Physicians treating sports-related concussions (SRCs) are faced with the challenge of determining when an athlete is ready to return to practice/competition. This decision is particularly important due to threats of second-impact syndrome (Wetjen, Pichelmann, & Atkinson, 2010). However, a clinician’s decision can be difficult because athletes frequently underreport the extent of the injury and/or their symptoms (Kroshus et al., 2015). This behavior can be attributed to a myriad of intra and interpersonal reasons, including but not limited to: (1) perceived intensity of injury and/or symptoms to be less than serious; (2) lack of knowledge about concussions; (3) fear of losing position on team; (4) stubborn competitiveness characteristic of many athletes; (5) athletes’ view on what coaches would prefer they disclose; (6) as well as a fear of stigma for failing to “push through the pain,” a common expectation by spectators (Meier et al., 2015).
Knowledge and attitudes about concussions among coaches present additional dangers (Kroshus et al., 2015). Kroshus et al. surveyed 927 male and female coaches of NCAA Division I, II, and III contact sport programs (e.g., ice hockey). Male coaches of male teams and female coaches of female teams endorsed more negative attitudes about concussions (e.g., If a player sustains an impact that might be a concussion during a critical part of an important game, I think it’s ok if they choose to wait until after the game to talk to the sports medicine staff about their symptoms) than did male coaches of female teams (Kroshus et al., 2015). However, Kroshus and colleagues had only 4.1% response rate.
In 2010, the NCAA Executive Committee introduced a new concussion policy which included: (1) an annual educational requirement, (2) elimination of same-day return, (3) instant removal in game if concussion is suspected, and (4) clearance by a medical professional (Meier et al., 2015). As the population of NCAA athletes – across Divisions I, II, and III – continues to proliferate, so too will the need to augment concussion management and preventative strategies.
Abstract: Determinants of coach communication about concussion safety in US collegiate sport (2015)
Background Communication between coaches and athletes about concussion safety can reinforce or undermine a sport culture in which concussion under-reporting is often endemic.
Method This study tested a model in which self-reported coach communication about concussion safety was predicted by factors including concussion knowledge, attitudes and beliefs, sex of the coach, and sex of the team coached.
Participants were 997 coaches of contact and collision sports teams competing in National Collegiate Athletic Association Division I, II, or III.
Results Concussion attitudes and beliefs were the strongest predictors of communication, and the small effect of knowledge on communication was transmitted nearly entirely through its effect on attitudes and beliefs. Much of the variability in communication was attributable to the sex of
the coach and the sex of the team coached.
Conclusions These results serve as a starting point for the design of coach-targeted interventions that encourage communication about health and safety with athletes.
Citation: Kroshus, E., Baugh, C., Hawrilenko, M., & Daneshvar, D. (2015). Determinants of coach communication about concussion safety in US collegiate sport. Annals of Behavioral Medicine, 49(4),532-541.
Multimedia Sources on Sports-Related Concussions:
Sports-Related Concussions: A Primer for Football Officials
Dr. Brian Hainline, NCAA chief medical officer, provides an overview of what football officials should look for during a game to determine if an athlete has suffered a potential concussion.
Concussion Webcasts: Tools to Improve Your Patients’ Lives
From American Academy of Family Physicians:
To help improve the lives of our members' patients, AAFP has created a series of webinars addressing the impact of head injuries in sports. These webinars, which address different topics concerning concussions, are hosted by a panel of AAFP and other experts.
Kin450 Wiki – Neurophysiology. (2016). Concussions. Retrieved May 22, 2016, from https://kin450-neurophysiology.wikispaces.com/concussions
Meier, T., Brummel, B., Singh, R., Nerio, C., Polanski, D., & Bellgowan, P. (2015). The underreporting of self-reported symptoms following sports-related concussion. Journal of Science and Medicine in Sport / Sports Medicine Australia, 18(5), 507-11. Link:http://www.ncbi.nlm.nih.gov/pubmed/25150463
Sports Concussion Institute. (2016). Concussion Facts. Retrieved May 21, 2016, from http://www.concussiontreatment.com/concussionfacts.html
The National Collegiate Athletic Association. (2016). Concussion. Retrieved May 24, 2016, from http://www.ncaa.org/health-and-safety/medical-conditions/concussion
Wetjen, N., Pichelmann, M., & Atkinson, J. (2010). Second impact syndrome: Concussion and second injury brain complications.Journal of the American College of Surgeons, 211(4), 553-7. Link:http://www.journalacs.org/article/S1072-7515(10)00397-2/fulltext?mobileUi=0
Zuckerman, S., Kerr, Z., Yengo-Kahn, A., Wasserman, E., Covassin, T., & Solomon, G. (2015). Epidemiology of sports-related concussion in NCAA athletes from 2009-2010 to 2013-2014.American Journal of Sports Medicine, 43(11). Link:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987636