Under-reporting Concussion

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Athletes under-report the signs or symptoms of concussion.

The most frequently cited reasons for not reporting concussion tend to be based on athletes knowledge and/or athlete commitment in their sport. Athletes cited:

  • a desire to play on
  • not wanting to let their team/club/coach down
  • that they were unaware that they had been concussed 
  • that they believed their symptoms were not important.

As a result athletes remain on the field, do not report their concussion, or symptoms and are subsequently at risk of further harm.

Athletes are found to have the worst attitudes towards concussion and tend to put the importance of the game ahead of their own welfare – a “win at all costs mentality”. Some athletes are even willing to put a team mates health at risk for the sake of an important game.

To challenge these behaviors, there is a need to understanding sporting norms, including under-reporting.

Did You Know?

Athletes who were removed from play immediately:

  • Returned to activity and play 3 days sooner than players who continued to play on, not coming off after an impact
  • Had less severe acute symptoms and their symptoms resolved sooner
  • Had 39% lower risk of recovery taking 14 days or greater
  • Had 47% lower risk of recovery taking 21 days or greater
Immediate Removal From Activity After Sport-Related Concussion Is Associated With Shorter Clinical Recovery and Less Severe Symptoms in Collegiate Student-Athletes B. M. Asken, R. M. Bauer, K. M. Guskiewicz, M. A. McCrea, J. D. Schmidt, C. C. Giza, et al. The American Journal of Sports Medicine 2018 Vol. 46 Issue 6 Pages 1465-1474
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Try This

Apply this to your setting

  • In your setting, identify the common reasons and factors for not reporting a concussion.
  • In your setting, identify the factors that would not hinder reporting of concussion.

  • How do/would you address the reasons you have identified that increase the risk of under reporting concussions in your setting?

SCENARIO:

Athlete H suffered a concussion and has a game in two hours. The athlete is still experiencing symptoms of concussion. However, athlete H knows that if the coach is told about the symptoms, the coach will not allow the athlete to play the game.

Discuss: e.g. I feel that Athlete H should tell the coach about the symptoms. Most players would feel that athlete H should tell the coach about the symptoms..

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Why athletes do not report concussion

I thought my coach would think I’m weak

I thought my teammates would think I’m weak

It was the end of the season; I didn’t want to miss a game

I thought my parents would be upset

didn’t know at the time it was a concussion

I didn’t want to let my team down

My team was going to the playoffs when it happened

I didn’t want to have to go to the doctor

I thought my coach would get mad

I didn’t want to lose playing time

I didn’t think it was serious