Migraine Twice as Prevalent Among High School Football Players

Migraines were nearly twice as prevalent in HS football populations than the general public.

In a survey of nearly 75 high school football players, more than one-third reported having a history of migraine, a rate twice that of the estimated prevalence in the general population. The study results were presented at the American Headache Society Annual Scientific Meeting in Washington, D.C.

Tad D. Seifert, MD, of Norton Healthcare in Louisville, KY, and colleagues conducted the retrospective cross-sectional survey to ascertain the self-reported prevalence of headache types in high-school aged (14-18 years) American football players.

“Despite a wealth of studies exploring the epidemiology of headache in the layperson, little is known about the prevalence and nature of headaches in high school student athletes,” Seifert told Neurology Advisor. “These scenarios are challenging in the [return-to-play] context, as it is often unclear whether an athlete has an exacerbation of a primary headache disorder, new onset headache unrelated to trauma, or has suffered a genuine concussive injury.”

The final analysis included 74 football players from six Louisville area high schools. Players were asked 20 questions, which assessed personal and family history of headache and concussion history.

In all, 33.8% of football players reported having a history of migraine compared with a 16.2% estimated prevalence of migraine/probable migraine in the general population.

“Whether this increased prevalence is due to increased awareness of headache disorders, a consequence of contact exposure or a predisposition for migraine development after concussion remains unclear,” Seifert said.

Additionally, 37.5% of participants reported a history of previous concussion, of whom 40.7% had a history of migraine. Among those with a history of multiple concussions (29.6%), 50% had a history of migraine.

Seifert said the nonspecific nature of headaches provides unique challenges to headache specialists and sports medicine physicians alike. 

“Any primary headache type can also occur in the setting of contact and/or collision sports and does not necessarily represent concussion sequelae,” he said. “Clinicians must be aware of these unique presentations so that a correct diagnosis can be made and effective treatment instituted.”

Seifert added that increased awareness by medical staff and athletes alike on migraine will help limit associated dysfunction and time away from sport participation. 

“A comprehensive preseason evaluation that reviews personal headache history, family history of headache, and documentation of previous head trauma is recommended to aid medical staff in the diagnosis and management of future headache complaints,” he said.


  1. Seifert TD et al. Abstract 90860. Presented at: American Headache Society Annual Scientific Meeting 2015; June 18-21, 2015; Washington, D.C.