symptom. Notable group differences in the prevalence of amnesia, loss of consciousness, and SRT may be associated with more severe SRCs, warranting further attention.

Community organization factors affecting veteran participation in adaptive sports

Objective: This study aims to describe United States military veteran participation in adaptive sports and to assess the demographic make-up and organizational characteristics of existing adaptive sports programs. Design: Prospective, cross-sectional survey. Setting: Community organizations with adaptive sports programs. Participants: 85 adaptive sports programs. Interventions: Nine question survey. Outcome Measures: Demographic data and sports offered by adaptive sports programs in the United States. Results: The survey response rate was 70%. The median number of total participants in an organization was 75 and the median number of veterans was 50. 76% of organizations had some degree of affiliation with a VAMC. Organizations affiliated with a VAMC are more likely to be rehabilitation centers, whereas community organizations with no VAMC affiliation are most commonly independent organizations with no rehabilitation component. Individuals of all ages participate in adaptive sports, with increasing participation associated with increasing age. Golf was the sport offered most commonly by adaptive sports programs in this survey. Low-contact sports were offered more often than high-contact sports, and the majority of programs offered adaptive sports year-round. Conclusions: Our results suggest that U.S. Military veterans represent a large proportion of the individuals participating in adaptive sports. Further research specifically focusing on factors veterans find desirable when considering participating in adaptive sports is indicated to identify programs that should be promoted, developed, and funded to increase veteran participation in adaptive sports.

ACSM Call to Action Statement: COVID-19 Considerations for Sports and Physical Activity.

ACSM Call to Action Statement: COVID-19 Considerations for Sports and Physical Activity.

Head, Neck, and Traumatic Brain Injury Among Children Involved in Sports: Results From the Adolescent Brain Cognitive Development Study

PurposeThe purpose of this study was to assess the prevalence of head and neck injury (HNI) requiring hospitalization or emergency care and traumatic brain injury with loss of consciousness (TBI-LOC) among youth athletes and nonathletes (ages 9–10 years) using the baseline cohort of the Adolescent Brain Cognitive Development study. MethodsNational data from the baseline cohort of the Adolescent Brain Cognitive Development study (2016–2018; n = 11,869) were analyzed. ResultsThe analysis found that 12.1% of the sample indicated HNI during their lifetime, while .8% indicated TBI-LOC. Participation in multiple sports (adjusted prevalence rate ratio [aPRR] = 1.29, 95% confidence interval [CI] = 1.06,1.55), contact sports (aPRR = 1.19, 95% CI = 1.05,1.34), and who had participated in sport for five or more years (aPRR = 1.42, 95% CI =1.16,1.73) had modestly higher prevalence rate ratios of reporting HNI compared to nonparticipants. Sport participation was not found to be associated with TBI-LOC. ConclusionsThe study provides needed epidemiological information on the prevalence of HNI and TBI-LOC among younger adolescents who participate in sports. While the risk of TBI-LOC appears to be low among youth athletes and nonathletes, the risk of more serious head injuries may increase due to length of participation in sport and involvement in high contact sports.

A-14 Competitiveness and Past Nondisclosure Decreases Future Concussion Reporting Intention Among Males in High-Contact Sports

Abstract Objective With some variability, research indicates that a high percentage (20–60%) of athletes do not report post-concussion symptoms, despite having sufficient concussion knowledge. Our study examined whether competitiveness and past reporting predicted future reporting intention in males participating in high contact sports. Method Participants included 92 male athletes (M = 19.35 years, SD = 4.35) recruited from a mid-sized Canadian city participating in high contact sports (American football, rugby, or hockey). Competitiveness was measured using the Sport Orientation Questionnaire. The Rosenbaum Concussion Knowledge and Attitudes Survey-Student Version was used to assess concussion knowledge and nondisclosure. Logistic regression was conducted to predict future intention of playing despite experiencing post-concussion symptoms. Age, knowledge, competitiveness, sport, and past history of concussion nondisclosure were included as predictors. Results Age, sport, and concussion knowledge were not significant predictors. Competitiveness was a significant predictor for the model, such that higher competitiveness predicted less likelihood to report post-concussion symptoms. Our findings also suggest that athletes who have not disclosed a concussion in the past are more likely to have higher intention to continue to play with symptoms of a concussion in the future. Over half (54%) of the athletes reported past history of concussion nondisclosure. Conclusions Interventions focusing on increasing general concussion knowledge are not adequate to prevent symptom nondisclosure. The results suggest that highly competitive athletes or athletes with a past history of nondisclosure are most vulnerable to future nondisclosure. These findings could help improve future interventions by targeting athletes at high-risk of concussion nondisclosure.

A-46 Deconstructing Competitiveness: The Effect of Age on Athlete’s Desire to Succeed, Win, and Achieve Goals

Abstract Objective Our previous research indicated that athletes scoring high in competitiveness were less likely to report sports-related concussion symptoms and withdraw from the game. The present study examined whether athletes’ desire to succeed (competitiveness motive), win (win orientation), and achieve personal goals (goal orientation) were related to the age of players. Method Participants included 161 athletes, ages 14–32 (M = 17.6 years; 33.2% female), recruited from a mid-sized Canadian city participating in low (rowing), moderate (soccer) and high (hockey, rugby, football) contact sports. Confirmatory factor analysis was first used to evaluate the structure of the Sports Orientation Questionnaire. Then, using SEM, athletes’ competitiveness, goal orientation, and win orientation were predicted by age. Results High internal consistency was obtained within each factor (.84–.93). The model demonstrated suboptimal fit for this sample (CFI = .84; χ2f/df ratio = 2.02; RMSEA = .087; 90% CI: .077–.097). All factors were significantly related to age, indicating that athletes’ desire to succeed (competitiveness motive; β = .18, p = .009), achieve personal goals (goal orientation; β = .26, p = .007), and win (win orientation; β = .30, p = .000) increases with age. Conclusion The small positive association between age and competitiveness, win, and goal orientation indicates that older athletes are more competitive than younger athletes. Given that competitiveness predicts athletes’ intention to report a concussion, clinicians and coaches should pay particular attention to senior athletes who demonstrate high levels of general competitiveness and who are driven by the desire to win and achieve personal goals. Therefore, interventions targeting the barriers to reporting concussions should evaluate subco.