Objective To assess the incidence of concussions among adolescent volleyball players in Canada.

Design Cross sectional survey.

Setting Online survey.

Participants In total, 663 registered Volleyball Canada members completed a national survey, with a response rate of 13.0%; web-based survey response rates rarely exceed 5%. The 452 (68.2%) female and 211 (31.8%) male responders had a mean age of 16.2 (95% CI: 16.1to 16.4) years with a range from 14 to 19 years.

Assessment of risk factors The type of environment: controlled non-competitive environment (practice or warm-up) versus competitive game play environment.

Outcome measures Whether the athletes sustained a concussion as defined by the 2012 Zurich Consensus.

Main results A total of 86 concussions were reported, of which 52 were in the previous 12 months, yielding a one-year cumulative incidence per 100 athletes of 7.1 (95% CI: 4.3 to 11.4) and 7.5 (95% CI: 5.4 to 10.3) for males and females, respectively. In total, 57.1% (95% CI: 46.2 to 67.5) of all concussions involved ball-to-head contact. Player-to-player contact and head-to-floor contact were less prevalent at 20.2% (95% CI: 12.8 to 30.4) and 15.5% (95% CI: 9.1 to 25.1) respectively. Practice environment accounted for 46.5% of all concussions while 38.4% occurred in game play. The remaining 15.1% occurred in warm-up. In total, 61.6% (95% CI: 50.2 to 71.7) of concussions occurred outside of free-flow competitive game play, in a more structured environment.

Conclusions There is a significant margin for injury prevention as a substantial proportion (61.6%) of concussions happening in a noncompetitive, controlled environment that may be amenable to change that would reduce the potential for such injury.

Competing interests The authors have no competing interest to state.