Incidence of Concussion in a Cadet and Junior National Wrestling Tournament from 2013 to 2025

OBJECTIVE: Examining sport-related concussion (SRC) epidemiology in large national tournament settings can provide insights beyond traditional high school and collegiate settings, informing prevention and management strategies. To determine the epidemiology of SRC within a single large Cadet and Junior National Tournament spanning 2013 to 2025, excluding years affected by the COVID-19 pandemic (2020-2022). DESIGN: Secondary analysis of existing medical records. SETTING: Large annual wrestling tournament. PATIENTS OR PARTICIPANTS: Athletes ages 13 to 18 competing in boys' freestyle and Greco-Roman, and girls' freestyle divisions, representing 49 states and Puerto Rico. INTERVENTIONS OR ASSESSMENT OF RISK FACTORS OR INDEPENDENT VARIABLES: Annual clinical incidence. MAIN OUTCOME MEASURES: Medical professionals recorded total number of participating athletes, SRCs, matches. SRC clinical incidence was computed per 100 athletes and per 100 matches. Each incidence interval includes the effect estimate and 95% confidence intervals (CI). RESULTS: In total, 58 535 participating wrestlers and 495 diagnosed SRCs yielded an overall clinical incidence of 0.85 per 100 athletes (95% CI: 0.77-0.92), and 0.42 (95% CI: 0.38-0.46) per 100 matches. A total of 80 (16.2%) SRCs were reported among girls. Clinical incidence was lowest in 2025 (0.50, 95% CI: 0.36-0.67) and highest in 2015 (1.31, 95% CI: 1.00-1.68). CONCLUSIONS: This study represents a comprehensive evaluation of SRCs among boys and girls participating in one of the largest Cadet and Junior National Wrestling Tournament in the United States, with results demonstrate an overall low and declining clinical incidence of SRC. Continued longitudinal surveillance and evidence-based prevention strategies are warranted to sustain and further this positive trend in youth wrestling, as well as examining female SRC incidence in wrestlers.