Head Acceleration Events Sustained During High School Wrestling Matches: Grappling With Differences Between Male and Female Adolescents

Wrestling is a popular high school sport despite high injury and concussion rates. Instrumented mouthguards can reliably measure head acceleration events (HAEs) accrued by wrestlers and may highlight potential sex differences; important considering the higher concussion rates among female athletes. The purpose of this study was to measure HAEs accrued in high school wrestling matches and compare frequency, magnitude, and head impact location between female and male wrestlers. Forty-five (16.5 [0.8] y) wrestlers (20 females; 25 males) wore instrumented mouthguards during high school matches. A total of 2843 (857 females; 1986 males) HAEs above an 8g trigger threshold from 452 player-matches were video verified. Results indicate that males accrue 30% higher HAE count per match (mean frequency = 6.9 HAEs/match) compared to females (mean frequency = 5.3 HAEs/match) (IRR = 1.297; 95% confidence interval, 1.051-1.594). Results also show females and males have similar HAE biomechanics including peak linear acceleration, angular velocity and acceleration, change in angular velocity in all planes, and impulse duration. Finally, females accrue 50% more head impacts high and to the right side of the head than males (IRR = 1.499; 95% confidence interval, 1.053-2.137). Higher HAE match counts for male wrestlers and varied impact locations highlight varied wrestling HAE mechanisms for female and male adolescent wrestlers and potential sex-specific HAE and concussion prevention strategies.