Concussion reporting rates at
the conclusion of an intercollegiate athletic career

T, Burdette T, Joyner B, Buckley TA. Clinical Journal of Sports Medicine.

Take Home Message: Nearly
half of the collegiate athletes reported a recognized, unreported, or
unrecognized concussion injury. The unreported rate is lower then previous
reports; however, the potentially unrecognized concussion rate was high.

are many reasons why an athlete may not report his/her concussion (e.g., they want to be part of the game, don’t want to let
the team down,).
However, many athletes may not report their concussion because they simply do
not recognize that they sustained a concussion. Therefore, the purpose of this
study was to investigate the current reported, unreported, and potentially
unrecognized concussion rates among collegiate student-athletes who had
completed their collegiate athletic career. One hundred and sixty-one athletes
that finished their collegiate athletic career from 10 NCAA institutions from
an array of sports completed a novel 21-item questionnaire during their 2011 to
2012 academic year. The athletes answered questions about their reported
concussions, acknowledged unreported concussion, reasons for not reporting, and
potentially unrecognized concussions (e.g., have you ever been knocked out,
have you ever seen stars while playing, and have you ever lost your memory
while playing). Athletes from 15 different sports were included in this study.
Most of the athletes in this study played women’s soccer (19%), football (16%),
men’s soccer (16%), and track and field/cross country (14%).  Overall, 50% noted that they had at least 1
potential concussion whether it be reported, unreported, or unrecognized.
Thirty-four percent of the athletes indicated in the questionnaire that they had
a history of a concussion. The sports with the most self-reported history of a concussion
included women’s soccer (61%), men’s soccer (43%), and men’s football (24%). Of
the 54 athletes that reported a concussion history most (52%) stated that they
sustained 1 concussion and 22% reported a history of 3 or more concussions. Nearly
12% of the athletes recognized they sustained a concussion but did not report
it. The sports with the most unreported concussions were women’s soccer (24%), men’s
football (21%), field hockey (13%), and cheerleading (10%). Over a quarter (26%)
of the athletes did not recognize a potential concussion injury. The sports
with highest potentially unrecognized concussions were football (55%),
cheerleading (50%), and cross-country (28%). The most unrecognized concussion
symptoms were seeing stars, knocked out, and memory loss.

half of the athletes received a concussion during their collegiate career, and
22% reported 3 or more concussions. Though the unreported concussions rate (12%)
is lower than previous studies (30.5%) it represents a persistent minority
who may not appreciate the seriousness of a concussion injury and the possible deficits
later in life if a proper rest and treatment regimen is not implemented.  Of most concern is the alarming 26% of
athletes that did not recognize a potential concussion injury. It is also
interesting to note that the sports with the most unreported concussions were
women’s soccer. Previous research has stated that females report more
concussion injuries than their male counterparts in the similar sports, which
may be attributed to women being more honest. This is not the case in this
study. Additionally, football has been the target of much of the concussion
research; however, football has one of the highest rates of unreported
concussions and potentially unrecognized concussions. Another noteworthy point
is that concussions can occur in any sport and everyone needs concussion
education. Sports like cheerleading and cross-country may not receive proper
concussion education, which may be the reason they had high rates of reporting
potentially unrecognized concussions. This study highlights that we may need to
improve our current education strategies to raise awareness about signs and
symptoms as well as the importance of promptly reporting those symptoms.

Questions for Discussion:
How do you perform concussion education? Do you give concussion education to
teams with low incidence of concussions? Do you think concussion education is

by: Jane McDevitt, PhD
by: Jeffrey Driban, PhD, ATC, CSCS


Related Articles:

Meehan WP 3rd, Mannix RC, Oʼbrien MJ, & Collins MW (2013). The Prevalence of Undiagnosed Concussions in Athletes. Clinical Journal of Sport Medicine PMID: 23727697

Llewellyn T, Burdette GT, Joyner AB, & Buckley TA (2014). Concussion reporting rates at the conclusion of an intercollegiate athletic career. Clinical Journal of Sport Medicine, 24 (1), 76-9 PMID: 24157468