Sports-related concussions are a huge concern in all levels of sports, especially in high school athletes. It has been estimated that over 300,000 concussions occur in high school athletes each year. According to the Head Case Company, “football accounts for forty-seven percent of all diagnosed/reported sports-related concussions, with thirty-three percent occurring during practice” (Head Case Company). While football has the highest risk for concussions, girl’s soccer accounts for about thirty-three percent, as does girls’ softball. Contrary to popular belief, the loss of consciousness is not a necessity to be considered a concussion; nor are headaches and dizziness the only symptoms. The severity of concussions is being overlooked as people are oblivious to the effects that is has both in the short-term and long-term. The lack of education of students and coaches on the symptoms and effects of a concussion leads to short and long term complications both on the field and in their personal lives. 

Growing up, I was an energetic, athletic child who loved playing sports. Whether it was spring/fall softball, summer league swim, or polar bear club lacrosse, I always had enormous amounts of adrenaline and a competitive nature. Sooner or later, I quit both swimming and lacrosse to focus on travel softball. In the twelve years I played softball, I was my team’s catcher for ten years. It was my favorite position for many reasons, but for the predominant point being that I was involved in every pitch. Looking back now, I can recall the numerous occasions in which I was hit in the head and “shook it off.” To my recollection, they were not that “severe” as none of them resulted in a loss of consciousness and I resumed playing. Because of this, I never took into consideration the likelihood of those head impacts resulting in a possible concussion. Once diagnosed with my first concussion, I became intrigued in society’s interest and awareness of this issue. 

As stated by the Centers for Disease Control and Prevention [CDC], a concussion is “a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth.” A brain injury is defined as a concussion when it results in the change of one’s mental status. Such change can include amnesia, blurred vision, confusion, mental fogginess, nausea, vomiting, or loss of consciousness. There is a common misconception that, “a person will become unconscious during a mild concussion” (Abbott Company), however it is not an indicator of the injury’s severity. The stigmas and misconceptions related to concussions are the repercussions of the lack of education in this issue. 

“One of the main factors responsible for athletes not reporting their injury to an appropriate health care professional is a lack of knowledge about the signs, symptoms, and consequences of concussions” (Cournoyer and Tripp). A research study, authored by Janie Cournoyer and Brady L. Tripp, suggests that many high school athletes lack the education and knowledge of concussions. Out of the 334 varsity football players that were questioned in the survey, the athlete’s average age was 16.3 years and had an average of 2.1 years of experience in high school football. Fifty-four percent of the athletes said that they received concussion education from their parents, while sixty percent received it online or in class. However, twenty-five percent admitted to never receiving any information on concussion education. The survey consisted of a questionnaire that specifically focused on concussion education, outcomes, and symptoms. Out of all possible symptoms, only three obvious ones were identified. These players were not aware of symptoms including nausea, vomiting, neck pain, difficulty concentrating, or behavioral changes. If an athlete did experience nausea or vomiting during play time, one could look at is as heat exhaustion and not a state of concussion. These results are terrifying being that football has the highest risk for concussions. With that said, these athletes know the game well, but that does not mean they know the risks they take. 

Regardless of an athlete’s knowledge on short-term complications, their lack of knowledge about long-term complications can be a deciding factor on whether or not they seek medical attention after a concussion occurs. The repercussions of a severe injury like this can consist of problematic issues that are long-term. These effects can include vision problems, memory deterioration, impaired balance, loss of coordination, persistent headaches and other issues regarding cognitive functions. Unfortunately, concussions can lead to disorders such as early-onset Alzheimer’s disease, Parkinson’s disease, and multiple anxiety disorders. While these are serious occurrences, there are two more notable complications: Second Impact Syndrome and Chronic Traumatic Encephalopathy. Educating athletes at this age will give them an insight into the severity of the issue at hand. If players have the knowledge on long-term effects, the concern for themselves will influence the overall impact that this injury could have on them. If in the moment, a traumatic brain injury has occurred, an athlete is more likely to think twice about whether or not they will seek help due to what they know and how the possible concussion can affect them. Without the education on long-term effects, athletes are prone to Second Impact Syndrome which then leads to an increase in risk for Chronic Traumatic Encephalopathy. 

Second Impact Syndrome occurs when a person who is recovering from an initial concussion sustains a subsequent concussive injury, resulting in diffuse brain swelling and severe, permanent, neurological dysfunction or death. Once an athlete has suffered an initial concussion, their chances for occurrence of another is “three to six times greater than an athlete who was never” (Prevacus). In a September 2008 football practice, Jaquan Waller hit a middle linebacker head-on. Once he came off the field, he complained of headaches and balance issues. The team trainer, who was only trained for CPR and First Aid, checked him and sent him home with no further instructions to seek medical attention. That Friday night, about forty-eight hours after suffering the undiagnosed concussion, Waller took the field for the game. One play resulted in what is described as, “a relatively, low, intensity hit” (Gupta) and it was obvious to everyone in attendance that something was wrong. Once Waller walked to the sidelines, dazed and confused, where he began to foam out of the mouth and later collapse. Emergency Medical Services arrived about ten minutes after and at this point Waller was unconscious. Sadly, after nearly seventy-two hours of this first undiagnosed concussion that had taken place in practice, Jaquan Waller died due to the severe swelling of his brain. If Jaquan, his teammates, the trainers, coaches and anyone else surrounding him knew the facts about concussions, there is a possibility he would still be here today. 

Another long-term complication is the diagnosis of Chronic Traumatic Encephalopathy, also known as CTE, which is the progressive degenerative disease of the brain found in athletes with a history of repetitive brain trauma. The brain degeneration accumulated here is associated with memory loss, confusion, impulse control problems, aggression, depression, and eventually dementia. These changes in the brain can begin months, years, or even decades after the last brain trauma. CTE can only be diagnosed in an autopsy but it is found to be most common in contact sports. In April 2010, Owen Thomas, a football player from the University of Pennsylvania, committed suicide after those surrounding him have described as a sudden and uncharacteristic emotional collapse. Boston University doctors received permission from Thomas’s family to examine his brain tissue which led them to the discovery of early stages of CTE. The concerning problem here is that Thomas has never been diagnosed with any concussions, nor complained of any headaches. While his parents said there were no apparent signs, Owen Thomas was the type of player who would ignore symptoms in order to stay on the field. With that said, his CTE must have “developed from concussions he dismissed from the thousands of sub concussive collisions he withstood in his dozen years of football, most of them while his brain was developing” (Schwarz). Perhaps any of the hits that occurred in high school were concussions and if he was knowledgeable they could have been addressed. These complications, and the stories that relate to them, prove that the little education one has on concussions, the higher the risk for severe consequences later down the road. 

While stressing the point that athletes need to know more about concussions, one can argue that educating players does not guarantee that an athlete will admit to such problems. An athlete can attend multiple informational meetings, take numerous educational classes, and know everything they need to know about concussions; however, it is what they do with it all that will determine if it makes it effective for them or not. Martin Fishbein and Icek Ajezen developed the Theory of Reasoned Action [TRA] which states, “two predictors of a person’s intention are attitude toward the behavior and subjective norms” (Taylor and Sanner 74). After obtaining concussion knowledge, an athlete will report any concussion symptoms only after considering how those surround him/her will view them. Research has found that an athlete’s favorable attitude toward reporting any symptoms and beliefs of their peers had the greatest impact on the player’s intentions of reporting symptoms. It is in part the athlete’s responsibility to notify his coach or other teammates if he/she feels any possible concussion like symptoms, or simply just had a hit to the head. You would think that because it is in the best interest of the athlete that they themselves would seek the help, however in some cases they do not. Why? Concussions equal recovery time, which equals absence from the field, which means missed playing time. As one who has experienced it first hand, I can truly say this is almost every athlete’s biggest fear.

I can remember everything about one softball game in particular. It was the first Saturday of May, my parents were at my sister’s prom pictures, so I went to the game with one of my teammates. The sun was shining on this beautiful Saturday afternoon, and I mean shining. I had sunglasses on when I was playing third base, along with my required facemask as my protection. I always hated that facemask; for one it was very hot, and two it was just not very fashionable. That day though, it saved me from having more problems than I did, well in a way. A pop fly was hit straight up in the air to me. I called it, went to catch it, and lost it in the sun. The next thing I know I was shaken up on the ground and the umpire had called a time out. I told my coach I was fine and that I could continue playing, but he insisted that I come out for the inning and at least hydrate a little, so I did. At the end of the inning, I went back into play although I already had a huge bruise forming that did in fact make me look/ feel like a unicorn. After the game, I called my parents to tell them how the team and I played and that I was hit in the head, but told them I was perfectly fine. I was in denial that I had a concussion. I was showing many symptoms, which were obvious to those around me, especially everyone who had just seen the play. My parents were not in attendance to see that actual hit, so that could be how I got “away” without a medical examination. But I lied to myself, and I lied to my coaches. Why? Because there was nothing more I hated than being injured and missing playing time. Doctors, coaches, parents, researchers, etc. can all stress the removal from play after a head injury, but it lies in the athlete’s hand to be willing to accept the severity of the hit and come to the realization that it could be bad.

The high occurrence rate of concussions and the dangerous potential consequences have resulted in the need for awareness to better protect and educate high school athletes. A study, on the perceptions of concussions as seen by a high school athlete, was completed by the Physical Therapy and Human Movement Sciences College of Sacred Heart University. In their results, a statistic was found that an athlete “will lie about a concussion injury if there is an important upcoming game/event” (Miyashita et al) so they will be able to play. Educating athletes, coaches and parents is very important as partial or no information can lead to a poor misconception of what a concussion is. The mindset high school athletes obtain regarding concussions should have high importance because of their increased risk to second-impact syndrome and both the short and long-term effects. Increasing the knowledge of concussions has potential to recreate the environment of the sports’ world into one that is safety-conscious. 

While it may seem like a daunting task to ensure all athletes and their families know the signs, symptoms, and effects of a concussion it is very important for the welfare of athlete’s past, present, and future. As I was growing up, my parents believed that my siblings and I should not be coddled, that we should “rub some dirt in it” and toughen up. They never neglected us by any means, they just wanted us to be prepared to pick ourselves up and dust ourselves off in the real world. I did not go to the hospital to be checked out by a doctor until my second concussion. My generation has grown up with very little knowledge on concussions and looking back, it would have been beneficial to not only me, but both my classmates and teammates, to just like we were taught First Aid and CPR in health class. 

Due to the fact that sports related concussions are a serious injury that occur in high school athletes, a focus on traumatic brain injury should be a part of every school’s curriculum and practiced by each team. Caring for the adolescent brain is crucial in order to ensure the athlete’s success in school, sports, and their future wellness. Athletes should make it a point to look out for themselves as well as their teammates when it comes to concussion safety. Coaches should do their part to stress that it is more important for an athlete to be healthy than to compete with a potentially life threatening injury. This way if an athlete thinks that they might have a concussion they do not have to worry about missing out on playing time or their team thinking less of them. Players must feel confident in their ability to recognize when a concussion occurs, and must feel safe reporting symptoms. In conclusion, the best way to approach concussion safety is to provide correct information regarding the signs and symptoms. Ensuring that all athletes, coaches, and parents know the difference from a simple bump on the head to a concussion can save lives and improve the futures of those affected. It is important that high school athletes, who have their whole life ahead of them, realize the potential dangers of a hit in the head regardless of how severe the impact is. Something as simple as the education on concussions, in high school athletes, can change one’s life for better or worse based on the amount of knowledge they have. 
