Why university athletes choose not to reveal their concussion symptoms during a practice or game
Delaney JS, Lamfookon C, Bloom GA, Al-Kashmiri A, and Correa JA. Clin J Sport Med. 2014. [Epub ahead of Print].
Take Home Message: Over 75% of surveyed collegiate athletes, who believed they sustained a concussion in the past year, reported not seeking proper medical attention for that concussion. The most common reason athletes reported not seeking proper medical attention was not believing the concussion was severe enough to warrant stopping the activity to seek out a medical professional.
Concussions are a common injury among athletes. While many concussions occur each year, many go unreported and undiagnosed. If clinicians could gain a better understanding of why athletes do not report, or underreport potential concussions, then clinicians may be able to better educate athletes on the importance of reporting concussion symptoms, which could lead to better concussion management. Therefore, Delaney and colleagues completed a retrospective survey study to identify why athletes who believe they had a concussion would not seek proper medical attention. The authors invited 469 Canadian Interuniveristy Sport athletes (football, ice hockey, basketball, soccer, and rugby) to complete an anonymous questionnaire. The questionnaire assessed demographic information, past diagnosed concussions, and other head injuries sustained. Participants were also asked about sporting activity and if the respondent believed they had sustained a concussions within the previous 12 months, if they sought treatment, and if not, why they chose not to seek medical treatment. The survey did not list or ask participants about specific concussion symptoms but instead only asked about self-diagnosed concussions. Overall, 92 (20%) of participants believed that they had suffered at least one concussion in the previous 12 months. Of the 92 participants who reported sustaining a concussion, 72 (78%) did not seek medical attention for their concussion during a game or practice at least once in the past year. The most common reason provided (55 athletes [60%]) for not seeking medical attention was “did not feel the concussion was serious/severe and felt you could still continue to play with little danger to yourself.”
Ultimately, these findings are of great interest to clinicians because underreporting or non-reporting of concussion is common in all sports and places the athlete at an elevated risk for more serious, debilitating injury. Understanding why athletes do not report their concussion is the first step in finding ways to better educate athletes on the importance of seeking medical attention following a suspected concussion. While the study in its current form is informative, many more questions need to be addressed. For example, it would be informative to know the participant’s knowledge of concussions or their symptoms. It would be interesting to see if more educated athletes could more easily identify concussion symptoms and understood the importance of reporting these symptoms. Perhaps if clinicians can understand how, and if the education of athletes allows them to better hide their symptoms, we can identify and set in place protocols to rely on more objective measurements and/or less widely known testing procedure to better identify athletes with concussions. In the meantime, this study highlights that we should talk to our athletes about the implications of concussions and the dangers of failing to report a possible concussion.
Questions for Discussion: How have you as a clinician, dealt with underreporting or non-reporting of concussions? Have you found any strategies particularly successful in identifying athletes with concussions?
Written by: Kyle Harris
Reviewed by: Jeffrey Driban
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