Concussion reporting rates at the conclusion of an intercollegiate athletic career
Llwellyn 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.
There 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.
Nearly 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 improving?
Written by: Jane McDevitt, PhD
Reviewed by: Jeffrey Driban, PhD, ATC, CSCS
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