May 23, 2014
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High school athletes resist reporting concussions during games

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High school athletes were reluctant to report concussion symptoms to coaches, according to results of this study, and team coaches have difficulty recognizing the symptoms of concussions in their athletes despite mandated concussion education.

Better methods of identifying concussions and a changed culture in high school athletics, among athletes, as well as coaches, may help reduce concussion rates in this setting, according to the study by Frederick P. Rivara, MD, MPH, of Seattle, and colleagues.

“In addition, attitudes of athletes regarding the reporting of concussive symptoms are a major barrier to the proper care of players with concussions, and a change in these attitudes will not be accomplished through legislation alone, although legislation can reinforce voluntary educational efforts. It will likely require a change in the culture of a team; the attitude of athletic staff, athletes, and parents; and educational interventions that are effective in underscoring the reasons for reporting,” Rivara and colleagues wrote.

The study the investigators conducted included 20 high schools’ football and girls soccer team athletes in Washington State the fall season of 2012 and 778 athletes, in all. The rate of concussion in the study was 3.6 per 1,000 athlete-exposures; 11.6% of girl soccer participants received concussions during that period compared to 10.4% of football players.

Sixty-nine percent of athletes reported playing through concussion symptoms and 40% percent of them reported their coaches didn’t know about their symptoms.

“Further interventions to improve the recognition, reporting, and management of concussions are needed, and these should be tested with rigorous research designs. All these interventions may require time to ensure that the change in culture is fully embraced by the next, as well as current, generation of student athletes, their coaches, and their parents,” Rivara and colleagues wrote.

Disclosure: The study was supported by the Public Health Law Research Program of the Robert Wood Johnson Foundation. The grant went to the University of Washington and not to any of the individual authors.