Young hockey players face pressure to hide concussions

Young teens who play hockey may feel pressure from their teammates, parents, and coaches to deny their concussion symptoms, which puts them at serious risk for re-injury, according to a recent Canadian study.

Players, others often didn't fully understand consequences such as risk of disability or death

Thomson Reuters Posted: Aug 05, 2016 11:00 AM EDT | Last Updated: August 5, 2016

Young teens who play hockey may feelpressure from their teammates, parents, and coaches to denytheir concussion symptoms, putting them at serious risk forre-injury, according to a recent study.

Sports are a major source of concussions in teens, andexperts agree that players should not return to sports whilestill experiencing concussion symptoms, the researchers write inthe Clinical Journal of Sports Medicine.

Players who do return to sports before fully healing fromconcussions can suffer serious consequences and possible deathfrom even minor subsequent head injuries, the researchers write.

"Teenage hockey players often do not report theirconcussion," said lead author Dr. Michael Cusimano, aneurosurgeon at St. Michael's Hospital in Toronto.

There are a variety of reasons for this, with players ofteninfluenced by parents, coaches and their peers, Cusimano toldReuters Health by email.

Coaches and parents need to have serious discussions aboutthis topic with their young athletes to make sure they know theimportance and need for rest and recovery.-StefanDuma

He and his colleagues conducted one-on-one interviews with38 youth hockey players and 23 other people who might have aninfluence on the way the young players behave, such as parentsand coaches.

They found that players and others often did not fullyunderstand the health risks of concussions, and peoplerarelymentioned the possibility of disability or death.

Counter hero culture

Many players and coaches did not recognize the symptoms ofconcussion and some players were unsure if they had gotten aconcussion in the past.

In addition, about half of parents, coaches, and trainersallowed players to return to the ice immediately after a headinjury without seeking medical attention.

There was also a "hero" culture, with teammates, parents,and coaches encouraging players to be "tough." In this culture,players who were injured too often might be viewed as "wimps,"the authors say.

Players also mentioned pressure from coaches who want to winat all costs as a motivator not to report injuries or symptoms.

Both players and coaches also experienced pressure fromparents, who may view hockey not just for fun, but as apotential profession for their child.

One third of interviewed parents reported witnessing coachesor other parents put pressure on players to perform.

Players were also motivated not to report symptoms becausethey did not want to miss games, and this was particularly truefor larger players. Many interviewees believed that largerplayers were at lower risk for injury and could safely return toplay more quickly.

Participants from hockey leagues that did not allow bodychecking tended to report fewer concussions on their teams thanleagues that allowed full body contact.

Stefan Duma, a professor at Virginia Tech in Blacksburg,Virginia who studies sport-related head injuries, noted by emailthat underreporting is an issue in all sports. He said risks runhigh without proper rest after an injury.

"The vast majority of concussions resolve within 7 to 10days without long-term consequences; however, there is strong

concern about having an athlete continue to play while injured,"said Duma, who was not involved in the study.

Cusimano said that while there are guidelines for when youthshould return to sports after an injury, this study suggests

that these rules are not enough to prevent kids from returningtoo early.

"Our findings strongly support the need formandatoryeducation of players, parents, and coaches to improve awarenessand recognition of concussion," Cusimano advised.

"Coaches and parents need to have serious discussions aboutthis topic with their young athletes to make sure they know theimportance and need for rest and recovery," Duma added.

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Factors Influencing the Underreporting of Concussion in Sports

Young hockey players face pressure to hide concussions

Players, others often didn't fully understand consequences such as risk of disability or death

Counter hero culture

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