While education and awareness is growing, many athletes still do not report concussion.
There are up to 3.8 million concussions in sport in the US each year. But, these numbers are likely an underestimation because more than 50% of all concussions are not reported to an authority figure. We have the same problem in Canada.
If some of the world’s best and well-known athletes like Sidney Crosby, Dale Earnhardt Jr. and many others are openly talking about their concussions, then why do we still have this problem? Why don’t athletes report concussion?
In this blog post, we look at some of the reasons why athletes at every level may hide their symptoms or choose not to report concussion – suspected or diagnosed – to their coaches, parents, healthcare providers or other supervising adult.
The culture of sport and toughness
This is a big one. Particularly in high-risk, contact sports like football, hockey and rugby, the culture of toughness is ingrained. Playing through injuries is common. But, unlike a knee or shoulder problem, playing through a concussion can result in severe long-term impact, and potentially, death.
There have been several studies done on this topic. A recent study from the Journal of Athletic Training found that players did not want their coaches or teammates to think they are weak, or get mad at them.
In many sports, competition and toughness tend to go hand-in-hand. It’s up to parents, coaches and teachers to make sure this association stops at concussions. Afterall, a concussion is a brain injury.
Is concussion a serious injury?
Well, the answer is YES.
But, the belief among some athletes is that it’s not a serious injury, or they did not believe that their injury was serious enough. Ongoing education and awareness is helping to address this problem.
The brain is complex and every injury is different. Symptoms may appear immediately after injury, or they could take days to present. These signs can also be subtle, and often overlooked by loved ones or even doctors.
The reality is a concussion is a serious injury with the potential for long-term complications. That said, if it is recognized early and properly managed, most athletes can make a full recovery.
Concussion is not THAT bad
Stop it. We no longer grade or rate concussions. Each concussion case and approach to management should be unique and personalized, but a concussion is a concussion. It’s a brain injury. If you happen to get one, take it seriously. Take the right steps at the right time.
Maybe it was something else?
A concussion can have similar symptoms of other injuries. For example, headaches, dizziness and difficulty focusing are also symptoms of neck dysfunction – or whiplash. If there is a mechanism of injury – such as a big hit to the head or body – and at least one symptom, then a concussion should be suspected. Even if you think it’s whiplash, err on the side of caution.
Don’t want to let the team down
This one is very common, and relates to the culture of sport and toughness. Athletes build relationships with teammates and coaching staff on and off the field. They become friends and mentors. Athlete’s often don’t want to let these people down. If they get a concussion, they may feel they need to sacrifice their health for the good of the team.
The reality is you are not going to be of value to your team when you are not 100% healthy. Recent research demonstrates that athletes who attempt to stay in the game after concussion take up to 2 times longer to recover from their injury. This doesn’t help you or your team.
Don’t want to miss a practice or game
Any significant injury, including a concussion, will likely cause an athlete to miss games or practices. This can have psychological and emotional consequences. Again, they could feel like they’re letting their team down. On a personal level, they might have a fear of missing out. If someone considers a sport as the most important part of their life, then not being able to participate is a hard pill to swallow.
This is my only shot
Despite what some people believe, many athletes will not go pro. Whether it’s a first game or a championship game, athletes need to understand this reality. Sports may be life, but without good health – and a healthy brain – you can’t play sports. Health should be at the top of the list of priorities.
Dispelling common concussion myths and misperceptions
There are still lots of myths and beliefs about concussions that impact sport and whether or not athletes choose to report these injuries. Let’s make a few things clear:
- Stop calling a concussion a stinger
- A concussion is not just getting your bell rung, it’s a brain injury
- You don’t need to lose consciousness to have get a concussion
- Concussions can happen in ANY sport, not just football, rugby and hockey
We need MORE concussion education and awareness
A survey commissioned by the Public Health Agency of Canada found that about 50% of Canadians did not know about the seriousness of sport-related concussions. To make matters worse, more than half did not know where to find information on how to prevent and manage these injuries, and 60% could not recognize the symptoms!
So, this begs the question, do we really know more about concussions and concussion management? While there are some people that DO know more about these injuries, about half of Canadians still do not.
Whether you’re a player, on the bench or sidelines, or watching from the stands, we all have a role to play. We must continue our mission of education and awareness to close this gap!
Why is it so important to report concussion?
Concussion is a mild form of brain injury that causes a temporary disturbance in cells caused by acceleration or deceleration of the brain. If an injury is not identified, there is risk for additional and more complicated injuries to the brain, which can result in delayed recovery or even fatal outcomes.
Recognition is also important for treatment and rehabilitation. The faster an injured athlete gets properly assessed by a licensed healthcare practitioner with training in concussion, the faster they can start the recovery process. Early intervention of various therapies may improve recovery and help athletes safely return to sport.
That said, do not rush it! Take your time. Follow the guidance of your healthcare provider.
How to improve player safety and concussion recognition
Concussion education and awareness continues to grow, but together we must take action to help keep athletes safe. Here are some ideas:
- Provide your sport organization and parents with concussion information early AND often. Annual information packages at the beginning of the year are good, but not enough
- Provide information in different ways – courses, brochures, videos, presentations – people learn and consume information in different ways
- Keep up to date information based on the latest sources
- Have emergency contact information readily available for your athletes
- Make sure everyone knows the signs and symptoms of concussion
- Put removal from sport and return to sport protocols in place
- Create a concussion code of conduct that reduces risky behaviour
- Encourage athletes to inform authority figures about possible concussions
- Enforce the rules of the sport
- Get your team involved in engaging awareness campaigns like Team Up Speak Up
- Shift the culture of toughness, and reward hard work, dedication, teamwork and safety, not big hits
- Find a healthcare provider with training in concussion immediately after a possible injury
- If healthcare practitioners are not on the sideline, establish relationships with local clinics with training in concussion
- Use easy-to-use mobile technology to report and track concussion
Together, we can help to put awareness into action.
We help sports and schools to protect the health and safety of their athletes by developing or enhancing concussion management programs and policies. Learn about our educational and management programs for sports and schools.
 Concussions and Sports. Brainline.org. Available at Brainline.org
 High school boys fear looking ‘weak’ if they report concussions. Journal of Athletic Training. Available at Reuters.com
 R.J. Elbin, Alicia Sufrinko, Philip Schatz, Jon French, Luke Henry, Scott Burkhart, Michael W. Collins, Anthony P. Kontos. Pediatrics Sep 2016, 138 (3) e20160910; DOI: 10.1542/peds.2016-0910
 Canadians know little about the dangers of concussions, federal survey suggests. The Globe and Mail. July 2018. Available at Globeandmail.com
 Register-Mihalik, J. K., Guskiewicz, K. M., McLeod, T. C., 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), 645-53.
This information is designed to provide education and awareness. This article is not intended as a substitute for the medical advice of doctors and/or healthcare professionals. The reader should always consult their physician and/or healthcare providers in matters relating to their health, and in particular, with respect to any concussion and/or symptoms that may require diagnosis or medical attention.