4 Reasons Why Athletes Under-Report Concussion Symptoms

In today’s contact sports, concussions are becoming more frequent and increasing in severity. Researchers estimate that 1.6 to 3.8 million concussions due to participation in sports and recreational activities are sustained annually (5). Why is the estimated range so large, you ask? Well, it has a lot to do with the fact that at the high school and collegiate levels many concussion symptoms are under-reported by athletes (1-5). As a masters student studying sport psychology at Boston University and a former collegiate athlete who sustained multiple concussions, I have great insight as to why this might be the case. Here are four reasons why athletes choose not to report their symptoms.

1. Fear of Losing Playing Time

In the competitive sport world, athletes work hard to earn their playing time and are not willing to risk losing that over a suspected concussion. Playing through the pain is weighed as a better option than potentially losing minutes in a game (3).

2. Lack of Medical Professionals Available

If the athlete does not physically see an athletic trainer at the moment of impact, or directly after, the athlete is less likely to report his/her symptoms (3).

3. Fear of Social Isolation

If an athlete has been injured in the past, he/she may have experienced some disconnect from the team. In an attempt to make sure the athlete maintains his/her role on the team, he/she might choose not to report any symptoms the next time around (3).

4. Fear of Letting Others Down

Athletes think that coaches, teammates, and/or parents expect them to stand up everytime they get knocked down. These perceptions of other people’s expectations of them can prevent them from reporting concussion symptoms (3).

Now what? How do we influence more athletes to report their concussion symptoms? How can we address all of these problems with one solution? It’s easy… through education. Educating athletes about concussions is an essential element of concussion management. However, it is not enough to just give them information pamphlets and send them on their ways. They need to not only have the knowledge, but understand the knowledge. They need to understand how it directly applies to them. Most importantly, they must understand the potential consequences of returning-to-sport too soon after sustaining the concussion. Educate your athletes and empower them with knowledge so that they can make the responsible decision (1-5).

References

(1) Kay, M. C., Welch, C. E., & McLeod, T. C. V. (2015). Positive and negative factors that influence concussion reporting among secondary-school athletes. Journal of Sport Rehabilitation, 24(2), 210-213. doi:10.1123/jsr.2013-0132

(2) Kroshus, E., Baugh, C. M., Stein, C. J., Austin, S. B., & Calzo, J. P. (2017). Concussion reporting, sex, and conformity to traditional gender norms in young adults. Journal of Adolescence, 54, 110-119. doi:https://doi-org.ezproxy.bu.edu/10.1016/j.adolescence.2016.11.002

(3) Kroshus, E., Garnett, B., Hawrilenko, M., Baugh, C. M., & Calzo, J. P. (2015). Concussion under-reporting and pressure from coaches, teammates, fans, and parents. Social Science and Medicine, 135, 66-75. doi:https://doi-org.ezproxy.bu.edu/10.1016/j.socscimed.2015.04.011

(4) Kroshus, E., Kubzansky, L. D., Goldman, R. E., & Austin, S. B. (2015). Norms, athletic identity, and concussion symptom under-reporting among male collegiate ice hockey players: A prospective cohort study. Annals Of Behavioral Medicine, 49(1), 95-103. doi:10.1007/s12160-014-9636-5

(5) Register-Mihalik, J. K., Guskiewicz, K. M., McLeod, T. C. V., Linnan, L. A., Mueller, F. O., & Marshall, S. W. (2013). Knowledge, attitude, and concussion-reporting behaviors among high school athletes: A preliminary study. Journal of Athletic Training, 48(5), 645–653. http://doi.org/10.4085/1062-6050-48.3.20

Note: Photo from http://www.abc.net.au/news/2015-11-06/abby-wambach-custom-black-and-white/6920022