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
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
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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Delaney, J., Lamfookon, C., Bloom, G., Al-Kashmiri, A., & Correa, J. (2014). Why University Athletes Choose Not to Reveal Their Concussion Symptoms During a Practice or Game Clinical Journal of Sport Medicine DOI: 10.1097/JSM.0000000000000112